Max Bupa Health Insurance

Investing in a health insurance plan should be as easy and seamless as buying groceries. Hence, Max Bupa, a strategic collaboration between Max India Limited and Bupa, offers a wide range of health insurance products that not only protect your health, but also ensure that you don’t have to break a sweat later.

Max India Group is considered to be a forerunner in the Indian health and insurance segment.

Their repertoire includes life insurance, hospitals, and health related clinical research. On the other hand, Bupa boasts of over 6 decades experience in the healthcare industry and it has over 11.3 million customers spread across 190 countries. Max Bupa health insurance envisions of being India's most preferred health insurance company by being committed to their esteemed customers.

Max Bupa Health Insurance Plan

Max Bupa Health Insurance Company Ltd. is a joint venture between Max India Ltd. and Bupa, a UK-based healthcare services company. It combines two of the best global minds of the healthcare and insurance industry to create effective health insurance plans that are tailor-made to meet varied health insurance needs of individuals and families.

Features of Max Bupa Health Insurance

  • No. of members - The Max health insurance plan covers maximum 4 members of your family with up to 2 children and 2 adults.
  • Lifelong Renewal – The Max health insurance plans offered are lifelong renewable hence it saves you from the financial burden and stress caused by a medical emergency and keeps you well prepared to handle any situation.
  • Pre & Post hospitalization cover - The Max health insurance plan covers medical expenses for 30 days prior to hospitalization and 60 days post hospitalization only for related medical expenses.
  • Pre-existing diseases - Max health insurance covers Pre-existing diseases after 4 years of waiting period.
  • Room-rent- There are zero or no sub-limits on room rent in Max health insurance.

Benefits of Max Bupa Health Insurance

  • Max-Bupa health insurance has no involvement of the TPA, direct liaison with the company initiates quicker resolutions.
  • No age restriction for enrolment in the Max health insurance plans.
  • Max health insurance plans also offer Maternity and New Born Child benefits.
  • Claim Settlement Ratio - The incurred claim settlement ratio of Max Bupa Health Insurance for F.Y. 2017 - 18 is 50.19%.

What is Covered in Max Bupa Health Insurance Policy?

  • Convenience of quick and easy online purchase of Max Bupa health insurance policies.
  • Health insurance policies offer a sum insured of a maximum of Rs. 1 crore.
  • Offers coverage for the entire family, including new born babies and senior citizens, through its range of individual and family floater plans.
  • Covers maternity related expenditures for mothers and new born babies after the completion of 2-year waiting period since the purchase of a Max Bupa HeartBeat health insurance policy.
  • Certain health insurance plans from Max Bupa cover pre-existing illnesses as well.
  • Includes lifetime renewal option.
  • Offers an attractive 12.5% discount on the premium amount during renewal for the second policy term.
  • Covers medical expenses like hospital room rent, pre and post hospitalization, OPD expense cover, organ donation, and day care.
  • Also includes home hospitalization and domiciliary hospitalization.
  • Includes Restore Benefits that enables the policyholder to refill the base annual sum insured in case it has been totally or partially exhausted. This benefit is applicable on all plans except the Family First plan.
  • Covers regular health check-ups once or twice annually.
  • Max Bupa has an extensive list of 3,500+ network hospitals in India where the insured can avail cashless facilities on being hospitalized.
  • Certain Max Bupa health insurance plans are designed to offer international cashless facilities for specific critical illnesses such as cancer, organ transplant, etc.

What is Not Covered of Max Bupa Health Insurance Policy?

  • Health concerns arising from overuse of alcohol or drugs
  • AIDS
  • Congenital disease
  • Medical treatment required due to attempted suicide
  • Medical conditions and treatments related to pregnancy, miscarriage, childbirth, and abortion
  • Treatments related to infertility and in vitro fertilization
  • Hospitalization owing to injuries caused in certain situations like riot, war, terrorist activities, nuclear weapons, etc.

