Your health deserves nothing less.

PLATINUM
VARIANT BROCHURE
Your health deserves nothing less.
 Max Bupa
Max Bupa Health Insurance Company Ltd. came into
being in 2010 through the formalisation of a joint
venture between Max India Limited, a multi-business
corporate and UK’S 70-year-old healthcare giant Bupa.
Max Bupa is a venture that combines the rich legacy
of Max India, a specialist in life insurance and healthcare
sector, and Bupa, a renowned name in health and care
industry across 190 countries.
At Max Bupa, our mission is to help our customers live
healthier, more successful lives by providing expertise
as healthcare partners. And this, we realise is only
possible by constantly raising the standard of health
insurance by keeping our promises to you, our
customer, and caring for you, for life.
 Presenting HEALTH PREMIA PLATINUM PLAN
A comprehensive health insurance plan,
‘Health Premia’ provides the perfect coverage
for you and your family according to your
needs and lifestyle. So, whether it’s going in
for newborn child benefits or emergency
medical treatments abroad, Health Premia
ensures that you get the best in healthcare.
After all, your health deserves nothing less.

Maternity (worldwide) New age treatment coverage - Cyber International coverage for
Comprehensive specified illness and
and newborn baby knife/Robotics surgery, Laser surgery
coverage up to ` 3cr medical emergencies
cover cover, Weight loss (Bariatric) surgery

In-built travel insurance Annual health

Refill benefit for any Loyalty Additions of 10% in
coverage for multiple check-up of your
illness in a policy year sum insured per year
trips in a year choice from day 1
Health Premia is thoughtfully designed keeping you in mind,
so that your focus is on getting healthy, while we take care
of the rest.
Higher Coverage Options In-patient Care
Every individual is different and so are their Getting a medical treatment done can have its share
requirements. Hence, we provide multiple sum of uncertainty, especially when it comes to money.
insured options, up to INR 3 Cr, to give you flexibility So, we make sure we cover all your expenses upon
to choose the coverage that suits your requirements. hospitalisation like room rent, doctor consultations,
medicine expenses, day care treatment. In-patient
treatments taken under Ayurveda, Unani, Siddha and
Homeopathy are also covered.
Worldwide Maternity Benefit Cover
Welcoming a newborn into the family is a moment
that one treasures for life. And just like you take Day Care Treatments
care of your little one, we partner with you by Some treatments require hospitalisation but do
providing you maternity benefit worldwide post not require for you to stay overnight in hospital such
serving a waiting period#. In addition to this, your as dialysis, angiography, endoscopy among other
newly born gets covered under New Born Baby procedures$$. Our comprehensive policy provides
benefit# from the very first day, which includes coverage for such treatments.
defined vaccinations. (Not available under
individual plan).
Pre and Post Hospitalisation
Pre and post hospitalisation expenses are covered up
to the sum insured, 90 days prior and 180 days post
hospitalisation.

Keeping your lifestyle in mind, we have created a plan that covers new age
treatments to cater to all your needs.

01 Weight Loss (Bariatric) Surgery

Our sedentary lifestyle has led to obesity becoming a disease that plagues millions of people worldwide. Realizing this, we cover
your expenses for medically prescribed Bariatric surgery post serving a waiting period#, considering your BMI is over 35.

02 Laser Surgery Cover and Cyber Knife/Robotics surgery

Use of new age technology is now a part of many major medical practises. Which is why, we cover expenses incurred, post serving
a waiting period#, while undergoing a laser assisted surgery, or procedures using cyber knife and robotic surgeries with a specified
co-payment.

03 Living Organ Donor Transplant

In case of an organ transplant, medical expenses for the organ donor’s in-patient treatment for the harvesting of the organ donated
are covered by us.
International Coverage and In-built Travel Insurance.
Sometimes, there are certain planned procedures that you or your loved ones need to undergo. In such cases, you can avail
cashless treatments (post diagnosis in India) anywhere outside India. Our plan covers 9 specific illnesses under this facility:
Cancer, Myocardial Infarction (Heart Attack), Coronary Artery Bypass Graft, Major Organ Transplant, Stroke, Surgery of Aorta,
Coronary Angioplasty, Brain Surgery and Primary Pulmonary Arterial Hypertension.

There are times when you travel abroad, and an unplanned need for medical care arises. Health Premia comes with an inbuilt
travel insurance of INR 1 Cr per member that covers emergency hospitalisation, emergency medical evacuation, OPD cover,
compassionate visit, care and/or transportation of minor children, medical referral and medical repatriation in foreign countries.
We also give coverage for loss of passport, loss of checked-in baggage, return of mortal remains, trip cancellation & interruption,
trip delay and delay of checked-in baggage.

We’ve got you covered, even outside hospital.

