Niva Bupa Health Premia Health Insurance
Cashless Approval TAT | 30 mins Cashless Claim Processing |
Claim Settlement Ratio | 90.70% |
Network Hospitals | 10,000+ |
Pre-existing Disease Coverage From | Day 1 |
Special Benefits | Unlimited restoration |
Starting Premium for Rs. 5 lakhs SI | Rs. 550/month |
About Niva Bupa Health Premia Health Insurance
Niva Bupa Health Insurance has introduced the Health Premia Plan, a health insurance policy designed to provide complete protection for you and your family without breaking the bank. The plan offers three variants: Silver, Gold, and Platinum, and you can choose to cover yourself or your entire family under any of these variants. This comprehensive policy covers a wide range of medical expenses, including hospitalisation, daycare, ambulance services, maternity, and even travel insurance, e-consultations, and mental health treatment. Moreover, you can pick a coverage amount as low as Rs. 5 Lakh or as high as Rs. 3 crore.
Furthermore, the policy also comes with lifetime renewability, premium waiver options, refill benefits, and a 15-day free-look period for all its variants. In short, the Niva Bupa Health Premia Plan is a convenient and affordable way to safeguard your health and well-being.
Health Premia Health Insurance At a Glance
Health Premia Health Insurance highlights are listed below in the table:
Coverage |
Both Individual and Family Floater |
Riders |
Personal Accident Cover, Critical Illness Cover, Hospital Cash, etc. |
Variants |
Silver, Gold, and Platinum |
Key features |
Premium Waiver, New Age Treatment, Maternity Benefit, etc |
Inclusion |
Room Rent, Pre and Post Hospitalisation, AYUSH Treatment, etc. |
Exclusion |
Hazardous Activity, Conflict and Disaster, etc. |
Riders Available With Health Premia Niva Bupa Health Insurance
Following are the riders or add-ons available with Health Premia Niva Bupa Health Insurance:
- Personal Accident Cover - With this add-on, you can protect your family's financial security in the event of personal accidents, ensuring they're well taken care of during unexpected hardships.
- Critical Illness Cover - Gain peace of mind with coverage against major critical illnesses like cancer or kidney failure, depending on your initial coverage amount. This cover ensures you can focus on your recovery without worrying about medical bills.
- Hospital Cash - This rider allows you to receive extra financial support during your hospital stay. It provides cash for up to 30 days of hospitalisation when your hospital visit exceeds 48 hours, helping you manage additional expenses that may arise.
- Health Coach - Access a guiding hand on your journey to better health with a Health Coach rider. This feature offers support and advice to enhance your overall well-being, ensuring you make informed choices for a healthier lifestyle.
- Enhanced Geographical Cover - With enhanced geographical cover, you can extend your safety net beyond borders. This this add-on, you're entitled to international coverage in the USA and Canada, assuring you're protected no matter where you travel.
- Enhanced Loyalty Additions - Watch your insurance coverage grow steadily, increasing by 20% each year, up to a maximum of 200% of your initial coverage. This enhancement remains in effect regardless of your claim history, reinforcing your financial safety net.
Key Features of Niva Bupa Health Premia Health Insurance Plan
The following are the key features of the Niva Bupa Health Premia Health Insurance Plan:
- Premium Waiver: Receive a one-year policy extension at no cost if the policyholder passes away or is diagnosed with specified illnesses, ensuring continued protection for your loved ones.
- Emergency Assistance Service: Enjoy coverage for essential medical services like evaluations, referrals, and repatriation when traveling within India, provided you're at least 150 kilometers away from your home and your trip lasts fewer than 90 days, offering peace of mind on your journeys.
- New Age Treatment: Access modern treatments like CyberKnife, robotic surgery, laser procedures, and even weight loss (bariatric) surgeries, ensuring you can explore advanced healthcare options when needed.
- Maternity Benefit: Obtain maternity benefits for up to two deliveries, available after you and your spouse have been policyholders for two consecutive years, giving you added support during these special times.
- Refill Advantage: When your base coverage and loyalty additions are exhausted, receive an additional sum insured equivalent to your base coverage for a subsequent claim within the same year. This will provide you with extra financial security.
- Loyalty Additions: Regardless of your past claims, watch your coverage grow by 10% of your expiring base sum insured every year, up to a maximum of 100% of your base sum insured, offering stability and enhanced protection.
- Wellness Check-Up: Prioritise your health from day one, as you and your family can undergo diagnostic tests through our service provider on a cashless basis.
