Max Bupa Health Insurance Company

Max Bupa is a standalone health insurance company which is formed as a joint venture between two reputed companies – Max India Limited and Bupa. While Max India Limited is an Indian company, Bupa is a UK based expert in providing healthcare services with an experience of more than 60 years. Bupa is a multinational company with a presence across 190 countries and a customer base of more than 29 million individuals. Max India Limited, on the other hand, is an expert in both the insurance and health sector. Overall, both these promoters bring in value-addition to Max Bupa which is a reputed health insurance company in India.

Features and benefits of Max Health Insurance policies

Here are the salient features of health insurance plans offered by Max Bupa –

1. The company enjoys a high claim settlement ratio of 92%
2. It promises to settle your health insurance claims within 30 minutes
3. The company has an in-house claim settlement team thereby eliminating the need for TPAs (Third Party Administrators)
4. The company offers international coverage for critical illnesses through its hospital network in 190 countries
5. Max Bupa has been rated to be the ‘Most Trusted Health Insurance Brand’ for three consecutive years
6. The company allows cashless claim settlements across 4000+ hospitals in India

Coverage under Max Health Insurance plans

Common coverage benefits which are found in all Max Health Insurance plans are as follows –

What is not covered by Max Health Insurance plans?

While the exact exclusion list depends on the plan that you choose, here is a list of some of the most common exclusions which are found in Max Health Insurance plans –

1. Pre-existing illnesses are not covered during a specified waiting period. Coverage is allowed only when the waiting period is over
2. There is a waiting period for specific treatments and illnesses like hernia, piles, joint replacement surgeries, etc.
3. Illnesses within the first 30 to 90 days of buying the policy are not covered unless they are accidental in nature
4. Cosmetic treatments are not covered
5. HIV, AIDS and any other type of sexually transmitted or venereal diseases are not covered
6. Pregnancy and childbirth are not covered unless otherwise specified
7. Dental treatments are not covered under most plans
8. Illnesses or injuries due to war, rebellion, mutiny, civil unrest and nuclear perils are not covered

Optional coverage benefits

Max Health Insurance plans also offer optional coverage features, called riders, which can be taken for an enhanced scope of protection. These riders come at an additional premium. The available riders under different Max Health Insurance plans include the following –

Health insurance plans offered by Max Bupa 

Hospitalisation plans

Hospitalisation plans are indemnity oriented health insurance plans which cover the cost incurred on hospitalisation. The plans cover the actual costs incurred subject to a maximum of the chosen sum insured. Max Bupa offers a range of hospitalisation plans which are as follows –

1. Max Bupa Health Premia Insurance Plan

This is a comprehensive family floater plan which provides all the required coverage benefits. The salient features of the plan are as follows –

1. There are three plan variants – Silver, Gold and Platinum and the coverage benefits as well as the sum insured depends on the plan variant selected
2. Unlimited consultations can be availed from the company’s empanelled doctors online or over the phone
3. Maternity and newborn baby coverage is available worldwide 
4. In case you are diagnosed with a specific illness, the premiums would be waived for the next policy year
5. The sum insured increases by 10% every year irrespective of whether there have been claims or not
6. Coverage for HIV/AIDS is also available subject to certain terms and conditions
7. Treatments for mental disorders are covered
8. OPD expenses and treatments are covered under the higher variants of the plan
9. Coverage for robotics surgery and laser surgery is also available
10. The plan offers a range of riders, as mentioned earlier, depending on the plan variant selected

Plan parameters of Max Bupa Health Premia Insurance Plan

Entry age	Children – 90 days to 30 years Adults – 18 years to 65 years
Sum insured	INR 5 lakhs to INR 3 crores
Policy term	1,2 or 3 years

2. Max Bupa Health Companion Plan

This is also a comprehensive health insurance plan which you can buy on an individual or family floater basis. Moreover, there is a Family First option too under which up to 19 family relations can be covered under the single plan. The features of the plan are as follows –