Plans Offered By Max Bupa Health Insurance

Health @ Companion

Health @ Companion plan offers the most basic coverage when compared to all the other plans by Max Bupa. It has option of individual or family floater coverage. There are two variants of this plan offered by Max Bupa Health Insurance. Given below are the details of coverage offered on individual or family floater basis under both the variants:

Health @ Companion - Silver

Individual Coverage:

  • Max Bupa health insurance policy offers basic coverage in the range of Rs.2 lakh and Rs.4 lakh for individuals of between age 18 years and 65 years.
  • Pre and post hospitalization expenses, day care procedures, etc., are benefits provided in the Max medical insurance plan.
  • Co-payment of 20% (amount to be paid by the policy holder before claiming for the policy) is applicable for individuals above age 65 years in Max medical insurance plan

Family Floater Coverage:

  • This is a basic family floater Max Bupa medical insurance plan, which covers health costs of the entire family in the range of Rs.2 lakh and Rs.4 lakh.
  • A maximum of 2 adults (proposer & spouse) in the family between age 18 years and 60 years and 4 children between age 3 months and 23 years can be covered under this policy.
  • Pre and post hospitalization expenses, day care procedures, etc., are benefits provided in this plan.
  • Co-payment of 20 % (amount to be paid by the policy holder before claiming for the policy) is applicable for individuals above age 65 years.

Health @ Companion- Gold

Individual Coverage:

  • This Max Bupa Mediclaim policy offers basic coverage of Rs.5 lakh for individuals between age 18 years and 65 years.
  • Pre and post hospitalization expenses, day care procedures, etc are benefits provided in this plan. This plan offers higher expense cover than Health Companion @ Silver.
  • Co-payment of 20 % (amount to be paid by the policy holder before claiming for the policy) is applicable for individuals above age 65 years. Family Coverage:
  • This is a basic Max Bupa medical insurance family floater plan which covers health costs of the entire family in the range of Rs.5 lakh.
  • A maximum of 2 adults (proposer & spouse) and 4 children in the family between age 18 years and 60 years and dependent children between age 3 months and 23 years can be covered under this health insurance policy.
  • Pre and post hospitalization expenses, day care procedures, etc., are benefits provided in this plan. This plan offers higher expense cover than Health Companion @ Silver.
  • Co-payment of 20 % (amount to be paid by the policy holder before claiming for the policy) is applicable for individuals above age 65 years.

If you are looking out for a health insurance plan to cover your basic hospitalization expenses then know more about Health @ Companion click here.

Heartbeat

Heartbeat covers basic medical expenses along with offering a loyalty benefit for its customers. There are three variants under which different benefits offered. Given below are details of each variant of individual and family floater basis.

Heartbeat- Gold Policy

Individual Coverage:

  • This Max Bupa Mediclaim policy offers coverage in the range of Rs.5 lakh and Rs.50 lakh for individuals of any age above 18 years.
  • Pre and post hospitalization expenses, day care procedures, health check-up (every year), etc. are covered under this policy.
  • Under loyalty program, the plan offers additional sum insured or earn and redeem benefit on every renewal irrespective of claims made.
  • 10% or 20% co-payment is applicable above age 65 years.
  • This is a family floater plan which covers health costs of the entire family in the range of Rs.5 lakh and Rs.50 lakh.
  • A maximum of 2 adults and 4 children of any age in the family can be covered under this plan.
  • Pre and post hospitalization expenses, day care procedures, health checkup (every year), etc. are covered under the policy.
  • Under loyalty program, the plan offers additional sum insured or earn and redeem benefit on every renewal irrespective of claims made.
  • 10% or 20% co-payment is applicable above age 65 years.

Heartbeat- Platinum Policy

Individual Coverage:

  • This Max Bupa Mediclaim policy offers coverage in the range of Rs.15 lakh and Rs.1 crore for individuals of any individual above age 18 years.
  • Pre and post hospitalization expenses, day care procedures, health checkup (every year), etc. are covered for higher expenses than gold under this policy. Additionally, this policy also has international coverage for 9 treatments specified in the document.
  • Under loyalty program, the plan offers additional sum insured or earn and redeem benefit on every renewal irrespective of claims made.
  • 10 % or 20 % co-payment is applicable above age 65 years.