Eligibility Criteria of Niva Bupa Health Premia Health Insurance Plan
The eligibility criteria for the Health premia insurance plan are as follows:
Parametres |
Eligibility Criteria |
Minimum entry age |
18 years |
Maximum entry age |
65 years |
Number of people covered |
In the Niva Bupa family floater plan, you can include up to 19 relations in a single policy. |
Sum insured |
Rs. 5 lakhs to Rs. 3 crores |
Variants of Niva Bupa Health Premia Insurance Policy
The three different variants of the Health Premia plan are as follows:
Features |
Silver |
Gold |
Platinum |
Sum Insured |
Rs. 5 lakhs to 7.5 lakhs |
Rs. 10 lakhs to 50 lakhs |
Rs. 1 crore to 3 crores |
Health Checkup |
Up to Rs. 1,875 per person |
Up to Rs. 7,500 per person |
Up to Rs. 10, 000 per person |
Maternity Benefits |
Up to Rs. 60,000 (Only for family floater plan) |
Up to Rs. 100,000 (Only for family floater plan) |
Up to ? 200,000 (Only for family floater plan) |
AYUSH Treatment |
Upto Sum Insured |
Upto Sum Insured |
Upto Sum Insured |
Domiciliary Treatment |
Upto Sum Insured |
Upto Sum Insured |
Upto Sum Insured |
Benefits of Niva Bupa Premia Health Insurance Plan
Niva Bupa Premia health insurance plan brings a range of distinctive advantages for its policyholders:
- Tax Efficiency: You can save on taxes by claiming deductions under section 80D for the premiums you pay.
- Refill Assurance: In the event that your coverage is depleted due to claims in a policy year, it's refilled and made available for further use.
- Long-Term Savings: You can enjoy discounts for selecting a long-term policy. Get a 7.5% discount on the second year's premium for a 2-year policy and a 15% discount on the third year's premium for a 3-year policy.
- Premium Waiver Safeguard: If the policyholder passes away or is diagnosed with a critical illness during the policy term, the premium for the subsequent year is exempted. This feature applies exclusively to the family floater plan.
- Loyalty Rewards: Regardless of your claim history, you're rewarded with an extra 10% coverage based on the base sum insured each year, with the potential to increase it to 20% through an enhanced loyalty addition, up to a maximum of 200% of the sum insured.
- Enhanced Sum Insured: This plan allows you to boost your sum insured value or include additional family members in your policy when it's time for renewal.
Inclusions of Niva Bupa Premia Health Insurance Plan
Inclusions of the Niva Bupa Premia plan are mentioned below:
- In-patient Hospitalisation Cover: Your medical expenses for hospitalisation are covered up to the sum insured, ensuring you receive the care you need without financial worry.
- Room Rent: The cost of your hospital room is covered up to the sum insured, providing you with a comfortable place during your stay.
- Pre-Hospitalisation: Expenses incurred in the 90 days before hospitalisation are included in the coverage, so you're supported from the beginning of your treatment journey.
- Post-Hospitalisation: Medical costs in the 180 days after hospitalisation are covered, ensuring your recovery continues smoothly.
- AYUSH Treatment: Alternative and traditional treatments are covered, allowing you to explore various healing options.
- Living Organ Donor Transplant: Expenses related to organ transplants are covered up to the sum insured.
- Daycare Treatment: Even for procedures that don't require extended hospital stays, you're covered up to the sum insured.
- Domiciliary Hospitalisation: If you need to receive medical care at home, it's covered up to the sum insured.
- Specified Illness Cover: Treatment for specified illnesses is included, ensuring comprehensive protection.
- Emergency Assistance Service: You can access emergency assistance services within India, providing added peace of mind.
- Newborn Baby Cover: Coverage extends to newborns, offering protection right from the start.
- Child Care Benefits: Children up to 12 years old are covered up to the sum insured, taking care of their medical needs.
- Newborn Baby Vaccination Cover: For your newborn's well-being, vaccinations are covered for up to 1 year, following the recommended schedule.
- HIV/AIDS: For HIV/AIDS-related expenses, you're covered up to Rs. 50,000 after a waiting period of 4 years.
- Modern Treatments: Costs for modern treatments, including some surgeries, are covered up to the sum insured with a sub-limit of Rs.1 lakh.
- Maternity Benefit Covered up to 2 Pregnancies: Maternity benefits include coverage ranging from Rs. 60,000 to up to Rs. 2 lakhs, ensuring the well-being of both mother and child during pregnancy.
Exclusions of Health Premia Health Insurance Plan
The exclusions in the Niva Bupa Health Premia insurance plan are as follows:
- Ancillary Hospital Charges: Additional hospital fees that are not part of your treatment costs are not covered.
- Hazardous Activities: Injuries or illnesses resulting from risky activities like extreme sports may not be covered.
