With the modern world filled up with happiness and sorrows, it has become a necessity to buy an insurance policy for the reduction of financial risk associated with life in general. Max Bupa Insurance provides Max Bupa Heartbeat Family Floater Health Insurance Plan to ensure that the medical expenses are covered. They offer this policy through gold and platinum variants.
Types of Heartbeat Family Floater
This Insurance plan is provided under individual and floater basis with respect to two variants such as:
- Gold
- Platinum
Eligibility Criteria
| Parameters | Details |
| Entry Age | No age limits with respect to this policy |
| Maximum family members that can be covered under this plan | 2 Adults and 4 children [ For family floater basis] |
| Sum Insured | Gold variant-Rs. 5 Lakhs, Rs 7.5 Lakhs, Rs 10 Lakhs, Rs 15 Lakhs, Rs 20 Lakhs, Rs 30 Lakhs and Rs 50 Lakhs
Platinum variant – Rs 15 Lakhs, Rs 20 Lakhs, and Rs 1 Crore. |
| Policy Tenure | One and Two-year options |
Features
| Features | Particulars | |
| Gold | Platinum | |
| Claim Type [In house or TPA] | 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 |
| Pre-Hospitalization | Covered up to sum insured for a period of 60 days | Covered up to sum insured for a period of 60 days |
| Network Hospitals Count | 4000+ | 4000+ |
| Post-Hospitalization | Covered up to sum insured for a period of 90 days. | Covered up to sum insured for a period of 90 days. |
| Maternity treatment | Supported under this policy | Supported under this policy |
| Room Eligibility | Covered up to sum insured [ except in case of suite any room category above it] | Covered up to the sum insured. |
| Hospitalization at Home | Covered up to sum insured | Covered up to sum insured |
| Day-Care Treatment | Covered up to sum insured | Covered up to sum insured |
| Emergency Ambulance | For the network hospitals covered up to the sum insured.
For the non-network hospitals covered up to Rs 2000/- per event. |
For the network hospitals covered up to the sum insured.
For non-network hospitals covered up to Rs 2000/- per event. |
| Health Check-up | Annually covered up to Rs 1250 – Rs 2500. | Annually covered up to Rs 3750 – Rs 5000. |
| Worldwide Coverage | Subject to certain treatments | Subject to certain treatments |
Points to consider before choosing a plan
1. Network Hospitals
The network hospitals provided by the Insurance Company needs to be checked before purchasing a plan. This also tells us which hospitals provide cashless facility and which ones provide remuneration basis claim settlement.
2. Free Medical check up
The policyholder should check if their respective policy provides a medical check-up under their clause. The terms and conditions associated with it must be studied properly to know the conditions which apply to the medical check-ups
3. Lifelong renewal
Lifelong renewal factor needs to be considered if long term planning is concerned. This is beneficial when the insured gets older as their health tends to get affected more.
4. Claim process
The claim process should be hassle-free and simple for the policyholder to undertake. This would be favorable for both the company and the policyholder.
5. Pre and Post hospitalization
The pre and post hospitalization requirements need to be checked before buying an insurance policy. This is a retrospective factor, and thus the prospectus, brochure and claim form needs to be referred accordingly. Different policies have different conditions associated with their hospitalization requirements.
Filing claims with Max Bupa Heartbeat Family Floater
- In case you are admitted to the network hospital, the policyholder needs to approach the TPA desk at least 72 hours prior to the treatment to initiate the claim filing.
- Submit the necessary documents at the desk for the verification process.
- The network hospital will verify the relevant documents submitted and contact the insurer for validation purposes.
- Within four hours of the intimation, the insurer will let the network hospital know about the status of the claim.
- Upon acceptance of the claim, the bills are settled by the insurer, and they can discharge from the hospital respectively.
In case one is admitted to a non-network hospital, you need to pay the charges of the treatment and claim for reimbursement by contacting the insurance company. You will be required to submit the necessary documents as proof for your claim requirements to the policyholders. Upon verification of the documents, your expenses will be reimbursed within the period mentioned in the policy clause.
Documents Required
- Duly filled and respectively signed claim form to be provided.
- Doctor’s certificate regarding the treatment of diagnosis.
- Hospital discharge summary and bills [ Original format to be provided]
- FIR copy if needed under certain circumstances
- Original bills and prescription papers need to be submitted
Exclusions
- All Ancillary Hospital charges.
- Circumcision is excluded under this policy.
- All medical expenses which are termed as non-medical expenses
- All treatments for sleep disorders.
- All Sexually Transmitted 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 abuse and addictions are excluded under this policy.
- Engaging in unlawful activities which results in the breach of law is excluded under this policy.
- Artificial Life Maintenance
- 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 puberty and menopause disorders are excluded under this policy.
- Treatment on eyesight and optical services are excluded under this policy.
- All treatments which are received outside India will be excluded under this policy.
- All medicine which is complementary and alternative by nature.
- Participation in hazardous activities and sports is subject to exclusion under this policy.
- Conflict and disaster aspects are also excluded under this policy.
- All treatments which are off label categorized are excluded under this policy.
- All off label drugs.
- Robotic Assisted Surgery is excluded under this policy.
- Autoimmune disorders.
What time does claim settlement procedure take?
Please refer to the policy terms and conditions in the clause to know the exact time required to make claim settlements. It takes 30 days to submit the claim documents for initiating the claim process.
Renewal Process of Max Bupa Heartbeat Family Floater
For policyholders looking for renewing their policy may follow the below mentioned steps:
Step 1: Type your policy number and date of the policy
Step 2: Click “Submit”
Step 3: Know your premium amount for the current year
Step 4: Click “Pay” to make the payment
Advantages of Max Bupa Heartbeat Family Floater
- There exists no limit on hospital room category under this policy.
- Worldwide treatment is provided for certain diseases such as Heart Attack, Coronary Artery Bypass Graft, Brain surgery, Stroke and for organ transplants [major].
- OPD treatment and diagnostic services are provided at a reasonable charge under this policy.
- Carry forward feature of the unutilized amount under the situation of renewal. This is subject to renewal of a policy with the concerned company without any break.
- This policy covers Alternative treatments such as AYUSH [Ayurveda, Unani, Siddha, and Homeopathy].
- This policy provides cover for new-born baby without any additional premium.
- There exists a feature of second medical opinion in this policy.
- The free look period provided under this policy is of 15 days respectively.
- This policy supports domiciliary treatment for a period of three consecutive days.
- This policy covers organ transplant expenses. They are paid out of in-patient’s claim.
- This policy supports Loyalty addition.
- This policy supports maternity treatment too.
- There exists no age for getting eligible for this policy. So, individuals of all age groups can avail this policy respectively.
- An emergency ambulance is covered up to a specified limit of sum insured for both Gold and Premium variants.
FAQs
Q1. Does this policy support tax benefits?
Yes, this policy is subject to income tax benefits under section 80D of the Income Tax Act 1961 respectively.
Q2. What is the free look period provided under Heartbeat Family Floater Health Insurance Plan?
The free look period provided under this policy is for a duration of 15 days respectively.
Q3. Is daycare treatment covered under this policy?
Yes, day care treatment is covered under this policy. It is subject to a period of consecutive three days according to the policy clause.
Q4. Does this policy have any age limits?
This policy does not have any age limits. Any person can avail this policy via visiting the nearest branch or online purchase or via telephone.