Niva Bupa GoActive Plan: Avail Health Checkup From Day 1

Why Choose Niva Bupa Go Active Plan

Health insurance from Niva Bupa - Niva Bupa GoActive offers comprehensive coverage for medical treatment in the event of sickness or accident. Families are also covered by the family floater plan. The Niva Bupa GoActive health insurance plan covers the policyholder, his/her spouse, and up to four children. The benefits offered by Niva Bupa GoActive are diverse. A variety of medical expenses are covered, including charges incurred during hospitalization, as well as daycare services, office visits, and doctor's consultations. Policyholders can choose from a variety of sum-insured options according to their preferences. To enhance the effectiveness of the plan, policyholders can also choose optional covers. Moreover, policyholders can receive direct claim settlements, cashless benefits, and tax advantages. The Niva Bupa Go Active plan is one of the company's most popular plans, offering 24/7 access to hospitalization, OPD, diagnostic tests, COVID-19 coverage, and more. You can rest assured that the plan perfectly caters to mushrooming medical needs, including a dedicated health coach, no room rental (up to a sublime), and daycare treatments. Individual and family plans are further divided into categories.

Benefits of Niva Bupa Go Active Plan

1. Hospitalization cover-Niva Bupa Go Active offers hospitalization coverage of up to Rs. 25 lakhs, which makes it a viable option for covering medical expenses if they arise. Coverage ranges from Rs. 4 lakhs to Rs. 25 lakhs
2. OPD cover-Do you want a health insurance plan that offers you coverage every time you visit your doctor? You're covered by Niva Bupa Go Active. You will be covered for all doctor's visits under the policy. An average of 10 OPD consultations are included in the plan.
3. Age advantage-The First Policy Year Base Premium and all subsequent Renewal Base Premiums are likely to be discounted by 10% if you enter at or before the age of 35 (as at your last birthday).
4. i-Protect Benefits-This is another feature of Niva Bupa Go Active that offers yearly coverage increases of 10%.
5. Tests-Policyholders can expect up to Rs. 25000 per person each year for diagnostic tests under the policy.
6. Family combination-There are individual and family options available in this policy, as discussed earlier. Two adults and four children are covered under the family option.
7. Health checkup-You don't need to wait for a health checkup period like with other health insurance policies. Every year, Go Active policyholders are eligible for a "Free Health Checkup.".
8. Treatment for daycare -Insured Person's Medical Expenses incurred under a Day Care Treatment during the Policy Period following an illness or injury will be reimbursed Injuries. In order to be covered, the following conditions must be met:
a. Medical Practitioners recommend Day Care Treatment in writing as Medically Necessary.
b. The Day Care Treatment would be covered if the Insured Person was admitted for more than 2 hours and if treatment was taken for more than 2 hours Treatment for cancer may include angiography, dialysis, radiotherapy, or chemotherapy.
c. The Insured Person will also be indemnified for their pre-hospitalization and post-hospitalization medical expenses if their claim has been accepted under this benefit.
d. Hospitalisation at home-An Insured Person's Domiciliary Hospitalisation incurred during the Policy Period will be reimbursed on a reimbursement basis only. In order to be covered, the following conditions must be met:
i. As long as the domiciliary hospitalization continues for at least 3 consecutive days, we will pay the medical expenses under this benefit Hospitalisation costs incurred from the first day of domiciliary care
ii. In writing, the treating Medical Practitioner confirms that the Insured Person cannot be transferred to another facility due to their medical condition. Neither a Hospital nor the Insured Person is able to find a bed in a Hospital.

Inclusions of Niva Bupa Go Active Plan

1. Treatments that are modern - Depending on your policy schedule, the following procedures/treatments are covered either as inpatient care or as daycare treatment in a hospital.
a. HIFU (High intensity-focused ultrasound) and uterine arterial embolization
b. Sinuplasty of balloons
c. Stimulation of the deep brain
d. Chemotherapy administered orally
e. Injection of monoclonal antibodies
f. Injections into the vitreous
g. The use of robotic surgery
h. Radiosurgery using stereotactic techniques
i. Thoracic Thermoplasty
j. Prostate vaporization (Green laser treatment or Holmium laser treatment)
k. Intraoperative Neuromonitoring (IONM)
l. Hematopoietic stem cells for bone marrow transplantation for hematological conditions to be covered.
2. Program for behavioral assistance - Counseling sessions through telephonic mode will only be covered under this benefit to provide support on pre-marital counseling, nutrition, stress, child, and parenting taken by the insured person during the policy period.
a. As specified in the Policy Schedule, we will conduct the number of consultations.
b. Cashless Facility is only available through our impaneled service providers.
c. Unused consultations cannot be carried forward to the next policy year for the Permanent Exclusions.
3. Services related to pharmacy and diagnostics - With Our mobile application or website, you can purchase medicines and diagnostic services from Our impaneled Service Provider. Medicines or diagnostic services must be purchased by You. Furthermore, it is made clear that the decision to purchase medicines or diagnostic services from Our impaneled Service Provider is entirely at Your discretion.
4. I-Protect - Each Policy Year, if the Policy is renewed without a break, We will increase the Sum Insured by 10% of the Base Sum Insured for the immediately preceding Policy Year. Sub-limits for various benefits will remain the same and will not increase proportionately with the Sum Insured. Refill Benefits, OPD Consultations, Health Check-ups, Diagnostic Tests, Second Medical Opinion, Behavioral Assistance Programs, and Optional Benefits (if opted for) such as Health Coach and Personal Accident Cover are not covered by this benefit.
a. You can choose this benefit only at the start of your first policy with us, not at renewal. At inception, you have the option to opt out During the renewal of the policy, out of the benefit. As a result, the accumulated Increased Sum Insured under I-Protect will be as follows:
i. If You pay the same additional percentage of premium as in the preceding Policy Year, the benefit will not increase further.
ii. The premium for this benefit will be reduced to zero if you do not pay any additional premium
b. When the expiring policy covers an individual insured and the accumulated Increased Sum Insured under I-Protect in the expiring policy under this benefit, and the expiring policy is renewed with Us on a Family Floater Policy, then the I-Protect benefit and The Family Floater Policy shall also receive the accumulated Increased Sum Insured under I-Protect.
c. If the Insured Persons in the expiring Policy are covered under a Family Floater Policy and they renew their expiring Policy. The I-Protect benefit and the accumulated Increased Sum Insured under I-Protect will also be provided to each of the split Policies if the Floater Sum Insured stated in the Policy Schedule is split into two or more floater / individual policies.
d. If the Base Sum Insured under the Policy is reduced at the time of Renewal, the applicable accumulated Increased Sum Insured under I-Protect will apply The Base Sum Insured shall also be reduced accordingly.
e. If the Base Sum Insured under the Policy is increased at the time of Renewal, the accumulated Increased Sum Insured will apply proportionally to the Base Sum Insured.
5. Death by accident - During the Policy Period, the Insured Person suffers an Accidental Injury that directly results in their death within 365 days of the Accidental Injury. In the event of an accident, we will make payments under this benefit as specified in the Policy Schedule. Post payment of the benefit to the beneficiary, the coverage for that Insured Person will cease for all benefits under the Policy. According to the terms and conditions of this policy, any claim incurred before the death of such an Insured person will be admissible.

