Max Bupa Heartbeat Health Insurance, Max Bupa Heartbeat Medical Insurance, Max Bupa Heartbeat Mediclaim Insurance

Unique features
Individual & Family Floater
Family First
Exclusions
Claims procedure

Medical treatment abroad for 9 selected diseases (platinum plan only)
Buy policy for 2 years and get 12.5% discount on 2nd year premium
All day care procedures covered after 90 days (only in Max Bupa)
All life threatning medical situations and accidents are covered from day one.
Maternity up to Rs. 1Lac and new born baby coverage from day one.
Direct claim settlement, no third party involved.
Cashless hospitalization across network of quality hospitals.
Free health checkups on renewal.

Option for Individual+Spouse+Child1+Child2
Cashless hospitalization in 3500+ network hospitals
All life threatning medical situations and accidents are covered from day one.(only in Max Bupa)
All day care procedures covered after 90 days (only in Max Bupa)
Get insurance cover up to 1 Crore
Get 10% additional sum insured upon renewal or earn points worth 10% for your last paid premium upon renewal
No medical test required upto the age 60
Assured policy renewal for life
Complimentary health check up on renewal (as per plan choosen)
Get maternity cover, new born baby cover from day1, vaccinations cover (as per plan choosen)
OPD consultations and diagnostic tests are covered (platinum plan only)
Two years plan option. Get discount on 2^nd year premium
Emergency medical evacuation and hospitalization abroad (platinum plan only)
Tax benefit under section 80D
No age restriction for enrolment
Medical treatment abroad for 9 specified illnesses like Cancer,Heart Attack (Myocardial Infarction), Coronary Artery Bypass Graft (CABG), Major Organ Transplant, Stroke, Surgery of Aorta, Coronary Angioplasty, Primary Pulmonary Arterial Hypertension, Brain Surgery

Individual Health Insurance Plan Family Floater Health Insurance

Benefits	Silver Policy	Gold Policy	Platinum Policy
	2, 3 Lacs	5, 7.5, 10, 15, 20 & 50 Lacs	15, 20, 50 Lacs & 1cr In-patient treatment
In-patient treatment
Medical Practitioner's fees	Covered up to Sum Insured	Covered up to Sum Insured	Covered up to Sum Insured
Diagnostic procedures
Medicines, drugs and consumables
Intravenous fluids, blood transfusion, injection administration charges
Operation Theatre charges
The cost of prosthetics and other devices or equipment if implanted internally during a Surical Operation
Intensive Care Unit Charges
Hospital accomodation	Shared room or 1% of the Base Sum Insured	Single Private Room	Covered up to Sum Insured
Pre and Post hosptitalization expenses including doctor's consulation, diagnostics tests, intravenous fluid, blood transfusion, medicines, drugs and consumables	Covered up to 15% of Base Sum Insured	Covered up to 20% of Base Sum Insured	Covered up to Sum Insured
