Niva Bupa Health Insurance Plan

Unexpected medical costs are financially covered by the Niva Bupa Health Insurance Plan. You and your insurance company have an agreement with the Niva Bupa Health Insurance Plan that the policyholder will be financially protected by the insurer in the event of a medical emergency.

There is more than one type of health insurance available for each person because insurance companies understand that no one size fits all. In India, there are actually many different types of health insurance plans to suit different needs.

  • Choose the best health insurance for yourself, your family, and your business so that you won’t have to worry about mounting medical debt. In accordance with the type of plan, you select

  • Not only are your medical expenses covered, but you also receive cashless care at our network of hospitals.

  • When you choose to purchase a health insurance policy for yourself and your family, you can say goodbye to medical expenses.

Key Benefits of Health Insurance Plans in India

Cashless Medical Treatment – A network of hospitals across the country is accessible to each health insurance company. You won’t be required to pay anything for your care if you are admitted to one of these “empanelled hospitals.” Once you have given your insurer and the hospital your policy number, they will cover all of your expenses. Because the claim disbursement and documentation process is simple, cashless claims are preferred in health insurance policies.

Pre- and post-hospitalization coverage – Today’s health insurance provides its customers with coverage that goes beyond just covering hospital bills. Traditional health insurance policies now provide coverage for some pre- and post-hospitalization costs. A good health insurance plan will also pay for things like prescription drugs, doctor visits, ambulance fees, and more.

The No Claim Bonus – Some health insurance plans provide no-claim bonuses to their policyholders. As the name implies, if a policyholder has held it for a year without filing a claim, they are likely to receive a bonus in the form of a reduction in their premiums or an expansion of their coverage. When you renew your insurance, you can use the no-claims bonus.

Medical Examination Facility – One has the right to routine medical checkups when one choose a health insurance plan that one will need to use. This facility is provided as a part of a health plan by insurers.

Co-payment – Some insurance plans give you the choice of a copay with predetermined voluntary deductibles. This implies that the customer only needs to pay a set portion of their bill. The insurer will cover the balance of the payment once the predetermined amount has been exceeded. You can significantly lower the price of your premiums if you have a copayment option.

Several Good Reasons to Purchase Health Insurance – There are several strong justifications for purchasing health insurance policies.

Medical inflation – The cost of treatments has been alarmingly rising as medical technology and treatment quality have advanced. You can afford quality healthcare with adequate health insurance coverage without having to worry about medical inflation.

Protection of wealth – If you pay for hospitalization out of your savings, it could leave you with a sizable financial hole. However, health insurance can shield your money and assets. You only need to pay a small premium each time a policy period.

Protecting family – The entire family can be covered by purchasing health insurance. As a result, you can use the benefits of health insurance to meet the medical needs of every member of your family.

Tax advantages

Health insurance tax benefits are available for the premium paid. The premium paid may be subtracted from your total income under Section 80D of the Income Tax Act, which lowers your tax obligation.

How to buy health insurance plans online?

In the past, health insurance providers had to invest in infrastructure and enlist the aid of numerous brokers, agents, and financial consultants to sell health insurance plans in India. The process required a great deal of effort, time, and paperwork.

However, purchasing a health insurance plan is now almost as simple as placing an online pizza order. You can find a wealth of information about different health insurance plans, their features, and their benefits online. You can also find quick and easy instructions on how to purchase a health insurance plan online.

With little paperwork and middlemen, the process has developed to be extremely effective, transparent, and cost-effective. The only issue that remains is how to submit an application for a health insurance plan in India.

Research – You have access to a wealth of knowledge about the various health insurance companies. Depending on your preferences for premium, type of coverage, and other relevant factors, browse and compare all available options on various comparison portals.

Go to the website – Visit the website of the chosen insurance provider after you’ve made a shortlist of a few plans, and look over the plan specifics. The better informed you are, the better able you will be to choose. All Niva Bupa health insurance plans’ brochures and policy wording are available on their website.

Detail KYC information – Visit the website of the chosen insurance provider after you’ve made a shortlist of a few plans, and look over the plan specifics. The better informed you are, the better able you will be to choose. All Niva Bupa health insurance plans’ brochures and policy wording are available on their website.

Read all of the rules and regulations – Read the small print and scan for exclusions and riders. Note the crucial elements, such as the premium, the insured amount, the waiting period, the claim-processing procedure, the inclusions and exclusions, the flexibility, the renewal clauses, the additional benefits, etc.

