Niva Bupa Aspire Plan

Product Overview Of The Niva Bupa Aspire Plan

Niva Bupa Aspire is a health insurance plan offered by Niva Bupa Health Insurance Company Limited. Designed with young individuals in mind, the Niva Bupa Aspire Plan offers robust and extensive coverage. It stands out as a top choice with unique features, benefits, and add-ons. With this plan, you will be able to enjoy various discount options as well. It comes in four variants – Gold+, Diamond+, Platinum+, and Titanium+.

Eligibility Criteria For The Niva Bupa Aspire Plan

• Minimum Age Of Entry: 18 years

• Maximum Age Of Entry: 65 years
   

Benefits And Coverage Overview Of The Niva Bupa Aspire Plan

The Niva Bupa Aspire Plan not only takes care of your inpatient hospitalisation costs like room boarding, nursing, practitioner fees, prescribed medications, drugs, ICU charges, etc., but it also extends its support to various related expenses. Here's a quick look at some of the other expenses covered by the Niva Bupa Aspire Plan –

• Pre & Post Hospitalisation Expenses
  If your doctor needs to conduct tests before or after your hospital stay, you will be covered under the Niva Bupa Aspire Plan. It takes care of these expenses for a significant period of 60 days before hospitalisation and 180 days after you get discharged from the hospital. It is important to note that these expenses must be directly related to your medical condition and approved as part of your inpatient hospitalisation coverage.
   
• Daycare Treatment Coverage
  Daycare treatments are procedures or surgeries that used to require prolonged hospital stays but now can be done within 24 hours due to commendable advancements in medical technology. The Niva Bupa Aspire Plan covers all daycare treatments and sets no limits on expenses. This means that all expenses related to your daycare treatment will be covered up to the sum insured.
   
• Home Care / Domiciliary Treatment Coverage
  Home care treatment is a medical treatment for injuries or illnesses administered at home, which otherwise requires a hospital setting. To qualify for this coverage, your doctor must suggest it, and there must be ongoing treatment with daily monitoring, including a treatment chart signed by the doctor. The Niva Bupa Aspire Plan covers the costs of home-based treatment up to the sum insured.
   
• Organ Donor Coverage
  The Niva Bupa Aspire Plan also takes care of organ donor expenses. It covers the inpatient costs of the organ donor in case of an organ transplantation up to the sum insured. Moreover, it includes coverage for expenses related to harvesting the organ from you if you choose to be an organ donor.
   
• Modern Treatment Coverage
  Healthcare is advancing quickly with new technologies, bringing about treatments that were once thought impossible. The Niva Bupa Aspire Plan is designed in such a way as to keep up with these changes and covers the costs of these modern treatments up to the sum insured.
   
• Non-Medical Expenses
  Non-medical expenses include the cost of consumables like gloves, oxygen masks, nebulization kits and other such items needed for treatment. These items can get pricey and quickly pile up. With the Niva Bupa Aspire plan, you get coverage for these costs up to the sum insured, if you choose it as an add-on. Thus easing the financial load that comes with such costs.
   
• Booster+ (No claim bonus)
  Booster+ is designed to motivate you to stay healthy by giving you a bonus for each claim-free year. With the Niva Bupa Aspire Plan, your sum insured increases by 100% for every year you do not make a claim. The maximum bonus you can earn depends on your entry age and the plan you select. You should note that the bonus, however, remains intact even if a claim is made during a policy year.
  
  Here is a table outlining the maximum allowable bonus accumulation across different variants -

Thus, enrolling sooner means you get to enjoy more benefits.

• ReAssure Forever
  When you make the first claim on your policy, it activates ReAssure "Forever." Once triggered, it stays with you as long as you keep renewing the policy without any gaps. This means you can enjoy an unlimited sum insured for the entire policy period, even if a claim has been filed before. This benefit applies to both related and unrelated illnesses.
   