- Artificial Life Maintenance: Costs for life-sustaining devices or treatments may not be included.
- Circumcision: Routine circumcision is typically not covered.
- Conflict & Disaster: Injuries or illnesses arising from wars, conflicts, or natural disasters are not covered.
- Cosmetic and Plastic Surgery: Procedures done for cosmetic reasons are usually excluded.
- Unrecognised Physicians or Hospitals: Expenses incurred from healthcare providers not recognised by the insurer may not be reimbursed.
Documents Required to Purchase Health Premia Health Insurance Plan
To buy the Health Premia Insurance Plan, you'll need to provide these documents:
- A completed Application Form.
- Proof of identity like Aadhar card, Passport, Voter ID, or Driver's license.
- Proof of your age, like Birth Certificate, School Leaving Certificate, or Passport.
- Proof of address, which can be Utility Bills, Rental Agreement, or your Aadhar Card.
- Passport-sized Photographs.
- In some cases, you might need to provide pre-policy health check-up reports.
- Any other documents requested by the insurer.
How to Purchase a Health Premia Health Insurance Plan?
Here's how you can buy the Health Premia Health Insurance Plan through InsuranceDekho:
Step 1: Visit the official InsuranceDekho website and click on "Health Insurance" under the Insurance section.
Step 2: Choose "Niva Bupa Health Insurance" from the list of Health Insurance Companies.
Step 3: Select the "Health Premia" plan from the available list of health insurance plans.
Step 4: Carefully review the terms and conditions in the Niva Bupa Health Premia policy document.
Step 5: Upload all necessary documents to complete the KYC process.
Step 6: After KYC, proceed to make the premium payment online.
Step 7: You will receive the policy document at your registered email address.
Claim Process for Health Premia Insurance Plan
You can claim the Health Premia Health Insurance plan through two methods:
Cashless Claim
- Visit a hospital that is affiliated with Niva Bupa.
- Provide your Health Premia plan details and other required information.
- Submit the necessary documents, and the insurance company will send an approval form for the expenses.
- After reviewing the documents, the insurance company will directly pay the hospital.
Reimbursement Claim
- Choose a nearby hospital within Niva Bupa’s network.
- Pay your medical bills at the hospital.
- Request a reimbursement claim settlement on the insurance company's website.
- Submit the Niva Bupa Health Premia claim form and all plan-related information.
- After the insurance company reviews your claim, they will reimburse you for the medical expenses you incurred.
Health Insurance Calculator
Whom do you want the insurance for ?
Select the age of all members
- You
Where do you live ?
Choose required Coverage for yourself?
Key Inclusions and Exclusions of the Plan
What's Included
- In built travel insurance coverage
- Annual health check-up of your choice from day 1
- Inpatient hospitalisation expenses
- Daycare expenses
- Pre-hospitalisation and post-hospitalisation expenses
What's Not Included
- Treatment required due to participation in hazardous activities
- Inconsistent, irrelevant or incidental diagnostic procedures
- Sexually transmitted diseases and infections
- Non-medical expenses
- Expenses arising due to unproven treatments
10059 Niva Bupa Cashless Network Hospitals in India
Add-ons to Enhance Benefits
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Critical Illness Cover
With this add-on, you can enjoy coverage for 20 critical illnesses which the base plan does not cover you for. These illnesses include kidney failure, cancer, stroke, paralysis, etc., as mentioned in the policy document. -
Hospital Cash
On adding this add-on to your policy, you can avail hospital cash for up to 30 days of hospitalisation if the hospitalisation for more than 48 hours is required. -
Health Coach
This add-on allows you to track your health parameters and get help from virtual coach who help you achieve health goals and motivate you to stay fit. -
Enhanced Geographical Cover
By adding this add-on cover to your health insurance policy, you can avail international coverage as well. You can enjoy healthcare coverage in Canada as well as the USA, if required.
Claim Process at Niva Bupa Health Insurance
FAQs on Health Premia Health Insurance Plan
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What are the loyalty additions offered under the policy?
The policy offers you additional coverage (10% or 20% of base sum insured), as per the terms and conditions of the policy, on completing every year.
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Who all can be covered under this policy on a family floater basis?
On a family floater basis, the policy allows you to add 19 relationships. These include self, legally wedded spouse, son, mother, father, daughter in law, etc.
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Do I get any tax benefits on paying the premium for this policy in cash?
No. You can only avail tax benefits under Section 80D on the premium paid for this policy, if the premium is paid in any mode other than cash.
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What's the highest amount the plan covers?
The maximum coverage amount of this health insurance plan is Rs. 3 crores.