Family Floater Coverage:

  • This is a family floater plan which covers health costs of the entire family in the range of Rs.15 lakh and Rs.1 crore.
  • A maximum of 2 adults (proposer & spouse) and 4 children of any age in the family can be covered under this plan.
  • Pre and post hospitalization expenses, health checkup (every year), out-patient, maternity benefits and new born cover, etc. Are covered under this policy. Additionally, this policy also has international coverage for 9 treatments specified in the document.
  • Under loyalty program, the plan offers additional sum insured or earn and redeem benefit on every renewal irrespective of claims made.
  • 10% or 20% co-payment is applicable above age 65 years.

Heartbeat- Silver Plan

Individual Coverage:

  • This is a top plan (these plans have an agreed upon deductible amount to be paid at the time of claim) for any individual above age 18 years.
  • Pre and post hospitalization expenses, day care procedures, health checkup (every two years), etc. are covered under this policy.
  • Under loyalty program, the plan offers additional sum insured or earn and redeem benefit on every renewal irrespective of claims made.
  • 10% or 20% co-payment is applicable above age 65 years.

Family Floater Coverage:

  • This is a top-up plan (these plans have an agreed upon deductible amount to be paid at the time of claim) which offers coverage of Rs. and INR 3,00,000 for all the family members.
  • A maximum of 2 adults (proposer & spouse) and 4 children of any age in the family can be covered under this plan.
  • Pre and post hospitalization expenses, day care procedures, health checkup (every two years), maternity benefit and newborn cover, etc. are covered under the policy.
  • Under loyalty program, the plan offers additional sum insured or earn and redeem benefit on every renewal irrespective of claims made.
  • 10% or 20% co-payment is applicable above age 65 years. If you any variant of Heartbeat is suitable as per your needs, know more about Heartbeat plan, please click here.

Health Assurance

This is a unique plan which offers coverage for critical illness, hospital cash and personal accident at 4 different range/ levels of sum assured. It is available as individual and family floater coverage. Given below are the details:

Individual Coverage:

  • Critical illness benefit- The policy would provide lump sum amount in case of critical illness and coverage in the range of Rs.3 lakh and Rs.10 lakh between age 18 years and 65 years.
  • Hospital cash- This would additionally to cover miscellaneous expenses required on daily basis during hospitalization. It provides coverage in the range of Rs.1000 per day to INR 4000 per day between age 18 years and 65 years.
  • Personal accident- It would provide lump sum amount in case of accidents. The coverage offered would be in the range Rs.5 lakh and Rs.25 lakh between age 18 years and 65 years.
  • The plan also has 7 options having different combinations of benefits in it.
  • Option I- Will have critical illness cover, Hospital cash benefit and personal accident cover.
  • Option II- Will have critical illness cover and hospital cash benefit.
  • Option III- Will have critical illness and personal accident cover.
  • Option IV- Will have hospital cash benefits and personal accident cover.
  • Option V- Will have critical illness cover only.
  • Option VI- Will have hospital cash benefit only.
  • Option VII- Will have personal accident cover only.

Family Floater Coverage:

  • Critical illness benefit- It would provide lump sum amount in case of critical illness and coverage in the range of Rs.3 lakh and Rs.10 lakh between age 18 years and 65 years.
  • A maximum of 2 adults can be covered for this benefit. Hospital cash- This would additionally cover miscellaneous expenses required on daily basis during hospitalization. It provides coverage in the range of Rs.1000 per day to Rs.4000 per day between age 18 years and 65 years.
  • Proposer, spouse and 2 children can be covered for this benefit. Personal accident- It would provide lump sum amount in case of accidents. The coverage offered would be in the range of Rs.5 lakh to Rs.25 lakh between age 18 years and 65 years.
  • Proposer, spouse and 2 children can be covered for this benefit.
  • The plan also has 7 options having different combinations of benefits in it.
  • Option I- Will have critical illness cover, Hospital cash benefit and personal accident cover
  • Option II- Will have critical illness cover and hospital cash benefit
  • Option III- Will have critical illness and personal accident cover
  • Option IV- Will have hospital cash benefits and personal accident cover
  • Option V- Will have critical illness cover only
  • Option VI- Will have hospital cash benefit only
  • Option VII- Will have personal accident cover only

In case Health Assurance provides all the benefits that you are looking out for know more about the plan, contact Coverfox.

