Everything to know about Niva Bupa Health Insurance Plans

Niva Bupa Health Insurance 2023

Formerly known was Max Bupa Health Insurance Company Limited, Niva Bupa Health Insurance Company Limited is a joint venture between Fettle Tone LLP, which is an affiliate of True North Fund (a leading Indian private equity firm), and Bupa Singapore Holdings PTE Limited, a UK-based healthcare services expert. It is one of the most well-known insurers in India. Among the gamut of products and services offered by Niva Bupa is health insurance solutions for individuals, families, etc. If you are looking to buy a new health insurance plan or port your existing policy to a new one, then Niva Bupa health insurance plans can be a great choice. Read on to know about the reasons to purchase a Niva Bupa health insurance plan, its features, exclusions, eligibility, and much more. You will also find answers to some frequently asked questions about Niva Bupa health insurance.

Why Choose Niva Bupa Health Insurance Plans for Yourself & Your Family

Niva Bupa is one of the best known health insurance providers in the country. It has been operating since 2008 and has covered more than 70 Lac customers under its health plans. The company has a remarkable claim settlement ratio of 92 percent. Claim settlement ratio or CSR is the ratio of total claims settled and total claim received by an insurance company during a financial year. What sets Niva Bupa health insurance plans apart from other options available in the market is that the insurer settles claims directly, without the involvement of any TPA or third party administrator, which allows for speedy processing.

In addition to the above, Niva Bupa offers critical illness coverage across its massive international network spanning 190 countries. In case you were wondering about its network of hospitals, then rest assured as the insurer boasts more than 8600 hospitals in its network. Therefore, with Niva Bupa health insurance, you can easily find a hospital with cashless treatment facility across India. Moreover, all medical and health insurance-related processes are online, adding to the convenience of insured people and their families.

Eligibility for Niva Bupa Health Insurance Plans

The following factors are critical in determining the eligibility for a Niva Bupa health insurance plan.

Age: The entry age of the insured person is typically between 18 and 65 years of age. In some cases, the maximum age to purchase a Niva Bupa health insurance plan can be 70 years.

Pre-Existing Medical Conditions: It is essential to disclose all relevant pre-existing medical conditions at the time of purchasing the Niva Bupa health insurance plan. These medical conditions can trigger waiting period and affect the overall premium for the health insurance plan.

Tests: Niva Bupa Health Insurance Company Limited may ask for some medical test reports before insuring an individual. These may include routine urine and blood tests, as well as some other major organ-related tests. However, these medical tests are generally not requested for people below the age of 45 years.

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 Saving Tax with Niva Bupa Health Insurance Plans

Individuals and Hindu undivided families (HUFs) can claim tax deductions for premiums paid for a Niva Bupa health insurance plan. An annual deduction of INR 25000 is available for premium paid for a health insurance plan covering self, spouse, and dependent children. Another INR 25000 deduction is available for plans that include parents, who are not senior citizens. In case any of the parents is a senior citizen, then an additional tax deduction of INR 25000 is available. Insurance plan premium, health check-up cost, contribution towards a central government or notified health insurance scheme, and medical expenses incurred on a senior citizen not covered under health insurance are eligible for tax deduction.

Different Niva Bupa Health Insurance Plans

Depending on your requirement or need, you can choose from myriad Niva Bupa health insurance plans. Some popular Niva Bupa health insurance policies for individuals are Reassure, Health Companion, GoActive, Money Saver, Health Pulse, Health Premia, Senior First, and Super Saver. Reassure, Health Companion, HeartBeat, and Health Premia are some sought-after Niva Bupa health insurance plans for families. Apart from these, you can also opt for Niva Bupa health insurance plans for specific needs. For instance, Accident Care for accident-related medical expenses, Criti Care for 20 critical illnesses, Corona Kavach for COVID-19 infection, and more.

Features of Niva Bupa Health Insurance Plans

The policy features may vary depending on the type of health insurance plan. Following are some common inclusions of most, regular Niva Bupa health insurance policies.