We understand that not all treatments require hospitalisation. Which is why, we offer coverage to you even outside hospital by taking care of
health check-ups from day 1, pharmacy & diagnostic services, domiciliary treatment coverage as prescribed by a medical practitioner and
e-consultations. You even get coverage for emergency assistance services and ambulance costs, so that at no moment you ever feel that
healthcare is far away.
Good health comes with great benefits.
01 Tax Saving* 05 Tenure Discount
Income tax* benefit upto INR 42,744 under the Section 80D. If you pay for 2 year policy term, you get a discount of 7.5%
on the premium of second policy year. On the other hand, if
02 Zonal Coverage you choose 3 year policy term, you get an additional
India being a vast country, the cost of healthcare varies across discount of 15% on the third year’s premium.
cities. If you would like the flexibility of getting treated
anywhere in India, then, you can opt for Zone 1 pricing.
But if you live in a city other than Mumbai (including Navi
06 Premium Waiver
If an insured policy holder passes away or is diagnosed with
Mumbai and Thane), Delhi NCR, Kolkata & Gujarat you can avail
a specified illness during the policy period, then the
of a lower premium by opting for Zone 2 pricing, all you need
premium for next year will be waived off. (Not available
to do is to bear 20% co-payment in the aforementioned cities.
under individual plan).
03 Re-fill Benefit
When the same or different illness strikes in the same policy year, 07 Loyalty Additions
your base sum insured is re-filled and made available to you. For us, loyalty is a virtue. So, even if you've claimed in the

04 15 Day Free Look Period previous year, you get additional 10% of your base sum
insured annually, subject to a maximum of 100% of the base
You get the freedom to change your decision of continuing sum insured.
with the policy for a period of 15 days. For other cancellation
clauses, please refer to the policy document on our website.

We know that there is always room for more, which is why our care
comes with additional benefits you can opt for.
01 Personal Accident Cover 04 International Coverage Extension
In the most difficult times, we make sure we’re by your side. When you decide to travel abroad, we give you the option to
Through this optional cover, a lump sum payout is offered in case increase your international coverage sum insured from INR 1 Cr to
of accidental death, permanent total or partial disability. This INR 2 Cr to cover all your international travel needs. In case you
cover can be opted by any member of your family who is aged travel to USA/Canada, you can opt for enhanced geographical
18 years or above. coverage#.

02 Critical Illness Cover 05 Hospital Cash

For enhanced protection, an optional coverage against 20 major
We know that your journey of getting better is not yours
critical illnesses like Cancer, Open Heart surgery, Kidney Failure,
alone. There are loved ones who spend day and night by your
Strokes etc. is available. Upon first diagnosis of any of these
side at the hospital. Which is why, our plan provides
illnesses you get an additional coverage as a one time lump sum
additional payout to cover miscellaneous expenses that you
payout. This payment will be over and above your hospitalisation
may incur during hospitalisation.
expenses which are paid through the base policy. This cover can be
opted by any member of your family who is aged 18 years or above.
06 Health Coach
03 Enhanced Loyalty Addition To keep yourself healthy, you need a way to track your health
We make sure that your loyalty is rewarded, no matter what your parameters on a daily basis. With Max Bupa Health Coach App
claim history has been. You get an additional coverage of 20% of you get to track your calorie intake, calculate BMI and more. In
the expiring base sum insured every year as loyalty addition, sum, you get a virtual health guru to help you achieve your
subject to a maximum of 200% of the base sum insured. desired health goal.
One policy, no matter how big the family.
With Family First variant, you can get coverage for 19 relationships in a single policy.

Your family will be covered at the following two levels:

01 Individual Sum Insured 02 Floater Sum Insured
This cover provides an individual sum insured for each This cover is available as a pool for all family members and can
member of the family. The individual sum insured is the same be used by any member once his/her individual sum insured is
for each of the family members. exhausted.

FAMILY MEMBERS AGE BASE SUM INSURED (IN LACS)

FATHER 56 5

MOTHER 55 5

SON 30 5

DAUGHTER-IN LAW 25 5

BASE SUM INSURED FOR ALL INSURED

20 Lacs
PERSONS TAKEN TOGETHER

FAMILY FLOATER SUM INSURED 20 Lacs

SUM INSURED 40 Lacs

6 Simple steps to purchase any Max Bupa health insurance policy.

STEP STEP STEP STEP STEP STEP

Fill the application Read the offer

form. At this stage An offer is made
post evaluating your document carefully In case of any doubt,
please ensure you Undergo pre-policy and ask the sales
disclose details case and the reach out to us on
medical check-up, if premium may be representative for our customer Accept the offer.
correctly for all details on your policy
applicable at our loaded basis the helpline number or
members to ensure features, benefits,
smooth claims network centre. health disclosures of website.
all proposed exclusions and
processing when the
insured. waiting periods.
need arises.