Purchase – You can proceed to make the payment using one of the available payment gateways on the insurer’s website once you’ve selected your plan and determined the amount insured.

Considerations to make before purchasing Niva Bupa Health Insurance Plan

With so many health insurance options on the market today, you are spoiled for choice. Make sure you gather all the data you require before purchasing a policy.

When choosing the best health insurance plan for you, bear the following things in mind.

  • Always pick a policy with enough coverage, making sure that it will cover your entire family’s needs as well as your own.

  • Although the majority of workers today are covered by the group health insurance offered by their employers, it is always advantageous to select and buy an individual health insurance plan after carefully reviewing all the terms and conditions.

  • Combining hospital cash, critical illness care, and other benefits from their base cover is the ideal way for someone to try to get some sort of compensation for losses that aren’t recoverable.

  • Make sure you keep your health insurer well-informed and up to date on any diagnoses of pre-existing conditions.

  • Make sure to record the waiting period, the highest allowable limits, and the coverage options.

  • Make sure you are familiar with every clause in your health insurance policy. The cumulative bonus, deductible, waiting period, and any pre-existing illness provisions are just a few examples of the elements covered by this.

  • It is advised to select a policy that offers a high sum insured due to the annual increase in medical costs.

  • Make sure you renew your health insurance policy frequently. You might forfeit the advantages of your insurance if there is a gap between the expiration of your policy and its renewal.

  • The lower your premium coverage amount is for the amount of coverage you will receive, the earlier you purchase health insurance.

Characteristics of Niva Bupa Health Insurance Plan

Most health insurance policies include various features, some of which are:

  • Medical insurance for inpatient or hospital care

  • Coverage for hospitalization-related costs before and after a certain number of days

  • ICU fees and hospital room rent, with or without sub-limits

  • Coverage for medical care received at home if hospital beds are not available

  • Along with outpatient department care, ENT, dental, and other procedures are covered under the daycare treatment plan.

  • Cashless medical exams and diagnostic procedures

  • Payment for emergency ambulance services

  • Patients receiving inpatient care for organ donation

  • Permanent exclusions, which are a predetermined list of ailments and medical conditions, are another feature of health insurance policies.

  • There are also waiting periods in health insurance policies. Treatment after an accident is provided immediately. A 30-day waiting period is typical for other treatments. There is a longer waiting period of 2–6 years for pre-existing conditions.

  • Insurance companies also provide co-payment percentages and deductible amounts that reduce the cost of the premium. However, claims are decided upon after taking your deductible or co-payment into account.

  • Health insurance plans also provide extra riders for specialized medical requirements like critical illness and hospital cash, which can be purchased by paying an additional premium.

How can the best Niva Bupa Health Insurance Plan be chosen?

When choosing a health insurance plan, take into account the following factors in addition to the crucial claim settlement ratio:


Choose the plan that best meets your needs by comparing the coverage provided by the various options.

Sum assured

When choosing your policy’s assured sum, take medical expenses into account. Choose a sensible amount so that you are neither overly nor inadequately insured. When choosing a higher sum assured, take into account the premium affordability as well.

Coverage by hospitals

Health insurance offers many benefits, including cashless hospitalization. Verify your insurer’s extensive network of hospitals that accept its contracts.

Renewability for all time

As people get older, health insurance becomes even more crucial. Always choose a lifetime renewable insurance policy over ones that have an age restriction.

Floater over specific policies

Always choose a family plan over individual plans if your family needs health insurance. There will be a lower premium than with individual plans.

Indian Niva Bupa Health Insurance Plan Types

A cheap way to ensure that people and their families have access to medical care during emergencies is to purchase health insurance. In India, there are many different health insurance plans that aim to offer coverage against a variety of health risks in addition to a wide range of other advantages. However, you must be aware of all your options in order to select the one that is best for you.

A quick glance at the most well-liked health insurance options in India is provided below:

Plans for individual health insurance

According to the plan’s policy wordings, an individual is covered by an individual health insurance policy during medical emergencies, as the name suggests.

Note: The insured person’s age, health, and income level all directly affect the policy’s sum assured.

Health Insurance Floater Plans for Families

  • Specifically created to meet the needs of your entire family, a family floater policy. Most importantly, compared to an individual policy, a family floater policy is significantly less expensive and hassle-free because it saves a lot of time, effort, and money.

