• Max Bupa Heartbeat Family First Health Insurance Plan

    Health Insurance
    • Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
    • 10,000+ hospitals for cashless treatment
    • Claim up to Rs. 55,000 deduction under section 80D**

    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.

    Eligibility for Max Bupa Heartbeat Family First Health Insurance Plan

    The eligibility criteria outlined by Max Bupa Heartbeat Family First policy is quite flexible. Some of the eligibility criteria can be listed as follows.

    • People of all age can avail this cover as there is no entry age restriction from the insurer.
    • Lifelong renewability option is available for this policy without any extra loading.
    • Medical examination might be necessary at the time of sign up, but it is not required for renewal of policies.

    Features of Max Bupa Heartbeat Family First Health Insurance Plan

    Some of the key features of this cover can be listed as follows.

    • It offers coverage in two different levels. The individual sum insured can be used by any member of the family. Once this amount is exhausted, the floater sum insured can be used for covering medical expenses.
    • Coverage is available for extended family members (up to 19 members) including in-laws, siblings, grandparents, and grandkids.
    • Policyholders have the option of choosing the policy term in one or two years.
    • Pre-existing diseases have a waiting period of 24 months under the gold and platinum plans. For silver plan, the waiting period is 48 months.
    • Pre-hospitalisation medical expenses incurred up to 60 days prior to the date of hospitalisation can be covered under this policy.
    • Post-hospitalisation medical expenses incurred up to 90 days after the date of hospitalisation can be covered under this policy.
    • Coverage is available for alternative treatments such as ayurveda, unani, siddha, and homeopathy (AYUSH) up to the specified limit.
    • Day care treatments and outpatient expenses are also covered under this policy.
    • Maternity benefits are available for up two deliveries. However, there is a waiting period of two years for this cover.
    • Newborn baby cover and vaccination expenses are also covered by this policy without any additional premium charges.
    • Free health checkup can be availed by policyholders from the second year onwards. Gold and Platinum policyholders can also choose the types of diagnostic tests they want to undergo.
    • There is a free-look period of 15 days during which policyholders can cancel the cover without incurring any additional charges.

    Benefits of Max Bupa Heartbeat Family First Health Insurance Plan

    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)

    Exclusions of Max Bupa Heartbeat Family First Health Insurance Plan

    There are many exclusions for which the insurer is not liable for providing any compensation. Some of them can be listed as follows.

    • Ancillary hospital charges
    • Expenses related to artificial life support
    • Treatment for behavioral and neurodegenerative disorders
    • Treatment for congenital anomaly, hereditary, or genetic disorders
    • Any types of cosmetic or aesthetic treatments
    • Treatment related to eyesight or optical services
    • Expenses related to obesity or weight management programs
    • Treatment for mental disorder and psychiatric conditions
    • Sexually transmitted diseases, HIV, AIDS, and venereal diseases
    • Self-inflicted injuries, suicide, or injuries caused by attempted suicide
    • Treatment for substance related disorder or addictive disorders
    • Injuries caused by criminal activities or unlawful activities
    • Injuries caused while under the influence of alcohol or drugs
    • Treatment for which hospitalisation is not justified

    Claim Procedure

    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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