Max Bupa Health Plus Plan - Overview

Max Bupa Health Plus Plan is the best health policy that secures you from medical expenses arising out of health emergencies, personal accident and critical illness. Overall, this plan is cost-effective and reliable coupled with all the smart features you may want to secure yourself against unforeseen medical contingencies.

 

Key Features & Benefits



The key features covered under Max Bupa Health Plus Plan are as follows:

  • In-patient Hospitalisation Expenses:

     

    Max Bupa Health Plus Plan offers inpatient hospital expenses which include:

    • Room Rent/Boarding and Nursing Expenses
    • ICU Rent/ Boarding and Nursing Expenses
    • Fees of Medical Practitioner, Surgeon, Anesthetist, Nurses and Specialist Doctor
    • Operation theatre charges, Anesthesia, surgical appliances, diagnostic tests, medicines, blood, oxygen and cost of prosthetic and other devices or equipment if implanted internally like pacemaker during a surgical process

  • Hospital Accommodation Charges:

    This plan covers hospital accommodation charges up to 2% of the sum insured.

  • Hospital ICU Charges

    In this plan, the insurer can get the ICU charges covered which is double the room rent charges per day.

  • Day Care Treatments:

    Day-care treatments refer to those medical treatments and procedures that need hospitalization, but not for more than 24-hours, some of the examples of day-care treatments include cataract surgeries, nasal sinus aspiration, cancer chemotherapy, cancer radiotherapy, etc. All the costs incurred such treatments are also covered under the Max Bupa Health Plus Plan.

  • Hospital Accommodation:

    Get coverage for all hospital accommodations except suite & above room category without any room rent capping under this policy.

  • Pre and Post Hospitalization:

    You will also get the Pre-hospitalization and Post-hospitalization cover up to the sum insured including doctor's consultation, diagnostics tests, medicines, drugs and consumables. . All the expenses are done in 30 days before hospitalizing and 60 days after discharge. This charges can be claimed as reimbursement only.

  • Domiciliary cover

    If in case, you are not hospitalized, and all your treatments are done at home then all those expenses are also covered in this plan. Some individuals prefer their treatment to be done at home rather than in a hospital. On the other hand, some doctors also advise staying at home for the treatment.

  • Organ Donor Expenses:

    Medical Expenses incurred for an organ donor’s treatment for the harvesting of the organ donated will be covered under the policy.

  • Emergency Road Ambulance:

    The policy covers ambulance expenses needed to transfer the insured following an emergency to the nearest hospital. These expenses are paid up to Rs. 1000 per hospitalization.

Policy Details

Max Bupa Health Plus Plan
Policy Type Individual
Entry Age Minimum Entry Age: 18 years
Maximum Entry Age: 60 years
Tenure One year
Sum Insured Rs. 1 lakh – Rs. 10 lakh

Plans Available

Health Insurance helps you to be stress-free while dealing with medical contingencies due to sickness and accidental injuries. The plans are available starting from Rs. 715, with maximum coverage of Rs. 10 lakh, to know more about the premium rates in detail please click

How to buy the policy

  • To apply the Max Bupa Health Plus Plan, you can buy it easily online by filling in your basic and health details.
  • Ensure that the information given in the form is complete and accurate.
  • You may be required to undergo a pre-policy medical examination at our network diagnostic centres.
  • On buying this plan online, your policy will be generated instantly along with your policy kit and card. This is applicable for cases which do not require further underwriting or medical check-up.

List of Documents Required for purchasing the policy

The following mandatory documents will be needed to purchase the policy:

 
  • Photograph of the Applicant
  • Age proof such as birth certificate, Voter’s ID, PAN card, passport etc.
  • Identity proof such as passport, Aadhaar card, PAN card, Voter’s ID, etc.
  • Income Proof such as Form 16, salary slips, employment certificate etc.
  • Address proof such as telephone bill, electricity bill, passport, bank statement, Voter’s ID, etc.
  • Medical Test that the insurer requires you to undergo

How to process the claims

Cashless Claims
  • With the Max Bupa Health Plus Plan, you can avail the benefit of cashless treatment with our 3500+ network hospitals by following the following process:
  • Get admitted to any one of Max Bupa network hospitals.
  • Use your Max Bupa Health Card or share your policy number with the concerned team at a hospital along with your Passport/PAN card/ Voter’s ID as identification proof.
  • Now, the network hospital will verify your identity for validation and submit the pre-authorization request to the insurer
  • After validation, the insurer will review and provide their confirmation to the network hospital by fax and email. The insurer ensures you are also notified of the same through text message and email. The insurer will respond to your request within 30 minutes of filing of the claim request.
  • The only activity left to do now is the final settlement of your claim (as per policy terms & conditions) with the hospital after completion of all the necessary formalities

Reimbursement claim:

  • If you get hospitalized, notify the insurer within 48 hours of admission in our network or non-network hospital. After getting admitted pay the amount directly to the hospital you are in.
  • After you are discharged from the hospital, make sure you have all the relevant documents, invoices, medical reports and discharge certificate with you. The insurer would need the originals of all the mentioned documents to process your reimbursement.
  • Send all the documents to the insurer which should be filled and signed the claim form. Send your valid ID proof and age proof as well.
  • After receiving your documents, the insurer will review your claim request and accordingly will give our approval, raise a query or reject the same (as per policy terms & conditions)
  • Finally, the insurer will settle the claim (as per policy terms & conditions) and reimburse the approved amount.

Documents Required for Reimbursing Claims

Collect below mentioned relevant document in original from the hospital and submit them to us within 15 days of discharge from the hospital

 
  • Original investigation reports
  • Final hospital discharge summary FIR or post-mortem report if happened
  • Pharmacy bills along with the prescription
  • Cancelled cheque or NEFT details for payment
  • Original bills, receipts, and discharge report
  • Indoor case papers and duly filled claim form
  • Original hospital bills and a valid photo ID proof Treating doctor's report
  • Original consultation notes Nature of operation performed and surgeon's bill and receipt
  • Test reports along with attending doctor’s or surgeon’s report.

Major Policy Exclusions

  1. Dental treatments and cosmetic surgeries
  2. Ailments requiring treatment due to use or abuse of any substance, drug or alcohol and treatment for de-addiction.
  3. Circumcision unless required for the treatment of Illness or accidental bodily injury.
  4. Breach of law with Criminal Intent, intentional self-injury.
  5. Cosmetic, aesthetic and re-shaping treatments & surgeries.
  6. Psychiatric or psychological disorders, mental disorders.
  7. Ailment wise capping and ambulance charges.
  8. Hearing aids, spectacles or contact lenses including optometric therapy.Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances.
  9. Miscarriage, Abortion and C-section deliveries Sexually transmitted diseases such as AIDS and HIV.
  10. Refer the policy document to know more exclusions in detail

Claim/Assistance Contact Details

Toll free number –  08698010101/1800-209-0144 /1800-209-5858

E-mail –  wecare@bajajfinserv.in

Mailing address: Ground Floor, Bajaj Finserv Corporate Office, Off Pune-Ahmednagar Road, Viman Nagar, Pune – 411014.

 

*For claim related issues please refer your policy document or certificate of insurance (COI).