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Max Bupa Heartbeat Policy

Max Bupa Health Insurance

3.5/5 based on 08 User Reviews
Max Bupa Health Insurance Company Ltd. (Max Bupa) is a joint venture between Max India Limited and the UK-based healthcare services expert, Bupa. The Heartbeat Policy offers to provide a comprehensive medical coverage for individual as well as extended family covering up to 14 members. In their Family First Plan, an individual sum insured is offered for each member, and a floating sum insured to any family member.
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Highlights of Heartbeat Health Insurance Policy

  • The policy is available in three separate variants – Silver, Gold & Platinum
  • Discount on premium if you opt for a two-year policy term
  • Reward program on offer for the premium paid
  • No minimum or maximum age limit for the enrollment
  • Tax benefit on premium paid under Section 80D of the Income Tax Act, 1961

Scope of cover

Indivdual Plan

Entry Age

For children : 91 days

Adults :

Minimum : 18 years

Maximum : No Age Bar

Number of Members Covered

Maximum Members : 6

Maximum Adults : 4

Maximum Children : 2

Sum Insured

2 - 100 lakhs


discount

For longer policy term
family discount


Policy Periods Available

1, 2 years


Pre-Policy Medical Check-up

40 yrs/10 Lacs


Family Floater Plan

Entry Age

For children : 91 days

Adults :

Minimum : 18 years

Maximum : No Age Bar

Number of Members Covered

Maximum Members : 6

Maximum Adults : 2

Maximum Children : 4

Sum Insured

2 - 100 lakhs


discount

For longer policy term
family discount


Policy Periods Available

1, 2 years


Pre-Policy Medical Check-up

40 yrs/10 Lacs


Important Features

Day Care Treatments

Due to scientific advancement, some procedures/treatments do not require you to be hospitalized for a minimum of 24 hours to raise a claim. This plan covers such procedures.

Organ Donor Cover

This benefit covers medical costs up to the sum insured for an organ donor’s treatment for the harvesting of the donated organ.

Pre Hospitalization

The insurance company will compensate you for the medical expenses related to your hospitalization 30 days before the hospitalization.

Post Hospitalization

The insurance company will pay you for the medical expenses related to your hospitalization 60 days post hospitalization.

Good to Have Benefits

OPD Expense Cover

Only the Platinum plan includes the OPD expenses between Rs.10,000 to Rs.40,000 depending on the sum insured.

Daily Hospitalization Allowance

This policy does not offer any daily hospital cash.

Health Check-up

Offers complimentary health check-up that covers some listed tests, ranging from annual to once in two years depending on the plan variant.

Home Hospitalization/ Domiciliary Hospitalization

You can avail treatment at home up up to a limit ranging between Rs.10,000 to Rs.2.5 lakh, depending on the plan variant you have opted for.

Non- Allopathic Treatment Expense Cover

This plan offers to cover for expenses related to non-allopathic treatment for Platinum plan members only.

Emergency Ambulance

This plan provides ambulance cover at actuals in the network hospital up to the sum insured.

Value Adds

Eye-cover

This plan does not provide coverage for eye treatment expenses.

Maternity Cover

This policy includes the costs towards Maternity ranging between Rs.20,000 up to Rs.1 lakh.

Dental Coverage

This policy does not cover any dental treatments.

Recovery Benefit

Description

Critical Illness Cover

This policy does not provide additional cover for critical illness.

FREE LOOK PERIOD

For any reason, should you decide not to proceed with the policy, you can return the same and request for a refund within 15 days from the date of receipt of the policy document.

LOYALTY BENEFIT

This plan offers 10% discount on last paid premium or increase of 10% of sum insured up to a maximum of 50%. This benefit replaces the no-claim benefit offered in some other plans.

INTERNATIONAL COVERAGE

The Platinum plan offers coverage for treatment worldwide (except for USA and Canada) in the range of Rs.1.5 lakh to Rs.10 lakh for a family floater and individual coverage and Rs.5 lakh for family first coverage.

NEWBORN COVER

All the expenses related to the care of newborn baby are covered up to the sum insured.

Terms & Conditions

Room Rent / Room Category

The plan has defined limits for room rents and is equal to:

  • 1% of sum insured for Silver Plan
  • No limit on room rent for Gold and Platinum variant

  • 1% of sum insured for Silver Plan
  • No limit on room rent for Gold and Platinum variant

Co-Payment

This plan has the option of 10% to 20% co-pay for individuals below 65 years of age. However, it is mandatory for anyone above the age of 65 years. This co-pay reduces by 5% at each renewal making it zero at the 4th renewal.

Waiting Period

Cooling Off Period

A 90 days cooling off period for all claims except any arising out of accidental injuries.

Specific Illnesses

The policy covers some specific diseases/treatments only after 24 months. These include Cataract, Hysterectomy, Myomectomy for Fibroids, and so forth.

Pre-Existing Illnesses

You can claim for any pre-existing conditions after 48 months from the policy start date in case of Silver plan and 24 months for Gold and Platinum plans.

Permanent Exclusions

The Plan will not cover any liabilities towards the treatments of following conditions-

  • Attempted suicide
  • Use of alcohol or drug
  • AIDS
  • Pregnancy, childbirth, miscarriage, and abortion
  • Congenital disease
  • Infertility and in vitro fertilization.
  • Hospitalization out of war, riot, strike and nuclear weapons

The detailed list of what the policy does not cover is available in the policy wording.

Review of Max Bupa Heartbeat Health Insurance Policy

If you have a large family to cover under a single policy, Max Bupa's Heartbeat Family First plan is one to consider. With wide benefits on offer, the plan includes relevant medical expenses towards diagnostic procedures and newborn baby. At any point, if you wish to seek the medical treatment abroad, then you can consider Platinum plan.

**Reviews and ratings are based only on Benefits and Conditions. Things like Claim Settlement Ratio, Hospital Network have not been covered under product ratings. These are covered under Company ratings.

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