Pro Tip - At the time of purchase, ensure you opt for the auto debit option to ensure timely and hassle-free renewals.
We believe in making things seamless and effortless for you. And that’s
why, we ensure all genuine claims are processed as fast as possible.
01 Direct Claims Settlement 04 Hassle-free Reimbursements
For quick claims processing we ensure all claims are Sometimes, you may not be able to access a network hospital
processed by our team of in-house doctors. for availing cashless facility. In such cases, to get your claim
reimbursed as fast as possible, all you need do is submit the

02 Wide Hospital Network requisite documents to us.

Avail cashless facility across India at 4500+ network hospitals. 05 Point of Care Desk (POC)
At our select partner hospitals, a Max Bupa representative is
03 30 Minute Cashless Claims Processing $ available to assist you through all the formalities like filling
forms, submitting claims etc. so that you are at ease in an
We process all cashless claims in 30 minutes so that you can
unfamiliar hospital environment.
be with your loved ones in their hour of need.
Visit our company website for a list of hospitals with
this facility.
Our smooth renewal process only requires you to say yes and
we will do the rest.
01 Life-long Renewal
We offer life-long renewal, regardless of your health status or previous claims made under your policy. Your renewal premium will
increase as your age increases but will not alter based on your claim experience. Renewal premium rates for the product may be
revised in future subject to IRDAI approval and in accordance with the IRDAI’s rules and regulations as applicable from time to time.

02 Sum Insured Enhancement

To protect yourself from rising medical expenses, you can enhance your sum insured or add more members of your family in your
existing policy at the time of renewal. We may reach out to you for additional information/medicals in case needed.

03 Loyalty Additions
On completion of each policy year, you get additional coverage i.e. 10% or 20% of base sum insured under this benefit subject to policy
terms & conditions.

04 Portability and Migration

You can port your policy at the time of renewal according to the IRDAI guidelines. Please reach out to us for any query regarding
migration and portability.

Waiting periods and exclusions under Health Premia:

01 Pre-existing Conditions 04 The following benefits will have a waiting period of 36 months
since inception of the Policy and subject to continuous
Benefits will not be available for pre-existing conditions as per
renewal: Weight loss (Bariatric) surgery | Mental disorder
your policy plan until 24 months of continuous coverage from
treatment | LASER surgery cover
first policy start date.

02 30 Days Initial Waiting Period 05 For HIV /AIDS cover, there will be a waiting period of 48
months since inception of the Policy and subject to
Treatment during the first 30 days of the plan will not be continuous renewal.
covered, unless the treatment needed is a result of an
accident. This waiting period does not apply for renewal 06 For Critical Illness cover, a 90 days initial waiting period along
with the Pre-existing Disease waiting period of 4 years and
policies.
Survival Period exclusion of 30 days will apply for all

03 Specific Waiting Periods conditions.

(The aforementioned waiting periods shall not apply to
Few conditions like cataract, hernia, internal congenital
e-Consultation, Health Check-up, Premium Waiver, Pharmacy
anomaly, spinal disorder, etc. will be subject to a waiting
and Diagnostic Services, Personal Accident Cover and Health
period of 12 months.
Coach)