• Room Rent Limit:
  Your insurance company sets a maximum amount it will cover for the room you stay in during hospitalisation. This is called the room rent limit. If your chosen room falls within this limit, you will not have to pay anything extra. However, if you opt for a room with a higher rent, you will be responsible for a proportionate deduction. This means you will pay a proportionate share of the entire bill and not merely the difference in room rent. Under the Niva Bupa Aspire Plan, you are free to choose any room in all variants except Gold+. In the Niva Bupa Aspire Gold+ plan, there is a room rent limit of up to a single private room.
   

Other Important Features of the Product

• M-iracle Benefit
  M-iracle is a complete parenthood package covering prenatal check-ups, consultations, tests, vaccines for expecting mothers, and delivery costs (normal or C-section), including that of surrogate mother. It also includes expenses for infertility treatment, assisted reproduction, surrogacy, adoption, abortion, and other pregnancy complications. The sum insured of this benefit is over and above the base sum insured, Booster+ (No Claim Bonus) and ReAssure+ (Restore Benefit).
  
  What sets this maternity benefit apart is its similarity to Booster+. Either the entire or partial unused sum insured is carried over each year, gradually increasing the maternity cover up to a maximum Booster+ limit, depending on your entry age and chosen plan. It also covers a newborn from day 1. You should, however, keep in mind that specific terms and conditions apply to this coverage.

• Lock The Clock
  Under the innovative "Lock the Clock" feature from Niva Bupa Aspire Plan, your age remains fixed from the policy purchase until your first claim. This means you pay premiums based on your entry age until you make that initial claim. After your first claim, your premiums adjust according to your current age and continue changing based on the age slabs at each renewal.
  
  If you have chosen the Titanium+ variant, this unique feature will continue even if you make a claim under the M-iracle parenthood benefit, covering maternity, IVF, adoption, surrogacy, etc. This ensures that maternity claims will not affect the age lock feature, allowing you to maintain premiums based on your entry age. It is important to note that the Gold+ variant does not offer this age lock feature.
   
• Future Ready
  The Future Ready is an exclusive benefit from Niva Bupa Aspire Plan, making it the first of its kind in the industry. With this add-on, you can transfer all the waiting periods you have completed, such as the initial waiting period, PED waiting period, specified disease/procedure waiting period, and M-iracle waiting period, to your newly married spouse. This means that waiting periods apply at the policy level rather than the individual/member level, making it easier for your spouse to get coverage without starting from scratch.
  
  For example, if you enrol in the plan early and complete all waiting periods before marriage, your spouse, who is newly added to the plan, will be covered from day 1. You should keep in mind that there are specific terms and conditions for this feature that you should be aware of.
   
• Fast Forward
  You can include this feature in your Niva Bupa Aspire Plan as an add-on. If you have chosen a multi-year policy with a policy period of 2 or 3 years, this feature speeds up your coverage by adding the sum insured of all 2 or 3 policy years. Thereby, allowing you to utilise it anytime during the policy period. This means that the aggregated base sum insured, including the maternity sum insured, becomes accessible throughout the entire policy tenure, starting from the initial policy period.
   
• Cash Bag
• Cash Bag is an additional benefit that appreciates your claim-free record. With this, you can get 10% cashback on your initial renewal premium and 5% cashback on every following renewal. Accumulate these rewards in your cash bag to secure financial support for various healthcare needs. You can use this cash for copays, deductibles, future premiums, or even cover outpatient expenses. You also have the option to easily access your cash bag rewards through Niva Bupa’s user-friendly mobile app.
   