• Coverage for hospitalization as well as in-patient care
• ICU charges and hospital room rent, with and without limitations
• Pre and post-hospitalization expenses coverage for a pre-defined number of days
• Coverage of at-home medical treatment due to unavailability of beds at the hospital
• Day care treatments, including out-patient department treatment, dental, ENT, and other procedures
• Cashless diagnostic tests and health check-ups
• Ambulance charges
• In-patient procedures done on organ donor for organ harvesting
• A waiting period of between two and six years for pre-existing illnesses

While these are general features, you are requested to check your policy documents thoroughly to understand all the policy inclusions.

Niva Bupa Health Insurance Plans Exclusions

Dental treatments, unless necessary due to cancer or acute trauma.

Expenses towards purchase of external devices, such as hearing aids, spectacles, crutches, artificial limbs, veneers, artificial teeth, etc.

Treatment of self-inflicted injuries by the insured person.

Any cosmetic surgery, including botox and plastic surgery. Exceptions here are surgery for accidental bodily injuries, burns and surgeries necessary for the treatment of cancer.

Essential Documents for Niva Bupa Health Insurance Claim Reimbursement

In case of cashless hospitalization, the network hospital shares all the necessary documents with the insurer (Niva Bupa in this case). If there is request for reimbursement, then submission of a set of documents is required for Niva Bupa to process and approve the claim. These include the following documents:

• Diligently filled and signed claim form
• Discharge certificate received from the hospital
• All consultation documents and receipts
• Bbills signed & stamped by the concerned hospital
• All relevant reports, such as X-ray films, blood tests, urine tests, etc.
• Medical invoices and other treatment-related documents

Frequently Asked Questions about Niva Bupa Health Insurance Plans

Q. Niva Bupa Health Insurance Review and Benefits ?  

A. Buying health insurance Policy which is offering by Niva Bupa health insurance has a lot of benefits. It provides an excellent claim settlement ratio at the same time satisfactory incurred claim ratio.

Q. Niva Bupa Health Insurance Hospital List ?

A. Niva Bupa has cashless hospital network of NIVA Bupa. Complete Hospital Details including address, Phone no, website, google map on niva bupa official website.

Q. Can I buy Niva Bupa health insurance plan online ?

A. Yes. ZFunds allow you to purchase Niva Bupa health insurance plans for yourself and your loved ones online without any hassles.

Q. What are the documents required to purchase Niva Bupa health insurance plan ?

A. Age proof (Passport, Aadhaar Card, Driving License, PAN Card, Voter’s ID, or Birth Certificate), identity proof (Passport, Aadhaar Card, Driving License, PAN Card, or Voter’s ID), address proof (Passport, Aadhaar Card, Driving License, Ration Card, Electricity Bill, or Telephone Bill), passport size photographs, medical reports (if needed), and signed and duly filled Niva Bupa insurance policy form.

Q. What is the minimum age to get Niva Bupa health insurance plan?

A. The minimum age for a dependent child is 15 days. Also, the child can be covered up till the age of 18  years. Adults with the minimum age of 18 years can get health insurance for themselves. The maximum age to get Niva Bupa health insurance is 65 years.

Q. I am in my 20s. When should I get health insurance ?

A. It is advised that you get a health insurance plan as early as possible since premiums increase with age. Moreover, medical emergencies can occur at any time. Thus, it is best to have a health insurance plan at all times for its plethora of benefits, such as wealth preservation, tax benefits, etc.  

Q. Can I add riders to my Niva Bupa health insurance plan ?

A. Yes, several riders are available with Niva Bupa health insurance policies. Standard plans do not cover everything, but you have to option to add riders to increase coverage and inclusions of your Niva Bupa health insurance plan.

Q. What factors affect the premium for Niva Bupa health insurance plan ?

A. There are numerous factors that affect insurance premiums. These include age of the person to be insured, pre-existing illness, city of residence, family medical history, the BMI (body mass index) of the person to be insured, and lifestyle choices of the person to be insured, such as smoking and drinking habits.

Q. What factors should I consider while choosing a Niva Bupa health insurance plan ?

A. Room rent limit, co-payment, waiting period, period for pre and post hospitalization coverage, ambulance charges, and coverage of alternate treatments are among the most important factors to take into account while purchasing a health insurance plan.

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