Health Plus Cover

Healthcare is growing increasingly expensive and affording healthcare is not an easy feat to achieve. This goes all the way from pharmaceutical expenses to surgery fees. Vital requirements such as ambulance costs are sky-high too and in times of medical emergencies, a good health insurance is the only reliable backup.

 

Not only does this safeguard your savings, it also saves you from additional stress incurred during trying times. Hence, Bajaj Markets presents the Health Plus Cover from Niva Bupa which helps you manage the costs of ICU, hospitalisation, surgery, medicines and much more at the nominal premium amount starting at ₹999. 

You can be eligible for the Health Plus Cover by Niva Bupa if you match the criteria given below.

 

• The entry age for adults under this policy can be from 18 to 65 years.

• Day Care Treatment

  We cover 536 day care treatments under the product. Please refer to the policy document to know the entire list of day care procedures covered under the product.

• Hospital Accommodation

  While hospitalised, you can choose to stay in a room worth up to 2% of the sum insured chosen per day. ICU charges are covered up to double of the room rent per day.

• Emergency Ground Ambulance

  Emergency road ambulance services covered up to ₹1,000 per hospitalisation.

Given below are all the basic details and specifications of Niva Bupa’s Health Plus Plan that you need to know. 

*Please note that the Health Plus Plan by Niva Bupa comes with a waiting period of 30 days and it is only after this waiting period that claims can be made. Additionally, in case of accidents and pre-existing ailments, the waiting period is extended to 48 months.

Given below are the exclusions that state all that is not covered under this policy.

1. Investigation and Evaluation

Costs for medical investigation and evaluation will not be covered. 

2. Rest Cure, Rehabilitation, and Respite Care 

Expenses surrounding rehabilitation, respite care, and rest cure will not be covered under this policy. 

3. Obesity/Weight Control

Any surgeries or treatments surrounding obesity or weight control are not included under the Health Plus Cover.

4. Change-of-Gender Treatments

Gender changing operations and treatments will not be covered.

5. Cosmetic or Plastic Surgery

Any beautification, aesthetic, or cosmetic surgeries are not included in this plan.

6. Hazardous or Adventure Sports

This plan does not offer coverage for injuries resulting from adventure sports or other hazardous activities. 

7. Breach of Law

If the need for medical treatment arises as a result of illegal activities, the claim will not be entertained.

 

*For detailed exclusions list information, please refer to the policy terms and conditions document.

The following steps can be your guide to claiming this policy by Niva Bupa.

1. Cashless

With around 5000+ partner hospitals under Niva Bupa, you can claim a cashless transaction on your end while paying for medical expenses through this policy. You can start with approaching a Niva Bupa partner medical facility for treatment. There you can provide your identity proofs along with your policy number. The partner facility will issue an authorisation document for the insurer to approve of. 

 

Once this process has been validated by the insurer, you will receive a confirmation through email, fax, SMS or other means of communication as per your preference. Now, you may proceed with settling the claim with the hospital itself. 

2. Reimbursements

Reimbursement claims are carried out after all the payments have already been made to the hospital by the insured. This simply means that the insurer will reimburse or return the costs of certain expenses that you may have incurred during the billing period at the medical facility. 

 

Here you need to make sure that all the relevant documents and proofs such as bills, invoices and receipts are recorded and readily available with you. Send the insurer a complete claim form along with all the proofs and reports. Once approved, the claim will be processed and the reimbursement should be in motion. 

 

Following are the documents you will need to submit along with your claim forms within 15 days of discharge. 

 

• Discharge summary and report

• Cancelled cheque or NEFT information of the payment

• Original bills and receipts

• Treating doctor’s valid ID proofs

• Doctor’s/surgeon’s reports

• Investigation reports

• Pharmacy receipts

• Complete claim form

Contact Bajaj Markets by writing to insuranceconnect@bajajfinservmarkets.in if you have any queries, questions or concerns.

Niva Bupa Health Plus Brochure - PDF

Niva Bupa Health Plus Policy Wording - PDF