Exclusions of The Niva Bupa Go Active Plan

1. Waiting period of 30 days
a. Treatment expenses related to any illness within 30 days of the policy's start date are excluded, except for claims arising from illness. Accidents are covered, provided they are covered.
b. A continuous 12-month coverage, however, will not cause the exclusion to apply.
c. If a higher Sum Insured is granted subsequently, the within-referred waiting period is applied to the enhanced Sum Insured.
2. Evaluation & Investigation
a. Admissions primarily for diagnostics and evaluation are excluded.
b. A diagnostic expense that is not related or not incidental to the current diagnosis and treatment is excluded.
3. Rehabilitation, rest, and respite care - The costs associated with any admission are primarily for bed rest and not for treatment. Additionally, this includes:
a. Personal care such as bathing, dressing, and moving assistance at home or in a nursing facility Nursing assistants and non-skilled individuals can assist nurses.
b. The provision of physical, social, emotional, and spiritual support to people who are terminally ill.
4. Weight loss/obesity - Costs associated with obesity surgery that does not meet all the conditions below:
a. On the doctor's advice, surgery will be performed.
b. Clinical protocols should support the surgery/procedure.
c. Members must be 18 years or older
d. A measure of body mass index (BMI)
i. Equal to or greater than 40
ii. After the failure of less invasive methods of weight loss, have a body mass index greater than 35, as well as any of the following severe comorbidities:

Cardiomyopathy caused by obesity
Atherosclerosis
Sleep apnea of severe severity
Diabetes type 2 uncontrolled

5. Surgery for cosmetic or plastic reasons - Treatments to change appearance except for reconstructive surgery following an accident, burn(s), or cancer or as part of the medically necessary treatment to remove a direct and immediate health risk. In order for this to be considered a medical necessity, the attending physician must certify it as such.
6. Sports that are hazardous or adventurous - As a professional, you may be required to pay for any treatment you require as a result of participating in hazardous or adventure sports, such as para jumping, rock climbing, mountaineering, rafting, motor racing, horse racing, or scuba diving, hand gliding, skydiving, and deep sea diving, among others.
7. The causes and effects of sterility and infertility - Expenses associated with sterility and infertility. The following are included:
a. Sterilisation and contraception of any kind
b. Services for assisted reproduction, including artificial insemination and advanced reproductive technologies, such as IVF, ZIFT, GIFT, and ICSI
c. Surrogacy during pregnancy
d. Sterilisation reversed
8. Expenses associated with maternity leave
a. Amounts incurred for medical treatment related to childbirth (including complications and cesarean sections) except in cases of ectopic pregnancy
b. Pregnancy-related expenses (other than miscarriages caused by accidents) and the legal termination of a pregnancy during the policy period.

FAQ

What is the process for buying this policy?

This policy can be purchased in a variety of ways: Online: When you purchase a health insurance plan online, your policy and policy kit will be generated almost instantly. This applies to cases that do not require further underwriting or medical examination. Visit the branch in your city for more information. Contact Us on the website provides a complete list of branch locations.

When purchasing health Insurance, is there any tax benefits?

Yes, of course. A health insurance policy offers a tax benefit under Section 80D of the Income Tax Act 1961. Taxpayers can deduct Rs. 15,000 from their taxable income for premiums for themselves, their spouses, and their dependent children. The amount is Rs. 20,000 for senior citizens. Proof of premium payment will be required. (Section 80D benefit is in addition to the Rs 1,50,000 exemption under Section 80C). Please consult your tax advisor for more details regarding tax benefits.

Is it necessary to have a medical examination before purchasing an insurance policy?

When you sign up for a new health insurance policy, you may need a medical checkup. It is not usually necessary to undergo a medical checkup when renewing a policy. To ensure that it can provide speedy and efficient support and faster claim settlement when you need it, you should undergo a medical check-up at the time of enrollment.

How does COVID-19 fit into the GoActive individual plan?

Per the terms and conditions of the plan, GoActive Individual covers expenses incurred during Coronavirus treatment.

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