1. 20% no claim bonus is allowed if you don’t make a claim in a policy year
2. The sum insured is refilled if it gets used up in a previous claim in the same policy year
3. Annual as well as bi-annual health check-ups are allowed free of cost
4. You can choose the optional hospital cash benefit rider and receive daily cash benefits per day of hospitalisation 
5. The premium discount is also available if you buy a two-year continuous policy and pay the premiums at once
6. There is no limit on the maximum entry age under the policy

Plan parameters of Max Bupa Health Companion Plan

Entry age	90 days onwards
Sum insured	INR 2 lakhs to INR 1 crores
Policy term	1 or 2 years

3. Max Bupa Go Active Health Insurance Plan

This is a simple health insurance plan which has low premiums so that the policy becomes affordable. The salient features of the plan are as follows –

1. Home health care services are offered under the plan which can include dialysis, physiotherapy, chemotherapy, post-surgical care, etc.
2. Free second medical opinion can be sought through the company’s medical experts
3. OPD consultations are also covered 
4. Psychiatric consultations can be availed under the scope of the cover
5. A range of optional riders are available under the plan which can be chosen as per your requirements
6. If you buy the plan before 35 years of age, you get a lifetime premium discount of 10%

Plan parameters of Max Bupa Go Active Health Insurance Plan

Entry age	Children – 91 days to 21 years Adults – 18 years to 65 years
Sum insured	INR 4 lakhs to INR 25 lakhs
Policy term	1 year

4. Max Bupa Heartbeat Health Insurance Plan

This is one of the most popular health insurance plans offered by Max Bupa which allows quite a comprehensive scope of coverage. The plan has the following salient features –

1. There are two plan options of Gold and Platinum 
2. There is no sub-limit on room rent
3. Maternity costs are covered under the plan
4. You can insure up to 19 family members under the same plan
5. 10% increase in sum insured is allowed as no claim bonus
6. A daily cash benefit is paid in case of hospitalisation

Plan parameters of Max Bupa Heartbeat Health Insurance Plan

Entry age	The plan allows entry at all ages
Sum insured	INR 5 lakhs to INR 50 lakhs
Policy term	1, or 2 years

5. Max Bupa Health Recharge Plan

This is an indemnity health plan which covers the actual costs of hospitalisation. You also get the option to enhance the scope of the plan by adding optional coverage benefits –

1. Free e-consultations are allowed under the plan
2. There are four optional covers under the plan which can be chosen at additional premiums
3. You can buy medicines and diagnostic tests through the company’s application right from your Smartphone
4. Premium discounts can be enjoyed by opting for long term coverage

Plan parameters of Max Bupa Health Recharge Plan

Entry age	Children – 91 days to 25 years Adults – 18 years to 65 years
Sum insured	INR 2 lakhs to INR 25 lakhs
Policy term	1,2 or 3 years

6. Max Bupa Health Plus Plan

The plan allows you an all-inclusive scope of coverage at very affordable premiums. The salient features of the plan are as follows –

1. Free annual health check-ups are allowed from the second policy year itself
2. The sum insured can be refilled if it is exhausted
3. You can double your sum insured through a 10% increase through no claim bonus
4. Coverage is allowed for treating HIV/AIDS infections as well as mental disorders

Plan parameters of Max Bupa Health Plus Plan

Entry age	Children – 91 days to 25 years Adults – 18 years to 65 years
Sum insured	INR 3 lakhs to INR 25 lakhs
Policy term	1,2 or 3 years

7. Max Bupa Money Saver Health Insurance Plan

This is a combination of two health plans namely Health Companion and Health Recharge. The plan, therefore, gives you dual benefits of these plans at very affordable premium rates. The features of the plan are as follows –

1. Sum insured refill feature is available under the plan
2. The plan can be bought at any age under the Health Companion plan
3. The coverage features of both Health Companion and Health Recharge are available under a single plan
4. Coverage is allowed for vaccination costs in case of animal bites
5. There are different types of optional riders which can be selected with the plan

Plan parameters of Max Bupa Money Saver Health Insurance Plan

Entry age	Children – 91 days to 25 years Adults – 18 years to 65 years
Sum insured	Health Companion – INR 5 lakhs Health Recharge – INR 10,15 or 25 lakhs
Policy term	1 or 2 years

