Health is the leading priority of any individual. To make sure they get the adequate financial backup for it, Health Insurance policies are availed. Max Bupa Health Insurance provides Health Companion Family Floater Insurance plan for nuclear families especially [i.e., you, your spouse and up to 4 children are covered under this policy].
Types of Health Companion Family Floater
Health Companion Family Floater Insurance Plan is offered under three variants such as
- Variant-1
- Variant-2
- Variant-3
Eligibility Criteria
| Parameters | Details |
| Entry Age | Min: 90 days
Max: No maximum limit under this policy |
| Maximum members which can be covered under this plan | 2 Adults and 2 Kids |
| Sum Insured | Variant-1=Rs 3 Lakhs and Rs 4 Lakhs
Variant-2= Rs 5 Lakhs, Rs 7.5 Lakhs, Rs 10 Lakhs and Rs 12.5 Lakhs Variant-3=Rs 15 Lakhs , Rs 20 Lakhs , Rs 30 Lakhs , Rs 50 Lakhs- and Rs 1 Crore |
| Policy Tenure | One and Two-year options |
Features of Health Companion Family Floater
|
Features |
Particulars | ||
| Variant-1 | Variant-2 |
Variant-3 |
|
| Claim Type [In house or TPA] | Direct Claim Settlement is provided under this claim. | Direct Claim Settlement is provided under this claim. | Direct Claim Settlement is provided under this claim. |
| In-Patient Care | Covered up to sum insured | Covered up to sum insured | Covered up to sum insured |
| Pre-Hospitalization | Covered up to sum insured for a period of 30 days | Covered up to sum insured for a period of 30 days | Covered up to sum insured for a period of 30 days |
| Network Hospitals Count | Refer to www.maxbupa.com | Refer to www.maxbupa.com | Refer to www.maxbupa.com |
| Post-Hospitalization | Covered up to sum insured for a period of 60 days. | Covered up to sum insured for a period of 60 days. | Covered up to sum insured for a period of 60 days. |
| Room Eligibility | Covered up to sum insured [ except in case of suite any room category above it] | Covered up to sum insured [ except in case of suite any room category above it] | Covered up to sum insured [ except in case of suite any room category above it] |
| No Claim Bonus | An increase of 20% of the expiring Base of sum insured in the respective policy year which is maximum up to 100% Base sum insured | An increase of 20% of the expiring Base of sum insured in the respective policy year which is maximum up to 100% Base sum insured | An increase of 20% of the expiring Base of sum insured in the respective policy year which is maximum up to 100% Base sum insured |
| Ambulance Charges | Refer to Emergency Ambulance section | Refer to Emergency Ambulance section | Refer to Emergency Ambulance section |
| Hospitalization at Home | Covered up to sum insured | Covered up to sum insured | Covered up to sum insured |
| Day-Care Treatment | Covered up to sum insured | Covered up to sum insured | Covered up to sum insured |
| Exclusions | Refer to Exclusions section below | Refer to Exclusions section below | Refer to Exclusions section below |
| Emergency Ambulance | Limited to Rs 1000/- | Limited to Rs 3000/- | Limited to Rs 3000/- |
| Health Check-up | Once in 2 years | Annually | Annually |
| Worldwide Coverage | This policy does not support Worldwide coverage. Any treatment outside India is excluded under this policy. | This policy does not support Worldwide coverage. Any treatment outside India is excluded under this policy. | This policy does not support Worldwide coverage. Any treatment outside India is excluded under this policy. |
Points to consider before buying a plan
- Free Medical Health Check-ups-
The insured should check whether medical check-ups are offered under the respective policy. The terms and conditions associated with the health check-ups should be confirmed. The policyholder is advised to check all the prospectus, brochure, and the policy clause for more details on this feature.
- Network Hospitals
The policyholder should check the network hospitals provided under the respective policy. This will help them in recognizing which hospitals provide cashless facility and which hospitals provide remuneration facility.