Permanent Exclusions
Ancillary Hospital Charges | Hazardous Activities | Artificial life maintenance | Circumcision | AYUSH Treatments | Conflict & Disaster | External
Congenital Anomaly | Convalescence & Rehabilitation | Cosmetic or Plastic Surgery | Dental/oral treatment | Eyesight & Optical Services | Experimental
or Unproven Treatment | Hormone Replacement Therapy | Hospitalisation not justified | Inconsistent, Irrelevant or Incidental Diagnostic procedures |
Non-Medical Expenses | Obesity and Weight Control Programs | Reproductive medicine & other Maternity Expenses | Robotic Assisted Surgery,
Specialised Light Amplification by Stimulated Emission of Radiation (LASER) & Cyber Knife Treatments | Sexually Transmitted Infections & diseases |
Sleep Disorders | Substance Related and Addictive Disorders | Unlawful activity | Treatment received outside India | Unrecognised Physician or Hospital
| Generally Excluded Expenses | Refer to the policy document for detailed permanent, personal accident and critical illness cover exclusions.
PRODUCT BENEFIT TABLE - HEALTH PREMIA - PLATINUM VARIANT
Plan Platinum (Individual and Family Floater) Platinum (Family First)
Base Individual Sum Insured (per Insured Person): 10 Lacs, 11 Lacs, 12 Lacs, 13 Lacs, 14 Lacs & 15 Lacs
Base Sum Insured (in Rs) 1 Cr / 2 Cr / 3 Cr Floater Sum Insured (available on a floating basis over Base Individual Sum Insured): Number of Insured Persons (value to be considered as 10 for more than 6 members) * Base
Individual Sum Insured * Multiplier factor (1.5 for 2 member policy & 1 for others)
Benefits
In-patient care
Room rent
Pre-Hospitalisation Medical Expenses (90 days)
Post-Hospitalisation Medical Expenses (180 days)
Day Care Treatment
Domiciliary Hospitalisation
Alternative Treatment
Living Organ Donor Transplant
Child Care Benefits (Vaccinations for children up to 12 years including one consultation for nutrition and growth during the visit for vaccination) Covered up to Sum Insured
Specified Illness Cover (1) (outside the geographical boundaries of India for worldwide excluding USA & Canada)
Emergency assistance services (only within India)
- Medical referral
- Emergency medical evacuation (air ambulance)
- Medical repatriation
- Compassionate visit
- Care and/or transportation of minor children
- Return of mortal remains
New Born Baby (covered uptill the end of Policy Year) (2)
Vaccination of the new born baby Covered until new born baby completes one year, vaccinations as per pre-defined list
Emergency Ambulance Network Hospital: Covered up to Sum Insured Non-network Hospital: Covered up to Rs. 2,000 per event
HIV / AIDS (waiting period of 4 years) Covered up to Rs 50,000
Weight loss (Bariatric) surgery (waiting period of 3 years) Covered up to Rs 1,50,000
LASER surgery cover (waiting period of 3 years) Covered up to Rs 1,00,000
Cyber knife/ Robotics surgery Covered up to Sum Insured with a co-pay of 20%
Mental disorder treatment (waiting period of 3 years) Covered up to Sum Insured (sub-limit of Rs 1,00,000 applicable on few conditions)
Second Medical Opinion Covered worldwide, One opinion per Insured Person per Specified Illness / planned Surgery
Premium Waiver
Pharmacy and diagnostic services Available through our empanelled service provider
e-Consultation Unlimited tele / online consultations
International coverage (outside the geographical boundaries of India for worldwide excluding USA & Canada) Condition: Annual multi trip (Max 45 days coverage in a single trip); International Sum Insured: up to Rs. 1 cr per insured person
Emergency Hospitalisation
Emergency Medical Evacuation
Compassionate Visit
Care and/or transportation of Minor Children Covered up to International Sum Insured
Return of Mortal Remains
Medical Referral
Medical Repatriation
OPD Cover Covered up to International Sum Insured with a co-payment of 20%
Loss of Passport Covered up to Rs 20,000
Loss of Checked-in baggage Covered up to Rs 10,000
Trip Cancellation & Interruption Rs 25,000
Trip Delay Rs 10,000
Delay of Checked-in Baggage Rs 5,000
OPD Treatment and Diagnostic Services (3) Covered up to Rs 50,000 per policy Covered up to Rs 35,000 per policy
Health Check-up (from Day 1) Annual, tests covered up to worth Rs 10,000 per Insured Person Annual, tests covered up to worth Rs 5000 per Insured Person
Maternity Benefit (covered for up to 2 pregnancies or terminations) (2) Covered up to Rs 200,000 (worldwide excluding USA & Canada) Covered up to Rs 1,00,000 (worldwide excluding USA & Canada)
Loyalty Additions Increase of 10% of expiring Base Sum Insured in a Policy Year; maximum up to 100% of Base Sum Insured Increase of 10% of expiring Base Individual Sum Insured in a Policy Year; maximum up to 100% of Base Individual Sum Insured
Re-fill Benefit Not available
Optional Benefits
Personal Accident Cover (for insured aged 18 years & above on individual basis) 1 Cr
Critical illness cover (for insured 18 years & above on individual basis) 25 lacs / 50 lacs / 1 Cr
Enhanced Loyalty Addition Increase of 20% of expiring Base Sum Insured in a Policy Year; maximum up to 200% of Base Sum Insured Increase of 20% of expiring Base Individual Sum Insured in a Policy Year; maximum up to 200% of Base Individual Sum Insured
International Coverage Extension (outside the geographical boundaries of India for worldwide excluding USA & Canada) Double Sum Insured for ‘international coverage’ benefit
Hospital Cash (4) Rs 7,500/day Rs 6,000/day
Enhanced Geographical Scope for International Coverage USA & Canada included for Maternity Benefit, Specified Illness and International coverage
Health Coach Personalised health coaching for insured aged 18 years & above for any 90 days per Policy Year
(1)
The symptoms of the Specified Illness first occur or manifest itself during the Policy Period and after completion of the 90 day from the inception of 1st Policy with us.
(2)
Subject to a continuous coverage of 24 months of that Insured Person since the inception of the first Policy which offers Maternity benefit with us.
(3)
80% of the untilized amount in a policy year gets carried forward to next year; provided the total amount shall not exceed 2.5 times of the benefit limit.
(4)
Hospital Cash - Minimum 48 hrs of continuous hospitalisation required. Maximum coverage offered for 30 days/policy year/insured person. Payment made from day one subject to hospitalisation claim being admissible.
Your health deserves nothing less.

GOLD & SILVER

VARIANT BROCHURE
 Your health deserves
nothing less.