Fixed benefit health plans

Fixed benefit health insurance plans are those which pay a fixed amount of benefit in case of a claim irrespective of the actual medical costs that you suffer. Critical illness plans, hospital cash plans, etc. are some types of fixed benefit health insurance plans. Max Health Insurance offers a flexible critical illness plan called Criticare which is a fixed benefit health plan. Here’s the details of the plan –

1. Max Bupa Criticare Plan

Criticare is a unique health plan which offers you different types of coverage options and you can choose from any option as per your suitability. The plan’s salient features are as follows –

1. You can choose from six coverage options all of which give you fixed benefit claims. The options are as follows-
1. Criticare + Accident Care + Hospi Cash
2. Criticare + Accident Care
3. Criticare + Hospi Cash
4. Accident Care + Hospi Cash
5. Criticare only
6. Accident Care only
2. Criticare covers 20 critical illnesses and pays the sum insured if you are diagnosed with any of the covered illnesses
3. Accident care covers accidental deaths and disablements
4. Hospi Cash is a daily hospital cash benefit cover wherein you get a daily cash allowance if you are hospitalised for 24 hours or more
5. Lifelong renewability is available in all coverage benefits
6. Optional benefits are also available under Accident Care coverage

Plan parameters of Max Bupa Criticare Plan

Entry age	Children – 2 years to 21 years Adults – 18 years to 65 years
Sum insured	Criticare – INR 3 lakhs to INR 2 crores Hospi Cash – INR 1000 to INR 4000/day Accident Care – INR 5 lakhs to INR 5 crores
Policy term	1, 2 or 3 years

Personal accident plans

Personal accident plans are those which cover accidental deaths and disablements. These plans are also fixed benefit plans which pay a lump sum benefit if you die or become disabled in an accident. Max Bupa offers one personal accident plan which is described below –

1. Max Bupa Accident Care Plan

This personal accident plan covers a host of benefits along with death and disability so that you can enjoy a comprehensive scope of coverage. The plan’s salient features are as follows –

1. In case of accidental death and permanent disability, the plan also pays a lump sum benefit towards your child’s education. This is called Child Education Benefit
2. Funeral expenses are also covered under the plan in case of accidental deaths
3. Temporary total disability coverage can be availed by paying an additional premium. This coverage pays a portion of the sum insured weekly in case of temporary disablements
4. Accidental hospitalisation cover can also be chosen at an additional premium. This cover would pay the costs incurred on accidental hospitalisation 
5. Coverage under the plan is allowed not only in India but throughout the world

Plan parameters of Max Bupa Accident Care Plan 

Entry age	Children – 2 years to 21 years Adults – 18 years to 65 years
Sum insured	INR 5 lakhs to INR 5 crores
Policy term	1, 2 or 3 years

How to buy Max Health Insurance Plans?

Max Health Insurance policies can be bought online through the company’s website or Turtlemint. The benefits of buying the plan through Turtlemint are as follows –

1. You can compare the available health insurance plans and then choose the policy with the best coverage benefits and the lowest premium rates
2. You get personalised assistance from Turtlemint’s team of experts if you have any doubts or queries when buying any health insurance plan
3. The buying process is simple and quick. You can easily and instantly buy the best health insurance policy through Turtlemint through a click of some buttons
4. Turtlemint also helps you with your health insurance claims making the process hassle-free for you

To buy online through Turtlemint, here are the steps which you should take –

1. Visit https://www.turtlemint.com/health-insurance and choose ‘Buy new Policy’. If you have an existing health insurance policy and you want to switch to Max Health Insurance, choose, ‘Change insurer’
2.  In the next page, you would have to provide your details so that the most suitable plan can be found. You have to enter your gender, age, members to be insured, their age, whether or not you are planning a child, history of existing illnesses, PIN code, income level and your contact details
3. Once the details are entered, you get a list of the available health insurance plans which are recommended for you
4. You can choose the sum insured, policy tenure and also optional coverage benefits that you like
5. Compare the available plans and then choose the one which is the best and also the most suitable
6. After the plan has been selected, fill up the online health insurance proposal form
7. The premium should also be paid online
8. Once the form is filled and submitted and the premium is paid, the policy would be issued within the shortest possible time

How to renew Max Health Insurance policies?