All day-care treatment	Covered up to Sum Insured	Covered up to Sum Insured	Covered up to Sum Insured
OPD benefits
Outpatient benefits covering specialist consultation and costs of diagnostics tests prescribed by them	Not available		For 15 Lacs - Up to Rs 10,000 For 20 Lacs - Up to Rs 15,000 For 50 Lacs - Up to Rs 20,000 For 1 cr - Up to Rs 40,000
Child Care benefits
Maternity cover for up to 2 deliveries	For 2 Lacs - Up to Rs 20,000 For 3 Lacs - Up to Rs 30,000	For 5 Lacs - Up to Rs 40,000 For 7.5 Lacs - Up to Rs 45,000 For 10 Lacs - Up to Rs 50,000 For 15 Lacs - Up to Rs 55,000 For 20 Lacs - Up to Rs 65,000 For 50 Lacs - Up to Rs 80,000	For 15 Lacs - Up to Rs 60,000 For 20 Lacs - Up to Rs 75,000 For 50 Lacs - Up to Rs 100,000 For 1 cr - Up to Rs 150,000
New Born Baby Cover uptill the end of current Policy Year	Covered up to Sum Insured	Covered up to Sum Insured	Covered up to Sum Insured
Vaccinations for children up to 12 years and nutrition and diet consulting	Not available		Covered up to Sum Insured
Further benefits
Health check up at the time of renewal	Once in 2 years	Annual	Annual tests
Organ transplant when medically necessary	Covered up to Sum Insured	Covered up to Sum Insured	Covered up to Sum Insured
Emergency ambulance	Covered at actual cost in Network Hospitals up to Sum Insured	Covered at actual cost in Network Hospitals up to Sum Insured	Covered at actual cost in Network Hospitals up to Sum Insured
Domicialiary Hospitalisation	For 2 Lacs - Up to Rs 10,000 For 3 Lacs - Up to Rs 15,000	For 5 Lacs - Up to Rs 25,000 For 7.5 Lacs - Up to Rs 37,5000 For 10 Lacs - Up to Rs 50,000 For 15 Lacs - Up to Rs 60,000 For 20 Lacs - Up to Rs 80,000 For 50 Lacs - Up to Rs 200,000	For 15 Lacs - Up to Rs 75,000 For 20 Lacs - Up to Rs 100,000 For 50 Lacs - Up to Rs 250,000 For 1 cr - Up to Rs 400,000
Health Relationship Loyalty Program	10% equivalent redeemable points of the Last Paid Annual Premium OR Additional 10% Sum Insured of expiring Base sum insured upto a maximum of 50% of base Sum Insured
International Medical treatment & assistance
Worldwide excluding USA and Canada
Emergency Medical Evacuation and Hospitalization outside India	Not available		For 15 Lacs - Up to Rs 150,000 For 20 Lacs - Up to Rs 200,000 For 50 Lacs - Up to Rs 500,000 For 1 cr - Up to Rs 1,000,000
Specified Illness Cover for treatment abroad	Not available		Covered up to Sum Insured Worldwide excluding USA and Canada
Optional benefit/feature
Annual aggregate Deductible	1 lac/2 lacs/3 lacs	Not available
Co-payment for insured less than 65 yr old	Options of 10% and 20% co-payment	Options of 10% and 20% co-payment	Options of 10% and 20% co-payment