  • Plans like the Heartbeat plan from Niva Bupa can even cover 19 relationships with a single policy.

Remember that the oldest family member covered by the plan has a significant impact on the premium for a family floater policy.

Plans for Senior Health Insurance

  • Health problems increase in frequency as you age, and as a result, treatments also have a tendency to become more difficult and expensive. As a result, these health insurance plans are specifically created with senior citizens’ needs in mind.

  • Due to the higher cost of these plans for seniors due to their greater susceptibility to health problems, the insurer may also include a co-payment clause in the policy contract.

Note: Anyone over 65 years old is eligible to choose such a cover.

What does Niva Bupa Health Insurance Plan coverage include?

Do you want to know everything that traditional health insurance covers? Search no further. Here are a few examples of the guaranteed inclusions and exclusions found in a standard health insurance policy. The following list may aid you in determining what is and is not covered by your policy, but you should always check with your health insurance provider and carefully read your policy’s documents to be sure.

Inclusions in the Niva Bupa Health Insurance Plan:

  • Inpatient hospitalization

  • Post- and pre-hospitalization care

  • Daycare Policies

  • Emergency room fees

  • Covid-19 coverage

Exclusions from Niva Bupa Health Insurance Plan

  •  Dental care, unless it is related to cancer or an immediate trauma.

  • Purchases of extraneous items, such as eyeglasses, hearing aids, crutches, artificial limbs, and veneers, are not included.

  • A health insurance plan does not pay for cases of self-inflicted harm.

  • Botox and plastic surgery are not included in the definition of cosmetic surgery. Surgery for burns, unintentional injuries to the body, and cancer treatments are examples of exceptions.

Eligibility requirements for purchasing a medical insurance policy

Age: The insured’s entry age can range from 18 to 65 years old, but it can also be 70 years old in some circumstances. The age range for covered children is from 16 days to 18 years, although newborn and post-natal coverage is also offered.

Tests: A favorable set of medical test results may also be required by the insurer. Regular blood and urine tests, tests for the major organs, and other tests may fall under this category. In general, applicants under the age of 45 are exempt from medical examinations.

Condition of health: It is required to disclose any existing medical conditions. Due to this, the waiting period will begin, and the premium calculation will change.

Health Insurance Claims

  • Find the nearest network hospital where Niva Bupa (previously known as Max Bupa Health Insurance) members can submit a cashless claim by using the Niva Bupa Health app.

  • Gather the paperwork from the hospital that relates to your health insurance. Fill out and return those forms to the hospital. Your health insurance policy number, photo ID, and other proofs might be requested.

  • Depending on your treatment plan, supporting documentation, and insurance coverage, the internal claims committee will decide whether to approve or reject your claims after receiving them.

  • When claims are approved, you can either receive medical care at no cost to you from the hospital or only pay for supplies or services that are listed in the exclusions charter.

  • You can check the status of your claim request at every stage on the Niva Bupa website. Niva Bupa, formerly Max Bupa, processes cashless claims in 30 minutes or less on average.

Documents needed to submit a claim for medical insurance reimbursement

The network hospital sends all the paperwork to the insurer in a cashless hospitalization. You will be required to submit a number of documents in the event of reimbursement, which the insurer will review before approving your claim. It consists of the following:

  • Complete and signed the claim form

  • Hospital’s certificate of discharge

  • Consultation with a doctor and receipts

  • Hospital invoices that have been stamped and signed

  • Diagnostics and reports, such as X-ray films, blood tests, urine tests, etc.

  • Invoices for medicines and any other records pertaining to the treatment


What is the waiting period under a health insurance plan for critical illnesses?

Critical illness coverage is typically available under regular health insurance plans 90 days after the start of the policy, in most cases.

Can I purchase a family-wide health insurance plan?

Yes, you can choose to purchase a family plan or individual health insurance plans for each member of your family.

Is a family floater the same as a health insurance policy?

No. A health insurance plan can cover an individual, a family, or even a group of coworkers. However, a family floater is a single health insurance plan created to cover every person covered by the policy.

Can I switch my current health insurance policy to one from Niva Bupa?

Yes. By choosing health insurance portability, any current health insurance plans in India can be transferred to Niva Bupa. You must have continuously held the prior policy in order to qualify for this.