Let’s Know The Niva Bupa (Previously Known As Max Bupa) Health Companion Plan Better!
Health Companion (Variant 2022) is a health insurance policy offered by Niva Bupa Health Insurance Company Limited. It's designed to protect you and your family against the ever-rising medical expenses. This plan ensures that you have access to top-notch medical care when you need it. It offers a range of features and benefits to meet your specific healthcare needs.
Are You Eligible?
?Minimum Entry Age
- Adults: 18 years
- Dependent Children: 91 days
?Maximum Entry Age
- Adults: 99 years
- Dependent Children: 25 years
An Overview Of The Niva Bupa (Previously Known As Max Bupa) Health Companion Plan’s Benefits & Limits
The Niva Bupa Health Companion (Variant 2022) plan takes care of the inpatient hospitalisation expenses you incur when you are admitted to the hospital for more than 24 hours. This includes charges for your room, nursing care, doctor's fees, prescribed medications, ICU services, and other related costs. Here are some of the other expenses covered under the plan -
- Pre- and Post-Hospitalisation Expenses
You might have to go through a series of tests before or after your admission to the hospital. But worry not! Niva Bupa Health Companion (Variant 2022) is here to support you. The medical expenses you incur are covered up to the sum insured for 60 days prior to hospitalisation and 180 days after discharge. It's crucial to note that the insurer will only cover these expenses if they are directly related to the medical condition that led to your hospitalisation and your claim is approved as part of inpatient hospitalisation coverage.
- Daycare Treatment Coverage
Certain treatments used to require extended hospital stays but can now be completed within 24 hours, thanks to advancements in healthcare technology. These are known as daycare treatments. With the Niva Bupa Health Companion (Variant 2022) Plan, you can enjoy comprehensive coverage for all daycare procedures up to the sum insured.
- Domiciliary Treatment Coverage
Domiciliary Treatments are medical procedures for illnesses or injuries that need urgent attention in a hospital but can be given in the comfort of your own home if the severity of your condition prevents you from moving to a hospital or there are no hospital beds available nearby. With the Niva Bupa Health Companion (Variant 2022) Plan, you can have peace of mind knowing that your expenses related to domiciliary treatments are covered up to the sum insured.
- Organ Donor Coverage
The Niva Bupa Health Companion (Variant 2022) Plan also covers the inpatient costs of the donor incurred during organ transplantation up to the sum insured - where you are the organ recipient.
- Modern Treatment Coverage
We are seeing rapid and extraordinary transformation in the healthcare industry, all thanks to the advancements in technology. As a result, treatments that were once considered unimaginable are now becoming a reality. The Niva Bupa Health Companion (Variant 2022) Plan has been specifically designed to keep up with these advancements and provides coverage for such modern treatments up to the sum insured. However, there is a sub-limit of Rs 1,00,000/- for each claim on some robotic surgeries as outlined in the policy.
- Non-Medical Expenses
The Niva Bupa Health Companion (Variant 2022) provides coverage for non-medical expenses or costs associated with consumables such as gloves, gauze, bandages, nebulisation kits, oxygen masks, and more. With this coverage, you can rest easy knowing that these expenses are taken care of, relieving you from additional expenses. Note that you need to opt for the add-on to avail of this coverage up to the sum insured.
- Cumulative Bonus
If you don’t make any claims during the policy year, the insurer will reward you with a cumulative bonus. With the Niva Bupa Health Companion (Variant 2022), you can enjoy a cumulative bonus of 20% of the sum insured every year you don’t make a claim, which has the potential to increase up to a maximum of 100% of the sum insured. Note that if you do make any claims during the policy year, the bonus remains unchanged.
- Refill Benefit (Restoration Benefit)
The Refill Benefit is an invaluable feature that restores your base sum insured if it gets exhausted within a policy year. This benefit comes into play once you partially or entirely utilise your base sum insured. It remains accessible immediately after the first claim under the Niva Bupa Health Companion (Variant 2022). You can use it for any type of illness, whether it is related or unrelated, once in a policy year for subsequent claims. This benefit is available for a lifetime as long as you renew your policy promptly.
