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Max Bupa is one of the major standalone health insurance service providers operating in the Indian market. The company is renowned for its diverse offerings and affordable health insurance plans. Heartbeat Family First is a family floater plan specifically designed for large joint families in the country. It offers coverage for up to 19 family members within a single policy. Unlike most health insurance plans, this cover comes with an individual component and a total family component to ensure complete coverage for all family members. This policy also comes in three different variants namely Silver, Gold, and Platinum.
The eligibility criteria outlined by Max Bupa Heartbeat Family First policy is quite flexible. Some of the eligibility criteria can be listed as follows.
Some of the key features of this cover can be listed as follows.
The specific benefits available in this policy cover can be provided in the following table.
|Sum insured options||Rs.1 lakh to Rs.15 lakh for individual cover Rs.3 lakh to Rs.50 lakh for floater cover|
|In-patient hospitalisation expenses||Covered up to the sum insured limit|
|Room rent during hospitalisation||Rs.3,000 per day (silver plan) Up to sum insured limit (gold and platinum plans)|
|Domiciliary hospitalisation, day care treatments, alternative treatments||Covered up to the sum insured limit|
|Organ donor expenses||Covered up to the sum insured limit|
|Maternity benefit||Rs.35,000 (silver) Rs.50,000 (gold) Rs.1 lakh (platinum)|
|Emergency ambulance cover||Up to Rs.2,000 per event|
|OPD expenses cover||Up to Rs.35,000 per year (only in platinum plan)|
|Loyalty additions||10% sum insured enhancement every year subject to a maximum of 50% (silver) or 100% (gold and platinum) of the sum insured|
|Optional copayment||10% or 20%|
|Hospicash (add-on cover)||Up to Rs.1,500 per day (silver) Up to Rs.3,000 per day (gold) Up to Rs.6,000 per day (platinum)|
There are many exclusions for which the insurer is not liable for providing any compensation. Some of them can be listed as follows.
For cashless claims, the company must be notified in advance before the patient gets admitted in the hospital. This rule can be relaxed in case of emergency hospitalisation. Customers can choose from any of the company’s network hospitals. The network hospital will verify the identity of the insured and provide a pre-authorisation form. Once the pre-authorisation form is submitted, the insurer will authorise the treatment within 30 minutes without any further documentation.
For reimbursement claims, the company must be notified about the hospitalisation within a reasonable time. There are no third-party administrators involved here. Hence, the claim process is simple and straightforward. Following the treatment, the insured must submit the claim along with the documents requested by the company. The company will verify the documents and approve or reject the claim. Once approved, the reimbursement amount will be provided to the insured.
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