Maternity and newborn

Health check-up
baby cover# (not
from day 1 In- built travel Insurance
available under
individual plan)

Loyalty Additions of 30 mins cashless

Refill benefit for any
10% in sum insured claims processing$
illness in a policy year
per year
 Max Bupa
Max Bupa Health Insurance Company Ltd. came into being in 2010 through the formalisation of a joint venture between Max India Limited,
a multi-business corporate and the UK’s 70-year-old healthcare giant Bupa. Max Bupa is a venture that combines the rich legacy of Max India, a specialist
in life insurance and healthcare sector, and Bupa, a renowned name in the health and care industry across 190 countries.
At Max Bupa, our mission is to help our customers live healthier and more successful lives by providing expertise as healthcare partners. And this, we realise
is only possible by constantly raising the standards of health insurance by keeping our promises to you, our customer, and caring for you, for life.

Presenting HEALTH PREMIA GOLD & SILVER PLAN

A comprehensive health insurance plan, ‘Health Premia’ provides the perfect coverage for you and your family according to your needs and lifestyle. So, whether it’s
going in for newborn child benefits or emergency medical treatments abroad, Health Premia ensures that you get the best in healthcare. After all, your health
deserves nothing less.

In case of hospitalisation.
Hospitalisation of a family member can be stressful. That’s why Health Premia has been thoughtfully designed to take care of all your healthcare expenses during
hospitalisation, including room rent, doctor consultations, medicine expenses, and more.

Pre and post In-patient treatments taken

Coverage options hospitalisation expenses of Day care under Ayurveda, Unani,
up to `50 lacs 90 days prior and 180 days treatments Siddha and Homeopathy
post hospitalisation

Coverage for New-age Surgeries.

Use of new-age technology is now a part of many major medical practices. Which is why, under the Gold plan we cover medical expenses incurred, post serving a
waiting period#, for a laser-assisted surgery, or procedures using cyber knife and robotic surgeries with a specified co-payment or for medically prescribed Bariatric
surgery considering your BMI is over 35.

Inbuilt Travel Insurance.

There are times when you travel abroad, and an unplanned need for medical care arises. Health Premia’s Gold plan comes with an inbuilt travel
insurance of INR 30 Lacs per member for a maximum of 15 days in one single trip that covers emergency medical hospitalisation, emergency medical
evacuation, OPD cover, compassionate visit, care and/or transportation of minor children, medical referral and medical repatriation in foreign
countries. We also give coverage for loss of passport, loss of checked-in baggage, return of mortal remains, trip cancellation & interruption, trip delay
and delay of checked-in baggage. For activating this benefit, you have to get a Policy Schedule issued by us at least 7 days prior to your trip.

Coverage outside hospital.

We understand that not all treatments require hospitalisation. Which is why, we offer coverage to you even outside hospital by taking care of health
check-ups from day 1, pharmacy & diagnostic services, domiciliary treatment coverage as prescribed by a medical practitioner and e-consultations. You
even get coverage for emergency assistance services and ambulance costs, so at no moment do you feel that healthcare is far away.

Good health comes with great benefits.

01 Income Tax* 05 Tenure Discount

Income tax* benefit upto INR 42,744 under the Section 80D. If you pay for 2 year policy term, you get a discount of 7.5% on

02 Zonal Coverage the premium of second policy year. On the other hand, if you
choose 3 year policy term, you get an additional discount of 15%
India being a vast country, the cost of healthcare varies across on the third year’s premium.
cities. If you would like the flexibility of getting treated anywhere
in India, then, you can opt for Zone 1 pricing. 06 Premium Waiver
But if you live in a city other than Mumbai (including Navi If an insured policy holder passes away or is diagnosed with a
Mumbai and Thane), Delhi NCR, Kolkata & Gujarat you can avail specified illness during the policy period, then the premium for
of a lower premium by opting for Zone 2 pricing, all you need to next year will be waived off. (Not available under individual
do is to bear 20% co-payment in the aforementioned cities. plan).

03 Refill Benefit 07 Loyalty Additions

For us, loyalty is a virtue. So, even if you've claimed in the
When the same or different illness strikes in the same policy year,
previous year you get additional 10% of your base sum insured
your base sum insured is re-filled and made available to you.
annually, subject to a maximum of 100% of the base sum

04 15 Day Free Look Period insured.

You get the freedom to change your decision of continuing with

the policy for a period of 15 days. For other cancellation clauses,
please refer to the policy document on our website.
 PRODUCT BENEFIT TABLE - HEALTH PREMIA - GOLD AND SILVER VARIANT
Max Bupa Plans Silver (Individual and Family Floater) Gold (Individual and Family Floater) Silver (Family First) Gold (Family First)