Renewing an existing Max health insurance plan is also simple as renewals can be done online. You can renew by visiting the company’s website https://www.maxbupa.com/. On the home page, there is an option to ‘Renew’. You can click the option whereupon you would be taken to a new page. On the page, you would have to enter your existing health insurance policy number and your date of birth. Once the details are submitted you will be shown your existing plan. You can make changes to your plan in the form of increasing the sum insured or choosing add-ons. Then you would have to pay the renewal premium online and the policy would be renewed.

Renewal of your Max health insurance policy can also be done through Turtlemint. Turtlemint allows you an easy online process to renew your existing plan. To renew, visit Turtlemint’s home page www.turtlemint.com and log into your account. Once you log into your account you can see the Max health insurance plan that you had bought. You can then renew the plan from your account by paying the renewal premium online.

Claims under Max health insurance plans

When it comes to claims under your Max health insurance policy, there are two ways of getting your claims settled. These ways are as follows –

1. Cashless claim settlement wherein the insurance company directly settle your medical bills with the hospital 
2. Reimbursement claim settlement wherein you pay your medical bills yourself and later the insurance company reimburses you for the medical expenses that you have incurred.

The processes for both these claims are different. Here are the different claim processes for Max health insurance plans – 

Cashless claim settlement process –

1. Choose a networked hospital for treatment of your illness or injury. The list of hospitals can be found on the company’s website
2. At the time of admission, the Health Card should be produced. If you don’t have the Health Card handy, you can provide your health insurance policy number and a photo identity proof
3. After your identity is verified by the hospital, the pre-authorization form would be sent by the hospital to the insurance company
4. Max Bupa would verify the form and confirm the approval for cashless claims. The approval would be sent to the hospital as well as to you, the policyholder 
5. Once the claim is approved, you can take treatments in the hospital and the insurance company would pay the hospital bills itself

Reimbursement claim process

1. Reimbursement claims occur when you take treatments at a non-networked hospital. In such cases, you should inform Max Bupa within 48 hours of your hospitalisation
2. You should, then, pay all the relevant medical bills which incur on your hospitalisation and treatment
3. When you are being discharged from the hospital, collect all the relevant medical bills and reports for making a claim. The Discharge Certificate should also be collected from the hospital
4. You should then fill up a claim form and send the form with all the medical reports, bills and Discharge Certificate which you collected from the hospital. You should also send your valid identity proof and age proof
5. When the insurance company receives the documents, your claim would be verified and authenticated
6. Thereafter, the insurance company would reimburse you for the medical costs that you incurred

Max Bupa Hospital Network

Max Bupa is tied up with more than 4500 hospitals across India for cashless claim settlements. To find out the list of cashless hospitals in your area, you can check the list on the company’s website. Here’s the process – 

1. Visit https://www.maxbupa.com/ and on the home page choose ‘Hospital Network’
2. Enter your State and city and the list of cashless hospitals would be displayed
3. You can check the hospitals and even search for your preferred hospital
4. You can then see which hospitals allow cashless facilities and seek treatments in those hospitals so that you get cashless claim benefits

Documents required for making health insurance claims

In either of the above-mentioned claim processes, the following documents would be required for claim settlements –

1. The claim form, duly filled and signed. You can get a claim form from the company’s website 
2. Medical reports
3. Doctor’s prescriptions diagnosing your illness and prescribing hospitalisation 
4. All the medical bills in original
5. Discharge Certificate 
6. Police FIR in case of accidental claims
7. Policy bond
8. Any other documents which the insurance company might require for settling your claims

Rather than remembering the claim process for Max health insurance policies, you can also choose an easier alternative and make your claims through Turtlemint. Turtlemint has an in-house claim settlement department which handles your claims and coordinates with the insurance company to get the settlement of your claims faster. You would just have to inform Turtlemint and Turtlemint would get the work done. To inform, call the company’s toll-free number which is 1800 266 0101 or send an email to the company’s claim department at claims@turtlemint.com. Once informed, Turtlemint would coordinate with Max Bupa and follow the necessary steps to get your claims settled at the earliest.