- Room Rent Limit
The room rent limit is the highest amount that your insurance company will cover for the room you select during your hospital stay. By choosing a room within this limit, you can avoid any out-of-pocket expenses. However, if you opt for a room that exceeds your eligibility, a proportional deduction will be applied. In such cases, you will be responsible for paying a proportionate share of the total bill, rather than just the difference in room rent. With the Niva Bupa Health Companion (Variant 2022), you can enjoy the freedom to choose the room that suits your preferences. Whether you prefer a shared room, single room, suite, or any other available option, there are no restrictions holding you back.
Noteworthy Niva Bupa (Previously Known As Max Bupa) Health Companion Plan Features You Should Be Aware Of
Health Checkup From 1st Day
With Niva Bupa Health Companion (Variant 2022), you can benefit from an annual health checkup right from the beginning of your policy. You can conveniently select tests from a predefined list within the limits specified in your policy document. To make the process even easier, Niva Bupa provides a user-friendly mobile app and other digital assets for booking your tests. This coverage is subject to policy T&Cs.
- Vaccination for Animal Bite:
The Niva Bupa Health Companion (Variant 2022) Plan covers costs related to vaccination after an animal bite, up to INR 5000/-. This valuable benefit is specifically designed to prioritise your health and safety, particularly if you are at risk of rabies or other infections. With this coverage in place, you can seek prompt medical attention without any concerns about the financial burden.
- No Financial Limits On Treatments/Diseases:
Under the Niva Bupa Health Companion (Variant 2022) Plan, there are no treatment or disease-wise sub-limits for procedures such as cataract treatments, joint replacement surgeries, and more.
Understanding Waiting Periods
After you purchase health insurance, certain illnesses and diseases will not be covered for a specific period of time. This period is referred to as the waiting period. However, once this waiting period ends, you can make claims for these conditions.
Here are some of the types of waiting periods -
- Initial Waiting Period
Once you purchase the policy, there will be a 30-day waiting period before you can make a claim for any treatment, except for accidents. During this period, you will not be able to make a claim for any treatment unless it is related to an accident.
- Waiting Period For Pre-Existing Diseases
A pre-existing disease refers to any illness or medical condition that you have had in the 48 months prior to applying for your health insurance. Under the Niva Bupa Health Companion (Variant 2022) there is a waiting period of 36 months for pre-existing conditions. It's important to note that during this period, the policy will not cover any expenses related to these conditions.
- Waiting Period For Specific Diseases
Insurance companies can impose a waiting period for certain diseases or medical conditions, even if you haven't experienced them previously. This waiting period is determined by the insurer and is not influenced by your current health status. With the Niva Bupa Health Companion (Variant 2022) there is a waiting period of 24 months for specific diseases.
What Is Not Covered Under The Niva Bupa (Previously Known As Max Bupa) Health Companion Plan?
Exclusions are situations or conditions that your health insurance policy will not cover at any cost. Here are some of the types of exclusions you should be aware of:
- Standard Permanent Exclusions
IRDAI has established a set of 'standard permanent exclusions' that all insurance companies must adhere to. Some of them include -
- Obesity/weight control: Treatments or surgeries for weight control or obesity.
- Profession in hazardous or adventure sports: Expenses incurred from engaging in adventurous activities like mountaineering, surfing, paragliding, etc., as a professional.
- Excluded providers: Treatment from a medical practitioner or hospital excluded by the insurer.
- Investigation and evaluation: Hospital admission for observation or monitoring purposes.
- Rest cure, rehabilitation, and respite care: Admission to a facility for bed rest without any active treatment.
- Plastic/cosmetic surgery: Treatment or surgery that aims to alter your body characteristics or appearance.
- Narcotics: Treatments related to addictive conditions such as alcohol addiction, drug usage, etc.
- Breach of law: Expenses related to the treatment if you have committed or attempted to commit a breach of law with criminal intent.
- Change of gender treatment: Treatment that aims to change your body's characteristics to match those of the opposite sex.
- Dietary supplements, substances purchased without prescription: Vitamins, minerals, or other supplements that haven’t been prescribed by a medical practitioner.
- Unproven treatments: Surgeries, medical procedures, or treatments that have not been proven to be effective.
- Treatments in establishments arranged for domestic purposes: Treatment received at health spas, nursing homes, or similar establishments that were arranged completely or partially for domestic reasons.