Base Individual Sum Insured

Max Bupa Health Insurance Company Ltd. came into being in 2010 through the formalisation of a joint venture between Max India Limited, (per Insured Person): 1Lacs, 2Lacs,
Base Individual Sum Insured (per Insured Person):
5Lacs, 6 Lacs, 7 Lacs, 8 Lacs, 9 Lacs & 10Lacs
a multi-business corporate and the UK’s 70-year-old healthcare giant Bupa. Max Bupa is a venture that combines the rich legacy of Max India, a specialist 3Lacs, 4Lacs & 5Lacs
Base Sum Insured (in Rs) 5 lacs 7.5 lacs 10 lacs 15 lacs 20 lacs 30 lacs 50 lacs
in life insurance and healthcare sector, and Bupa, a renowned name in the health and care industry across 190 countries. Floater Sum Insured (available on a floating basis over Base Individual Sum Insured):
Number of Insured Persons (value to be considered as 10 for more than 6 members)*
At Max Bupa, our mission is to help our customers live healthier and more successful lives by providing expertise as healthcare partners. And this, we realise Base Individual Sum Insured * Multiplier factor (1.5 for 2 member policy & 1 for others)
is only possible by constantly raising the standards of health insurance by keeping our promises to you, our customer, and caring for you, for life. Benefits
In-patient care
Pre-Hospitalisation Medical Expenses (90 days)

Presenting HEALTH PREMIA GOLD & SILVER PLAN Post-Hospitalisation Medical Expenses (180 days)

Day Care Treatment

Domiciliary Hospitalisation
A comprehensive health insurance plan, ‘Health Premia’ provides the perfect coverage for you and your family according to your needs and lifestyle. So, whether it’s
going in for newborn child benefits or emergency medical treatments abroad, Health Premia ensures that you get the best in healthcare. After all, your health Alternative Treatment
Covered up to Sum Insured
deserves nothing less. Living Organ Donor Transplant
Emergency assistance services (only within India)
- Medical referral
- Emergency medical evacuation (air ambulance)
- Medical repatriation
In case of hospitalisation. - Compassionate visit
- Care and/or transportation of minor children
- Return of mortal remains
Hospitalisation of a family member can be stressful. That’s why Health Premia has been thoughtfully designed to take care of all your healthcare expenses during Newborn Baby (covered uptill the end of Policy Year) (1)
hospitalisation, including room rent, doctor consultations, medicine expenses, and more. Vaccination of the newborn baby Covered until new born baby completes one year, vaccinations as per pre-defined list
Emergency Ambulance Network Hospital: Covered up to Sum Insured, Non-network Hospital: Covered up to Rs. 2,000 per event
Pre and post In-patient treatments taken HIV / AIDS (waiting period of 4 years) Covered up to Rs 50,000
Coverage options hospitalisation expenses of Day care under Ayurveda, Unani, Mental disorder treatment (waiting period of 3 years) Covered up to Sum Insured (sub-limit of Rs 50,000 applicable on few conditions)
up to `50 lacs 90 days prior and 180 days treatments Siddha and Homeopathy
post hospitalisation Premium Waiver One time premium waiver if the policy holder dies or suffers from specified illness
Pharmacy and diagnostic services Available through our empanelled service provider

Coverage for New-age Surgeries. e-consultation Unlimited tele / Online consultations

Re-fill benefit Reinstate up to base Sum insured. Applicable for same & different illness as well Not Available
Use of new-age technology is now a part of many major medical practices. Which is why, under the Gold plan we cover medical expenses incurred, post serving a Loyalty Additions Increase of 10% of expiring Base Sum Insured in a Policy Year; maximum up to 100% of Base Sum Insured
Increase of 10% of expiring Base Individual Sum Insured in a Policy Year; maximum up
to 100% of Base Individual Sum Insured
waiting period#, for a laser-assisted surgery, or procedures using cyber knife and robotic surgeries with a specified co-payment or for medically prescribed Bariatric Option 1: Rs 3,000 per day or
Shared Room; whichever is lower
surgery considering your BMI is over 35. Room rent Covered up to Sum Insured (except for Suite or above room category) Option 2: Rs 5,000 per day or
Covered up to Sum Insured (except for
Suite or above room category)
Single Private Room; whichever
Inbuilt Travel Insurance. is lower
Maternity Benefit (covered for up to 2 pregnancies or
Covered up to Rs 40,000 Covered up to Rs 60,000 Covered up to Rs 70,000 Covered up to Rs 75,000 Covered up to Rs 80,000 Covered up to Rs 1,00,000 Covered up to Rs 1,00,000 Covered up to Rs 35,000 Covered up to Rs 50,000
terminations) (1)
There are times when you travel abroad, and an unplanned need for medical care arises. Health Premia’s Gold plan comes with an inbuilt travel
Annual, Tests covered Annual, Tests covered Annual, Tests covered up Annual, Tests covered up Annual, Tests covered up Annual, Tests covered up Annual, tests covered up to
insurance of INR 30 Lacs per member for a maximum of 15 days in one single trip that covers emergency medical hospitalisation, emergency medical Once in two years, tests as per Annual, Tests covered up to worth Rs 2,500 per
Health Check-up (from Day 1) up to worth Rs 1,250 per up to worth Rs 1,875 per to worth Rs 2,500 per to worth Rs 2,500 per to worth Rs 2,500 per to worth Rs 5,000 per worth Rs 7,500 per Insured
pre-defined list Insured Person
Insured Person Insured Person Insured Person Insured Person Insured Person Insured Person Person
evacuation, OPD cover, compassionate visit, care and/or transportation of minor children, medical referral and medical repatriation in foreign
Weight loss (Bariatric) surgery (waiting period of 3 years) Covered up to Rs 1,00,000 Covered up to Rs 1,00,000
countries. We also give coverage for loss of passport, loss of checked-in baggage, return of mortal remains, trip cancellation & interruption, trip delay
Cyber knife/ Robotics surgery Covered up to Sum Insured with a co-pay of 50% Covered up to Sum Insured with a co-pay of 50%
and delay of checked-in baggage. For activating this benefit, you have to get a Policy Schedule issued by us at least 7 days prior to your trip.
LASER surgery cover (waiting period of 3 years) Covered up to Rs 50,000 Covered up to Rs 50,000