Notes:
* Emergency ambulance - Maximum of Rs.2000/-per event for out-of-network.

Key features

Family First plan has been designed keeping in mind the health insurance requirements of joint families. It allows you not just to cover your spouse and kids but each and every member of your family.

You can cover up to 14 relationships in your family. ( E.g. Your parents, in-laws, spouse, kids etc )

Option of buying the plan for 2 years thus saving 12.5% premium on the second year.

Treatment for selected 9 diseases, emergency evacuation and hospitalization outside India for platinum plan.

The Plan provides flexibility to families so that they can decide their optimal cover. The sum Insured may be chosen in the following two ways :

1. Individual Sum Insured: An individual insurance cover for each insured person up to Rs.15 Lac. The individual sum insured is same for all family members.

2. Floater Sum Insured: A floating insurance cover that is available to all family members up to Rs.50 Lac and can be used once the individual sum insured is exhausted. This provides flexibility for familes to decide their optimal cover.

Benefit table

Benefits	Silver Policy	Gold Policy	Platinum Policy
	Individual Base Sum Insured : 1, 2, 3, 4 & 5 Lacs per Insured Person Floater Base Sum Insured : 3, 4, 5, 10 & 50 Lacs	Individual Base Sum Insured : 1, 2, 3, 4, 5, 10 & 15 Lacs per Insured Person Floater Base Sum Insured : 3, 4, 5, 10, 15, 20, 30 & 50 Lacs	Individual Base Sum Insured : 5, 10 & 15 Lacs per Insured Person Floater Base Sum Insured : 15, 20, 30 & 50 Lacs
In-patient treatment
Medical Practitioner's fees	Covered up to Sum Insured	Covered up to Sum Insured	Covered up to Sum Insured
Diagnostic procedures
Medicines, drugs and consumables
Intravenous fluids, blood transfusion, injection administration charges
Operation Theatre charges
The cost of prosthetics and other devices or equipment if implanted internally during a Surical Operation
Intensive Care Unit Charges
Hospital accomodation	Rs. 3,000 or Shared room	Single Private Room	Covered up to Sum Insured
Pre and Post hosptitalization expenses including doctor's consulation, diagnostics tests, intravenous fluid, blood transfusion, medicines, drugs and consumables	Covered up to 15% of Base Sum Insured	Covered up to 20% of Base Sum Insured	Covered up to Sum Insured
All day-care treatment	Covered up to Sum Insured	Covered up to Sum Insured	Covered up to Sum Insured
OPD benefits
Outpatient benefits covering specialist consultation and costs of diagnostics tests prescribed by them	Not available		Covered up to Rs 30,000 per Policy Year
Child Care benefits
Maternity cover for up to 2 deliveries	Covered up to Rs 25,000 per Policy Year	Covered up to Rs 50,000 per Policy Year	Covered up to Rs 100,000 per Policy Year
New Born Baby Cover uptill the end of current Policy Year	Covered up to Sum Insured	Covered up to Sum Insured	Covered up to Sum Insured
Vaccinations for children up to 12 years and nutrition and diet consulting	Not available		Covered up to Sum Insured
Further benefits
Health check up at the time of renewal	Once in 2 years	Annual	Annual tests
Organ transplant when medically necessary	Covered up to Sum Insured	Covered up to Sum Insured	Covered up to Sum Insured
Emergency ambulance	Covered at actual cost in Network Hospitals up to Sum Insured	Covered at actual cost in Network Hospitals up to Sum Insured	Covered at actual cost in Network Hospitals up to Sum Insured
Domicialiary Hospitalisation	Covered up to Rs 15,000	Covered up to Rs 37,500	Covered up to Rs 250,000
Health Relationship Loyalty Program	10% equivalent redeemable points of the Last Paid Annual Premium OR Additional 10% Sum Insured of expiring Base sum insured upto a maximum of 50% of base Sum Insured
International Medical treatment & assistance
Worldwide excluding USA and Canada
Emergency Medical Evacuation and Hospitalization outside India	Not available		Covered upto Rs 200,000 for Individual Base Sum Insured of 5 lac, Rs 3,00,000 for Individual Base Sum Insured of 10 lac and upto Rs 5,00,000 for individual Base Sum Insured of 15 lacs
Specified Illness Cover for treatment abroad	Not available		Covered up to Sum Insured Worldwide excluding USA and Canada
Optional benefit/feature
Annual aggregate Deductible	Not available
Co-payment for insured less than 65 yr old	Options of 10% and 20% co-payment	Options of 10% and 20% co-payment	Options of 10% and 20% co-payment

Notes:
* Emergency ambulance - Maximum of Rs.2000/-per event for out-of-network.

Other than accidental injury/emergency, all other treatments are not covered during the first 90 days. For persons above 60 years of age some conditions will be subject to a waiting period of 24 months and will be covered after two years of continuous renewal.

Pre-existing conditions are covered after a waiting period of 4 or 1 years.(based on plan)
Coverage for expenses occurring from treatment of HIV or AIDS and related diseases.
Treatments for congenital diseases, mental disorder or insanity, cosmetic surgery and weight control.
Coverage for Non Allopathic treatments.
Coverage for expenses arising from abuse of intoxicant or hallucinogenic substances like alcohol and drugs.
Hospitalization due to events like war, damage caused from nuclear, chemical or biological weapons and any kind of harmful radiations.
Items of personal comfort and convenience.

Co-pay: There is a co-pay of 20% for senior citizens entering into the policy for 4 years which reduces by 5% upon each renewal. for example if a person buy the Maxbupa heartheat policy at the age of 65 years. Then he bears coppay of 20% at age 65, 15% at age 66, 10% at age 67, 5% at age 68 and during the next renewal when he is 69 years he has no copay.

Experimental, investigative and unproven treatment devices, psychiatric and psychosomatic conditions, reproductive medicine - birth control & assisted reproduction, self-inflicted injuries, sexual problems and gender issues, sexually transmitted diseases, sleep disorders, speech disorders, treatment for developmental problems, treatment received outside India, unlawful activity, unrecognised physician or hospital

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