Waiting Periods

When you buy health insurance, certain illnesses may not be covered initially for a certain period of time.  This time frame is called the waiting period. After this period, you can start claiming for these conditions. Waiting periods come in various types that include –

• Initial Waiting Period: When you buy your health insurance plan, there is an initial 30-day waiting period for all medical conditions except accidents. This means you will not be able to claim for hospitalisation during the initial 30 days, except in the case of accidents.
• Waiting Period For Pre-existing Diseases: These diseases are any health condition you have had in the 48 months before getting a health insurance policy. With the Niva Bupa Aspire Plan, there is a specific waiting period of 48 months for pre-existing diseases in the Gold+ variant and 36 months for other variants. During this time, the policy will not cover expenses related to your pre-existing diseases.
• Waiting Period For Specific Diseases: Insurance companies have a list of particular medical conditions or illnesses with a waiting period, separate from any pre-existing conditions you may have. This waiting period applies whether or not you have had these illnesses in the past. It is determined by the insurance company and not influenced by your current state of health. Under the Niva Bupa Aspire Plan, there is a fixed waiting period of 24 months for specific diseases in all variants.

Exclusions

Some situations will not be covered by your health insurance policy. These are called exclusions. Here are some of the types of exclusions –

• Standard Permanent Exclusions: Insurance companies must adhere to a set of rules called "standard permanent exclusions'' established by IRDAI. These exclusions include -
  • Hospital Observation: Being admitted to a hospital solely for observation or monitoring.
  • Rest Cure, Rehabilitation, and Respite Care: Getting admitted to a facility for rest without active treatment.
  • Obesity/Weight Control: Surgery or treatment for weight control or obesity.
  • Gender Change Treatment: Treatment aimed at changing one's characteristics to the opposite sex.
  • Plastic/Cosmetic Surgery: Treatment to change body characteristics or appearance.
  • Hazardous Sports: Treatment expenses incurred while engaging in hazardous sports like mountaineering, rafting, scuba diving and so on.
  • Breach of Law: Expenses related to treating a person involved in a criminal act.
  • Excluded Providers: Getting treatment from a medical practitioner or hospital excluded by the insurance company.
  • Narcotics: Treatment for alcohol addiction, drug usage, etc.
  • Domestic Establishments: Treatment in health spas, nursing homes, or similar establishments meant for domestic purposes.
  • Dietary Supplements: Vitamins, minerals, etc., not prescribed by a medical practitioner.
  • Refractive Error: Expenses/costs associated with correcting refractive errors up to 7.5 diopters for better eyesight.
  • Unproven Treatments: Medical procedures or treatments not proven to be effective.
  • Birth Control and Infertility: Expenses related to contraception, artificial insemination, sterilisation, advanced reproductive technologies like ZIFT, GIFT, ICSI, gestational surrogacy, IVF, etc.
  • Maternity Expenses: Childbirth-related hospitalisation expenses, pre/post-natal costs, etc.
• Additional Permanent Exclusions: Apart from the standard exclusions we discussed earlier, insurance companies might add more exclusions for specific situations or health conditions. If you have any disease or severe medical conditions that insurers find too risky to cover, they might permanently exclude them from your policy. However, it is essential to note that insurers can only apply permanent exclusions for illnesses listed by the IRDAI.
• Specific Exclusions (Non-Standard Exclusions): Beyond the standard exclusions laid out by the IRDAI, there are specific exclusions that go a step further. These exclusions may also differ among insurance companies and also depend on the terms and conditions of your policy. Let's look at some of the notable specific exclusions under the Niva Bupa Aspire Plan –
  • Expenses related to treating injuries or illnesses caused by nuclear incidents, radiation exposure, war, rebellion, acts of terrorism, etc.
  • Expenses for congenital anomalies related to screenings, counselling, or treatment.
  • Dental treatments other than those required due to cancers and accidents.
  • Artificial life maintenance/support for sustaining life in case of brain death or vegetative state.

Summary

Navigate Your Coverage Specifics With Our Reading Material!

• Brochure: https://www.nivabupa.com/content/dam/nivabupa/PDF/aspire/Aspire%20Single%20Sheeter.pdf
• Policy Wording: https://www.nivabupa.com/content/dam/nivabupa/PDF/aspire/Aspire_Policy%20Wordings_with%20logo.pdf

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