Coverage outside hospital. International coverage (outside the geographical boundar- Condition: One single trip (max 15 days) per insured person;
Condition: One single trip (max 15 days) per
insured person;
ies of India for worldwide excluding USA & Canada) International Sum Insured: up to Rs. 30 Lacs per insured person International Sum Insured: up to Rs. 30 Lacs per
insured person
We understand that not all treatments require hospitalisation. Which is why, we offer coverage to you even outside hospital by taking care of health Emergency Hospitalisation
check-ups from day 1, pharmacy & diagnostic services, domiciliary treatment coverage as prescribed by a medical practitioner and e-consultations. You Emergency Medical Evacuation
even get coverage for emergency assistance services and ambulance costs, so at no moment do you feel that healthcare is far away. Compassionate visit
Care and/or transportation of minor children Covered up to International Sum Insured Covered up to International Sum Insured
Not available Not available

Good health comes with great benefits. Return of mortal remains

Medical referral
Medical Repatriation
01 Income Tax* 05 Tenure Discount OPD cover Covered up to International Sum Insured with a co-payment of 20% Covered up to International Sum Insured with a
co-payment of 20%
Income tax* benefit upto INR 42,744 under the Section 80D. If you pay for 2 year policy term, you get a discount of 7.5% on Loss of Passport Covered up to Rs 20,000 Covered up to Rs 20,000

02 Zonal Coverage the premium of second policy year. On the other hand, if you
choose 3 year policy term, you get an additional discount of 15%
Loss of checked-in baggage
Trip Cancellation & Interruption
Covered up to Rs 10,000
Rs 25,000
Covered up to Rs 10,000
Rs 25,000
India being a vast country, the cost of healthcare varies across on the third year’s premium. Trip Delay Rs 10,000 Rs 10,000
cities. If you would like the flexibility of getting treated anywhere
in India, then, you can opt for Zone 1 pricing. 06 Premium Waiver Delay of Checked-in Baggage
Optional Benefits
Rs 5,000 Rs 5,000

But if you live in a city other than Mumbai (including Navi If an insured policy holder passes away or is diagnosed with a Personal Accident cover (for insured aged 18 years & above
25 lacs 50 lacs 25 lacs 50 lacs
Mumbai and Thane), Delhi NCR, Kolkata & Gujarat you can avail specified illness during the policy period, then the premium for on individual basis)
Critical illness cover (for insured 18 years & above on
of a lower premium by opting for Zone 2 pricing, all you need to next year will be waived off. (Not available under individual individual basis)
5 lacs / 10 lacs 10 lacs / 15 lacs / 25 lacs 5 lacs / 10 lacs 10 lacs / 15 lacs / 25 lacs

do is to bear 20% co-payment in the aforementioned cities. plan). Increase of 20% of expiring Base Individual Sum Insured in a Policy Year; maximum up
Enhanced Loyalty Addition Increase of 20% of expiring Base Sum Insured in a Policy Year; maximum up to 200% of Base Sum Insured