- Maternity expenses: Pre/post-natal costs, expenses related to childbirth hospitalisation, and more.
- Refractive error: Expenses related to correcting refractive errors of up to 7.5 diopters to improve your eyesight.
- Expenses related to birth control, sterility, and infertility: Contraception methods, sterilisation procedures, artificial insemination techniques, advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc.
- Additional Permanent Exclusions
In addition to the standard permanent exclusions discussed earlier, insurance companies may also apply specific exclusions in your policy for certain situations or medical conditions. If you have certain diseases or severe medical conditions that insurers consider high-risk to cover, they may choose to permanently exclude them from your policy. It's worth noting that in India, insurers are only allowed to apply permanent exclusions to a specified list of illnesses provided by the IRDAI.
- Non-Standard Exclusions (Specific Exclusions)
Niva Bupa Health Companion (Variant 2022) Plan has specific exclusions that go beyond the standard exclusions set by the IRDAI. It's worth noting that these exclusions may differ among insurance providers and are contingent upon the policy's terms and conditions.
Let's take a look at some of the specific exclusions under the Niva Bupa Health Companion (Variant 2022):
- Circumcision, unless it is necessary for the treatment of a disease or required due to an accident.
- Treatment for any injury or illness that is directly or indirectly caused by nuclear or radiological emissions, war or war-like situations (regardless of whether war is officially declared), rebellion (an armed resistance against an established government or leader), or acts of terrorism.
- Screening, counselling, or treatment related to external congenital anomalies.
- Treatment, procedures, and preventive, diagnostic, restorative, cosmetic services that are related to diseases, disorders, and conditions of natural teeth and gums, except if these are necessary while you are hospitalised due to an accident.
- Medical and ambulatory devices used at home, such as BP monitors, Sugar monitors, automation devices for peritoneal dialysis, CPAP machines, BiPAP machines, crutches, wheelchairs, etc.
- Any treatment for self-injury inflicted deliberately or attempted suicide carried out by any means.
- Artificial life maintenance for an insured person who has been declared brain dead or in a vegetative state.
A Quick Recap Of The Benefits & Limits
Covered for 60 days up to the sum insured
Covered for 180 days up to the sum insured
Daycare Treatment Coverage
All daycare treatments up to the sum insured
Domiciliary Treatment Coverage
Up to the sum insured
Organ Donor Coverage
Inpatient expenses for harvesting the organ from the donor up to the sum insured
Up to the sum insured if you opt for an add-on
Modern Treatment Coverage
Up to the sum insured with a sub-limit of Rs 1 lakh per claim for some robotic surgeries as stated in the policy document.
Room Rent Limit
No Claim Bonus
20% increase in sum insured every year, subject to a maximum of 100% of the sum insured.
Available for subsequent claims once per policy year for both related and unrelated illnesses
Covered after a 36-month waiting period.
Covered after a 24-month waiting period.
The OG Reading Material for Your Reference
- What is the maximum cover you can opt for under the Niva Bupa Health Companion (Variant 2022) Plan?
With the Niva Bupa Health Companion (Variant 2022) Plan, you can enjoy comprehensive health coverage up to a maximum of INR 1 Crore.
- Are health checkup costs covered under the Niva Bupa Health Companion (Variant 2022) Plan?
With this plan, you'll be covered for the expenses related to your annual health checkups right from the day you purchase the policy.
- Does the Niva Bupa Health Companion (Variant 2022) Plan provide maternity benefits?
The Niva Bupa Health Companion (Variant 2022) does not provide coverage for maternity-related expenses.
- Does the Niva Bupa Health Companion (Variant 2022) Plan have any restrictions on room rent?
With the Niva Bupa Health Companion (Variant 2022) Plan, you have the flexibility to choose any room type available in the hospital. Whether it's a Single Private Room, Share Room, Deluxe Room, or any other room option, you have the freedom to select the one that suits your preferences.
- Does the Niva Bupa Health Companion (Variant 2022) Plan provide coverage for consumables?
Yes. Health Companion (Variant 2022) Plan covers all consumables, such as gloves, syringes, masks, cotton, etc., if you opt for an add-on.