Aditya Birla Health Insurance | Activ Health Platinum Enhanced Activ Health Platinum Enhanced

Hospitalisation for more than 24 hours includes room rent, doctor’s fees, operation theatre expenses, medicines, drugs and consumables.

For sum insured up to ₹3 lakh, room options include a shared room and single private AC room. For ₹4 lakh and above, any room can be selected.

Eligible medical expenses are covered for 60 days before hospitalisation and 180 days after discharge.

ICU charges are covered up to the sum insured.

Eligible procedures that do not require 24-hour hospitalisation, including dialysis, are covered.

Treatment at home is covered when hospitalisation would otherwise be required, provided the treatment lasts for more than 3 consecutive days.

Road ambulance expenses are covered up to the sum insured at network hospitals and up to ₹5,000 per hospitalisation at non-network hospitals.

Medical expenses for organ harvesting and transplantation are covered for the donor up to the sum insured.

In-patient treatment under Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy is covered on a reimbursement basis.

Hospitalisation expenses for clinically significant mental illnesses are covered up to the sum insured, subject to policy conditions.

Medically necessary bariatric surgery is covered for adults aged 18 years and above, subject to prior approval.

Cashless home treatment is covered up to the sum insured for specified conditions including chemotherapy, dengue, gastroenteritis, hepatitis and peritoneal dialysis.

Listed treatments such as robotic surgery, oral chemotherapy and stem cell therapy are covered under eligible in-patient and day-care treatments.

Cashless oral evaluation, oral prophylaxis and dental X-ray are covered in a single scheduled appointment.

One cashless health check-up is available once per policy year.

A cashless second medical opinion is available for major illnesses through the insurer’s network of doctors and medical experts.

Eligible outpatient consultation expenses are covered on a cashless basis through empanelled service providers in selected cities.

Domestic and international emergency assistance services, including air ambulance support, are available.

The Activ Health App includes an on-demand assessment covering BP, BMI, HWR, smoking status, blood sugar and total cholesterol.

Listed chronic illnesses receive Day 1 support through medical practitioner consultations and diagnostic tests.

One policy-year premium waiver is available after an accident or diagnosis of a listed critical illness, subject to the specified conditions.

A 50% increase in sum insured is added for each claim-free year, up to 100% of the sum insured or ₹1 crore.

Injuries caused intentionally by self-harm or self-inflicted acts are not covered.

Treatment arising from involvement in criminal activities or acts that breach the law is not covered.

Expenses arising from alcohol or drug abuse are not covered.

Treatment arising from war, mutiny or nuclear threats is not covered.

Treatments undertaken to alter or improve appearance for aesthetic purposes are not covered.

Treatments that are not established methods for treating an illness or injury are not covered.

Treatment for congenital abnormalities is not covered.

Costs of hearing aids, lenses, spectacles, crutches and similar items are not covered.

Any mental disorder is listed as an exclusion under the policy.

A daily cash allowance of ₹500 to ₹5,000 is available for hospitalisation, up to 10 days per claim and 30 days per policy year.

Covers accidental death and permanent total disablement, with the payout based on the selected sum insured.

Planned in-patient treatment for 16 major illnesses can be covered overseas, with a sum insured of ₹3 crore or ₹6 crore.

Covers up to 20 listed critical illnesses, with a 90-day initial waiting period and 15-day survival period.