Max Bupa Heartbeat Policy

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.

Highlights of Heartbeat Health Insurance Policy

  • The policy is available in three separate variants like 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


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


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


                      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


                              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


                                          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.

                                                  Max Bupa Heartbeat Policy Claim Settlement Process

                                                  Cashless Claims

                                                  This is applicable when a Max Bupa Heartbeat policyholder/insured member is admitted at a network hospital of the insurer.

                                                  • Show any proof of identity along with your Max Bupa Health Card, or your Policy number such as Passport / PAN card / Voter’s ID
                                                  • The network hospital will verify your identity and submit the pre-authorisation request form to the insurance company
                                                  • The insurer then reviews and takes a decision on whether to approve or reject the cashless claim by fax and/or email. The insurer also sends a text or a message on your registered mobile number and an email to you as a confirmation of your claim. The insurer responds to a claim request decision to the hospital within 30 minutes.
                                                  • Max Bupa then pays the claim amount that you are eligible for to the network hospital directly, as per policy terms and conditions, after all formalities have been completed.

                                                  Reimbursement Claims

                                                  This is applicable when a Max Bupa Heartbeat policyholder has not been hospitalized at any of the network hospitals of the insurance company.

                                                  • In case of hospitalization at a non-network hospital, you have to pay the hospital directly and then file a reimbursement claim.
                                                  • Make sure that you carefully collect all receipts, bills, doctors’ prescriptions, medical reports and discharge certificate from the hospital in originals
                                                  • Fill up the claims form with accurate details and send it to the insurance company, along with the above mentioned documents and your valid Proof of Identity and Proof of Age
                                                  • The insurer then reviews and takes a decision on whether to approve or reject the reimbursement claim. It may also decide to raise a query or reject the same, as per policy terms and conditions
                                                  • The insurer reimburses you the approved amount in your bank account.

                                                  Document Required For Claim Process

                                                  • Max Bupa Health Card
                                                  • Max Bupa Heartbeat Policy number
                                                  • Passport
                                                  • PAN Card
                                                  • Voter’s ID
                                                  • Driving License

                                                  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.

                                                  FAQ's Max Bupa Heartbeat Policy

                                                  Why choose Max Bupa Heartbeat Policy?

                                                  The benefits offered by Max Bupa Heartbeat Policy make it a much preferred choice for families looking for a health insurance policy:

                                                  Comprehensive Cover: The comprehensive features and benefits offered by Max Bupa Heartbeat Policy ensure a wide coverage and low waiting periods.

                                                  Covers the Entire Family: With the family floater plan of Max Bupa Heartbeat Policy, the entire family can be covered for hospitalization and other medical expenses, as specified in the policy document. Family members covered under a single plan start right from new borns to senior citizens.

                                                  Unique Features: The Heartbeat Platinum plan has a range of unique features that sets it apart from other health plans. Some of these features are international Cashless Treatment for 9 major critical illnesses like cancer and organ transplant through the insurance company’s network in 190 foreign countries across the globe (excluding treatment in USA and Canada). Not just that, this plan also covers OPD expenses.

                                                  Maternity Benefits: Maternity benefits include expenditures related to complications that may arise during pregnancy as well as pre and post- partum, provided the adult female is insured for at least two continuous policy years. The waiting period of 24 months is one of the lowest in the insurance industry. Additionally, the new born child who is covered by this maternity claim is automatically covered until the next renewal of the Max Bupa Heartbeat Policy.

                                                  Assured Renewal for Life: One of the most prominent benefits of Max Bupa Heartbeat Policy is that it can be renewed for a lifetime as opposed to some other health plans that specify a maximum maturity age. The renewability benefit is applicable, without any extra loadings, based on the policyholder’s claim, provided he/she makes continuous premium payments.

                                                  No Involvement of TPAs: Max Bupa settles claims directly with policyholders, without involving Third Party Administrators (TPAs). The skilled customer service professionals ensure a quick and hassle-free settlement of claims. The cashless settlement process is offered through an extensive network of more than 4000 network hospitals throughout India within 30 minutes of receiving the claims request from the network hospital where the policyholder has been admitted.

                                                  How Can I buy Max Bupa Heartbeat Policy?

                                                  Max Bupa Heartbeat Policy can be bought through the official website of the insurance company.

                                                  What are the minimum and maximum age limits of Max Bupa Heartbeat Policy?

                                                  On Individual Plan:

                                                  • Adults: 18 years – No Upper Limit

                                                  On Family Floater Plan:

                                                  • Children: At least 91 days
                                                  • Adults: At least 18 years – No Upper Limit

                                                  What is free-look up period in the policy?

                                                  There is a 15-day free look period applicable on Max Bupa Heartbeat Policy.

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