07 Loyalty Additions
to 200% of Base Individual Sum Insured

03 Refill Benefit For us, loyalty is a virtue. So, even if you've claimed in the
International coverage extension (outside the geographical
boundaries of India for worldwide excluding USA & Canada)
Not available
1. Double Sum Insured for ‘international coverage’ benefit
2. Additional single trips available from 1 day to 30 days
Not available
1. Double Sum Insured for ‘international coverage’
benefit
2. Additional single trips available from 1 day to
When the same or different illness strikes in the same policy year, 30 days
previous year you get additional 10% of your base sum insured Hospital Cash (2) Rs 3,000/day Rs 5,000/day Rs 1,500/day Rs 3,000/day
your base sum insured is re-filled and made available to you.
annually, subject to a maximum of 100% of the base sum
Enhanced Geographical Scope for International coverage Not available USA & Canada included for International coverage Not available USA & Canada included for International coverage
04 15 Day Free Look Period insured.
Health Coach Personalized health coaching for insured aged 18 years & above for any 90 days per Policy Year
You get the freedom to change your decision of continuing with
(1)
Subject to a continous coverage of 24 months of that Insured Person since the inception of the first Policy which offers Maternity benefit with us.
the policy for a period of 15 days. For other cancellation clauses,
please refer to the policy document on our website.
 We know that there is always room for more, which is why our care comes
with additional benefits you can opt for.
01 Personal Accident Cover 04 International Coverage Extension
In the most difficult times, we make sure we’re by your side. Through When you decide to travel abroad, we give you the option to increase
this optional cover, a lump sum payout is offered in case of accidental your international coverage sum insured from INR 30 Lacs to INR 60
death, permanent, total, or partial disability. This cover can be opted Lacs per member to cover all your international travel needs. In case you
for by any member of your family aged 18 years or above. travel to USA / Canada, you can opt for enhanced geographical
coverage#. Additional single trips of up to 30 days can also be opted for.
02 Critical Illness Cover
For enhanced protection, an optional coverage against 20 major critical 05 Hospital Cash
illnesses like Cancer, Open Heart surgery, Kidney Failure, Strokes etc. is We know that your journey of getting better is not yours alone. There
available. Upon first diagnosis of any of these illnesses you get an are loved ones who spend day and night by your side at the hospital.
additional coverage as a one-time lump sum payout. This payment will Which is why, our plan provides additional payout to cover
be over and above your hospitalisation expenses which are paid miscellaneous expenses that you may incur during hospitalisation.
through the base policy. This cover can be opted for by any member of
your family aged 18 years or above. 06 Health Coach
03 Enhanced Loyalty Addition
To keep yourself healthy, you need a way to track your health
parameters on a daily basis. With Max Bupa Health Coach App you get
We make sure that your loyalty is rewarded, no matter what your claim to track your calorie intake, calculate BMI and more. In sum, you get a
history has been. You get an additional coverage of 20% of the expiring virtual health guru to help you achieve your desired health goal.
base sum insured every year as loyalty addition, subject to a maximum
of 200% of the base sum insured.

One plan, no matter how big the family.

With Family First variant you can get coverage for 19 relationships in a single policy. Your family will be covered at the following two levels:

01 Individual Sum Insured 02 Floater Sum Insured

This cover provides an individual sum insured for each This cover is available as a pool for all family members and
member of the family. The individual sum insured is the same can be used by any member once his/her individual sum
for each of the family members. insured is exhausted.

6 Simple steps to purchase any Max Bupa health insurance policy.

STEP STEP STEP STEP STEP STEP

Fill the application Read the offer

form. At this stage An offer is made document carefully
post evaluating your and ask the sales In case of any
please ensure you Undergo pre-policy
case and the representative for doubt, reach out to
disclose details medical check-up, if
premium may be details on your us on our customer Accept the offer.
correctly for all applicable at our
loaded basis the policy features, helpline number or
members to ensure network centre.
health disclosures of benefits, exclusions website.
smooth claims
processing when all proposed and waiting periods.
the need arises. insured.

Pro Tip - At the time of purchase, ensure you opt for the auto debit option to ensure timely and hassle-free renewals.

Enabling smooth claims processing.

01 Direct Claims Settlement 04 Hassle-free Reimbursements
For quick claims processing we ensure all claims are processed Sometimes, you may not be able to access a network hospital for
by our team of in-house doctors. availing cashless facility. In such cases, to get your claim
reimbursed as fast as possible, all you need do is submit the
02 4500+ Wide Network Hospitals requisite documents to us.
Avail cashless facility across India at 4500+ network hospitals. 05 Point of Care Desk (POC)
03 30 Minute Cashless Claims Processing$
At our select partner hospitals, a Max Bupa representative is
available to assist you through all the formalities like filling forms,
We process all cashless claims in 30 minutes so that you can be submitting claims etc. so that you are at ease in an unfamiliar
with your loved ones in their hour of need. hospital environment. Visit our company website for a list of
hospitals with this facility.

Our smooth renewal process only requires you to say yes and we will do the rest.
01 Life-long Renewal
We offer life-long renewal, regardless of your health status or previous claims made under your policy. Your renewal premium will increase as your
age increases but will not alter based on your claim experience. Renewal premium rates for the product may be revised in future subject to IRDAI
approval and in accordance with the IRDAI’s rules and regulations as applicable from time to time.
02 Sum Insured Enhancement
To protect yourself from rising medical expenses, you can enhance your sum insured or add more members of your family in your existing policy
at the time of renewal. We may reach out to you for additional information/medicals in case needed.
03 Loyalty Additions
On completion of each policy year, you get additional coverage i.e. 10% or 20% of base sum insured under this benefit subject to policy
terms & conditions.
04 Portability and Migration
You can port your policy at the time of renewal according to the IRDAI guidelines. Please reach out to us for any query regarding migration and
portability.