Family First- Silver Policy

Max Bupa has some very unique family floater options Family First is one such plan. There are three variants under this plan. Given below are the details of the coverage offered.

  • This is a unique Max Bupa family health insurance plan specially designed for joint families which covers any number of family members from defined 14 family relations.
  • The base sum insured is divided into two insured values such that all the members are covered on an individual as well as floater basis under same plan.
  • The individual Sum insured value is the range of Rs.1 lakh and Rs.5 lakh.
  • The family Sum insured value is in the range of Rs.3 lakh and Rs.15 lakh.
  • The policy offers basic coverage like pre and post hospitalization expenses, day care procedures, health check-up (every two years), maternity benefit and newborn cover, etc.
  • Under loyalty program, the plan offers additional sum insured or earn and redeem benefit on every renewal irrespective of claims made.
  • 10 % or 20 % co-payment is applicable above age 65 years.

Family First- Gold Policy

  • This is a unique family health plan specially designed for joint families which covers any number of family members from defined 14 family relations.
  • The base sum insured is divided into two insured values such that all the members are covered on an individual as well as floater basis under same plan.
  • The individual Sum insured value is the range of Rs.1 lakh and Rs.15 lakh.
  • The family Sum insured value is in the range of Rs.3 lakh and Rs.50 lakh.
  • The policy offers higher coverage values than the silver policy in case of pre and post hospitalization expenses, day care procedures, health check-up (every year), maternity benefit and newborn cover, etc.
  • Under loyalty program, the plan offers additional sum insured or earn and redeem benefit on every renewal irrespective of claims made.
  • 10 % or 20 % co-payment is applicable above age 65 years.

Family First- Platinum Policy

  • This is a unique Max Bupa health insurance plan for family specially designed for a joint family, which covers any number of family members from defined 14 family relations.
  • The base sum insured is divided into two insured values such that all the members are covered on an individual as well as floater basis under same plan.
  • The individual Sum insured value is the range of Rs.5 lakh and Rs.15 lakh.
  • The family Sum insured value is in the range of Rs.15 lakh and Rs.50 lakh.
  • The policy offers higher coverage values than the gold policy in case of pre and post hospitalization expenses, health checkup (every year), maternity benefit and newborn cover, outpatient, etc. Additionally, this policy has international coverage for 9 treatments specified in the document.
  • Under loyalty program, the plan offers additional sum insured or earn and redeem benefit on every renewal irrespective of claims made.
  • 10 % or 20 % co-payment is applicable above age 65 years.

If you have a big joint family and family first is suitable as per your requirement then, know more about the terms and conditions under the policy, contact Coverfox.

Employee First Health Insurance Plan

This is group health insurance plan suitable for business owners seeking health insurance policies for their employees. Given below are the details of coverage offered.

  • This plan provides comprehensive health coverage to group of employees of any age in the range of Rs.1 lakh and Rs.50 lakh.
  • The plan has benefit of opting for private room and health check-up to parents and parents in laws.
  • This plan also provides maternity benefits and new born coverage.

If you want to buy health insurance plan for your employees you might want to know all the terms and conditions under the policy please contact us for any details.

Employee First Classic Health Insurance Plan

This group health insurance policy is for employers who wish to cover entire family of their employees. The benefits under this policy are given below:

  • This plan provides group health insurance to employees of any age in the range of Rs. 50,000 and Rs.5 lakh.
  • This plan can be extended as corporate floater.
  • It provides coverage to parents, maternity benefits and new born coverage.

In case group family floater policy for employees was something that you were looking for know more about the coverage offered, contact Coverfox.

Group Personal Accident

This is personal accident disability plan which offers compensation to entire group in case of an accident related death or disability. Given below are details of coverage offered:

  • This plan offers accidental coverage to the entire group and can be extended to cover family.
  • The plan has provided lump sum amount in case of accident, permanent total disability, etc. and option to have corporate floater, educational allowance, etc.

