Max Bupa Health Companion Top-Up

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Max Bupa

  • Max India & BUPA, an international health insurance company, has joined hands together to bring to India – Max BUPA health Insurance Company Ltd. world class provider of health insurance.

  • Vision: To become India's most admired Health Insurance Company. And to make this vision a reality, we have brought together our vast and varied experience as the experts in healthcare.

Sum Insured Option

       

Age Limit


Policy Combination


In-patient treatment

  1. Medical Practitioners’ fees
  2. Diagnostics Tests
  3. Medicines, drugs and consumables
  4. Nursing Charges 
  5. Intravenous fluids, blood transfusion, injection administration charges
  6. Operation theatre charges
  7. The cost of prosthetics and other devices or equipment if implanted internally during a Surgical Procedure.
  8. Intensive Care Unit charges

Hospital Accommodation

  • Reasonable and customary charges for hospital accommodation.
  • Reasonable and Customary charges means the charges for services or supplies, which are the standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services among comparable providers, taking into account the nature of the Illness / injury involved.

Pre & Post Hospitalization Expenses

  • Expenses  up to 30 days immediately before and 60 days immediately after an Insured Person’s admission to a Hospital for the same Illness.
  • Pre and post hospitalization expenses can be claimed as reimbursement only. 

All Day-care Procedures

  • Medical Expenses for all day-care procedures (< 24 hours). 
  • Including Chemotherapy, Radiotherapy, Hemodialysis, or any procedure which needs a period of specialized observation or care after completion of the procedure.
  • Any procedure undertaken on an out-patient basis will not be covered.
  • Covers all day-care procedures not just a list of procedures.

Organ Donor

  • Expenses for an organ donor’s treatment for the harvesting of the organ donated.

  1. Provided donation conforms to The Transplantation of Human Organs Act 1994 and the organ is for the use of the Insured Person;
  2. The Insured Person has been medically advised to undergo an organ transplant;

  • What is not covered?

  1. Pre or post Medical Expenses or screening expenses
  2. Any other costs directly or indirectly associated with the acquisition

Domiciliary Treatment

  • Medical Expenses for medical treatment for domiciliary treatment taken at home if this continues for an uninterrupted period of 3 days as long as either:

  1. The attending Doctor confirms that the Insured Person could not be transferred to a Hospital or 
  2. The customer satisfies the company that a Hospital bed was unavailable.

Refill Benefit for New Illness

  • Max Bupa provide Refill Sum Insured upto 100% of Base Sum Insured, only once a year, 
  • For a subsequent/future claim of an un-related illness only for the same member or any subsequent claim of a different member 

AYUSH Benefit

Reimbursement of medical expenses for alternative treatment taken under AYUSH provided the treatment has been undergone in:
  1. A government hospital or 
  2. In any institute recognized by government and/or accredited by Quality Council of India/National Accreditation Board on Health

Does not include pre and post hospitalization expenses

Emergency Ambulance

Reasonable and customary ambulance expenses following an Emergency to the nearest Hospital if:

  1. The ambulance service is offered by a healthcare or ambulance service provider.
  2. The Company has accepted an in-patient claim for the same illness or accident. 

Covered upto Rs. 3,000 per hospitalization for all hospitalization (network/out of network).

No Claim Bonus (NCB)

  • If no claim has been made in a Policy Year by any Insured Person. 
  • 20% increase on the expiring Base Sum Insured up to a maximum of 100% of the Base Sum Insured of that Policy Year.
  • Sub-limits applicable to various benefits will remain the same and shall not increase proportionately.
  • Provided that the Policy is renewed continuously.
  • NCB once accrued does not get reduced in case of claim.
  • In competition, in case of a claim, the NCB gets reduced.
  • In case of Family First, NCB gets accrued on Individual Base Sum Insured. 

Waiting Periods And Exclusions


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