- Claim process
The claim process is an important determinant to look at before buying an insurance plan. The simpler the claim process the more beneficial it will be to the policyholder.
- Lifetime Renewal
Lifetime renewal is a feature which needs to be considered before buying an insurance plan. This is a factor which needs to be considered in the long run. This feature comes into play more as the insured ages as health problems are more vulnerable at that age.
Filing claims with Max Bupa Health Companion Family Floater
The claim procedure under Health Companion Family Floater plan is as follows:
- The first step is involved is to approach the helpdesk 72 hours before treatment.
- The next step is to identify yourselves. It can be done via PAN card, Driver’s license or Max Bupa Health card or the respective policy number.
- Then the network hospital will validate your identity and send the pre-authorization form to the company.
- The next set of instructions will be provided to the hospital after four hours after all documents are submitted.
- The insurance company may or may not assign a relationship manager for smoothing the process.
- The insured can now get admitted and at the time of discharge sign all the documents, invoices and forms which may be required at the particular time.
- Then the payment will be approved as per the terms and conditions accordingly.
Documents Required
- Duly filled and signed claim form
- Doctor’s certificate who attended the patient
- Hospital discharge summary and bills[ in original format]
- FIR copy if needed
- Original bills and prescriptions of the concerned medical treatments.
Exclusions under Max Bupa Health Companion Family Floater
- All Ancillary Hospital charges are excluded under this policy.
- Involvement of hazardous activities or sports
- Circumcision is excluded under this policy.
- All medical expenses which are termed as non-medical expenses
- All treatments for sleep disorders.
- All Sexually Treated Diseases [STDs] infections and treatments are subject to exclusions under this policy.
- If hospitalization is done for purposes which are not justified.
- HIV and AIDS along with their complications are excluded under this policy.
- All substance-related and addictions.
- Engaging in unlawful activities is excluded under this policy.
- Artificial Life Maintenance is excluded under this policy.
- All dental and oral treatment is subject to exclusions.
- All mental and psychiatric conditions are excluded under this policy.
- Acquiring treatment from any unrecognized hospital or physicians.
- All disorders which may be related to puberty and menopause are excluded under this policy.
- Eyesight and optical services
- All treatments which are received outside India will be excluded under this policy.
- All medicine which is complementary and alternative by nature will be excluded under this policy.
What time is required for claim settlements?
Refer to the relevant terms and conditions in the policy clause to know the exact time required to make claim settlements. Usually, it takes 30 days for initiation of the relevant claims request.
Advantages of the policy
- Refill Benefit is provided under this policy up to the base sum insured in all the three variants of the policy.
- Alternative treatments are available under this policy such as AYUSH [Ayurveda, Unani, Siddha, and Homeopathy] under this policy.
- This policy also covers the organ transplant cost for the insured person.
- All vaccinations and treatments with respect to animal bites and OPD are covered up to a sum of Rs 5000/-.
- There is an additional Hospital Cash benefit option available under this policy.
- There exists no maximum age limit with respect to this policy.
- This policy also provides emergency ambulance covers with respect to all the three variants in the policy.
Also Read: Max Bupa Heartbeat Family Floater
FAQs
Q1. Does this policy support tax benefits?
Yes, under this policy income tax benefits are provided under section 80D of The Income Tax Act, 1961.
Q2. Are there any loyalty benefits provided under this policy?
There are loyalty benefits such as No-claim bonus and health check-ups provided under this policy.
Q3. Is this policy subject to any discounts?
Yes, when you take this policy for two years, the policyholder will avail a welcome discount of 12.5% on the second year’s premium amount respectively.
Q4. Are pre-existing diseases covered under this particular policy?
Pre-existing diseases will be available after 48 months have elapsed since the inception of the first policy respectively.
Q5. Are emergency ambulance charges covered under this policy?
Yes, this policy covers emergency ambulance charges with respect to its three variants.