Before buying this policy for entire group know more about the terms and conditions, contact Coverfox.

Claims Process at Max Bupa Health Insurance

Bupa Health Insurance, India offers two ways to make claim under its Max Health Insurance plans: on cashless basis and on reimbursement basis. In simple terms, for making a claim on cashless basis, the treatment must be done only at a network hospital of Max Bupa health insurance company servicing policy. For availing the treatment, you would have to first seek an authorization as per the procedures laid down and in the prescribed form. In case of claims on reimbursement basis, the insurance company has to be informed as per their prescribed procedures. The policyholder has to ensure that documents such as claim form, discharge summary, prescriptions and bills to be submitted for the claim on reimbursement are obtained after hospitalization.

Max Bupa Health Insurance plans has a well-defined claim processing system.

Cashless Service: Seeking Pre-Authorization

  • Complete the pre-authorization form available at the hospital's insurance/TPA Desk.
  • Send the completed form via email or fax.
  • Approved letter will be sent by the claim management team. Remember that the claim management team could send an inquiry to the hospital or you before authorization.
  • In case the authorization is rejected, initiate the treatment and file for reimbursement claim.

Reimbursement Claim: Claim Submission

  • Complete the necessary form and submit along with required documents, as per the policy terms and conditions.
  • Necessary documents include discharge summary, prescriptions, bills etc.
  • Approved letter will be sent by the claim management team. Remember that you will be answerable to any queries raised by the claim management team before the letter is issued.
  • In case the claim is rejected, the reasons will be communicated by the team.

In case of any emergencies, you need to inform Max Bupa within 24 hours of the admission. In case of planned emergencies, the notification has to reach the company 48 hours prior to the hospitalization. The claim intimation can be done via Max Bupa's toll-free number 1800-3010-3333. The same could also be emailed to customercare@maxbupa.com .

Note: If you are a Coverfox customer, you can directly reach out to us for all your claim-related issues and queries.

Max Bupa Health Insurance Premium Calculator

Max Bupa’s health insurance premium calculator generates the estimate for the premium you will have to pay, based on your chosen sum insured, unique needs and add-on riders that you may have selected. For instance, premium for an individual health insurance plan from Max Bupa health insurance will be lower than that of a family insurance plan.

Accessible on the insurance company’s website, all you need to do to check your premium eligibility is select your preferred health insurance plan from Max Bupa, choose the sum insured, followed by entering a few personal details like name, phone number, email ID, date of birth, city, etc. In case you are planning to opt for co-pay, you can get a clear idea about the percentage that you have to pay towards the total premium amount.

Why Purchase Max Bupa Health Insurance?

There are many reasons why you should buy health insurance. Whether you are rich or poor, young or old, or have been diagnosed with a disease that needs hospitalization - insurance plans of health are necessary to have. Here we will discuss why it is important to buy health insurance from Max Bupa.

  • Convenience of quick and easy online purchase of Max Bupa health insurance policies
  • Health insurance policies offer a sum insured up to Rs. 1 crore
  • Offers coverage for the entire family, including new born babies and senior citizens
  • Covers maternity related expenditures for mothers and new born babies after the completion of 1-year waiting period since the purchase of a Max Bupa health insurance policy
  • Includes lifetime renewal option
  • Max Bupa has an extensive list of 3,500+ network hospitals in India where the insured can avail cashless facilities on being hospitalized
  • Certain Max Bupa health insurance plans are designed to offer international cashless facilities through its global network of hospitals for specific critical illnesses such as cancer, organ transplant, etc.
  • Offers direct claim settlement and, hence, does not include TPA (Third Party Aggregator)
  • Emphasizes on their customer-first approach that is focussed on customer satisfaction
  • Includes tax benefits as per Section 80D of the Income Tax Act, 1961

How Can I Purchase Max Bupa Health Insurance Policy?

Online process:

  • Visit the official website of Max Bupa health insurance and fill up the relevant form with required details like name, contact number, email ID, etc., and request for a call back. You can call Max Bupa health insurance customer service for assistance with the process.
  • Max Bupa health insurance plans that are available online can be purchased through an online third-party aggregator or third-party website.

Offline process:

  • Visit any branch of Max Bupa health insurance of your convenience for the executives to guide you through the process of purchase.

Max Bupa Health Insurance Renewal Process

Max Bupa health insurance offers the flexibility of offline as well as online renewal facility. For offline renewal, you can visit any branch of Max Bupa health insurance to initiate the renewal process. If you prefer to renew it online, you can visit the company’s official website and click on the ‘Renew’ button and then pay online to complete the renewal procedure.

Review of Max Bupa Health Insurance

If you are looking to invest in a plan that has no age restrictions, no sub-limits on room rent, offers a decent No Claim Bonus up to 100% and Maternity and New Born Child benefits, Max Bupa is one of the top 5 picks. With no involvement of TPA, they claim to have a quicker resolution process including claims handling. The Max Bupa health insurance renewal is for life long. However, if you do not appreciate the element of co-payment, you may get disappointed. Overall, Bupa Health Insurance is one of the top players in India's health insurance market and its Max Bupa Mediclaim policy is worth considering if you are looking for a health insurance.

Faqs on Max Bupa Health Insurance

Why it is important to buy Max Bupa health insurance policies?

Max Bupa Health Insurance policies offer loads of features and benefits to fulfil your requirement. Let’s now have a look why you should buy a health insurance policy from Max Bupa:

  • Offers assured lifelong renewability
  • It doesn’t have any sub-limits under room rent
  • Offers maternity as well as new-born child benefits which makes them the most preferred health plans
  • Offers a direct claim settlement without involvement of any third-party
  • Offers international coverage with its Heartbeat Platinum Plan by providing international cashless treatment. This treatment is offered for 9 critical illnesses like cancer and organ transplant etc.
  • Offers tailor-made health insurance plan that offers coverage for the entire family right from new born babies to senior citizens

How to apply for Max Bupa health insurance policies?

You can buy Max Bupa Health Insurance policies through different channels:

  • You may directly call on the sales helpline number of Max Bupa and take an expert advice
  • You may visit the company website and fill in details like your name, age, mobile number, email id etc. and arrange for an advisor’s call back
  • You may visit the company website. Research the different plans available and click the ‘Buy Now’ button against the different plans available
  • You may also visit any Max Bupa branch and buy a plan that suits your requirement
  • You may visit Coverfox.com and buy a plan of your choice

Renewal process of Max Bupa health insurance?

The health insurance renewal process is very simple. Mentioned below are the steps:

  • Visit the company website and click on the ‘renew’ option
  • Enter your Max Bupa health insurance policy number and click the ‘submit’ option
  • You will get the renewal premium amount
  • All you need to do is click on the ‘pay now’ option and make the payment to renew your health insurance policy

Can I Apply for Max Bupa Health Insurance Plans Online?

Yes, Max Bupa’s health insurance plans can be bought online. The following are the different modes of applying for Max Bupa Health Insurance Plan online:

  • Visit the official website of Max Bupa health insurance and fill up the relevant form with required details like your name, contact number, email ID, etc., and request for a call back. You can call Max Bupa health insurance customer service for assistance with the process.
  • Max Bupa health insurance plans that are available online can be purchased through any online third-party aggregator or third-party website

What is the difference between a network and non-network hospital?

A network hospital refers to a hospital that Max Bupa Health Insurance has collaborated with for hospitalization and medical treatments. Max Bupa Health Insurance policyholders can avail cashless facilities on being hospitalized in a network hospital.

In contrast, non-network hospitals are those that are not a part of the list of network hospitals and, therefore, policyholders are not eligible for cashless benefits on hospitalization or medical treatments.

Can a non-Indian individual purchase Max Bupa Health Insurance policy?

Foreigners living in India can be covered under Max Bupa’s health insurance policy. The coverage, however, will be applicable within the country only.

What does Max Bupa Health Insurance consider a pre-existing illness or condition?

Any medical ailment or condition that has been diagnosed or treated before buying a Max Bupa health insurance policy is termed as a pre-existing disease by the insurance company.

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