Max Bupa Go Active Health Insurance

Brief Overview - Max Bupa Go Active Plan

Max Bupa is a well-known name in the health insurance sector. The company is a collaboration between Max India Ltd and Bupa. Max India Limited is an Indian company that has been a specialist in the domain of health insurance. The other pillar of the venture, Bupa, a multinational expert, has been in the international healthcare services for over 6 decades now. 

Max Bupa provides a wide range of health insurance policies that suit individuals and families from different economic backgrounds. Many innovative health insurance products and plans have been launched by the company that are unparalleled and extend numerous benefits. The company has started the Max Bupa Health App. The AI system helps the customers in managing their policy through their smartphones. From fixing OPD appointments to getting medicine delivery, everything has been made all possible through the App. 

One of the most popular plans by the company is Max Bupa Go Active Plan. This is a comprehensive plan that offers multiple customised benefits and services which can greatly help in securing the health of the entire family. An affordable plan, it offers coverage up to INR 25 lakhs, with a 10% increase annually with the i-Protect benefit. Apart from the in-patient care, the plan incorporates health check-ups, OPD consultation, pre and post-hospitalisation etc. Another standout feature of the policy is the refill benefit that secures you even when you use up the entire sum insured. 

Best Features of Max Bupa Go Active Plan

1. Max Bupa Go Active Plan is available as an Individual as well as a Family plan option
2. It offers a hospitalisation cover from INR 4 lakhs to INR 25 lakhs
3. The plan offers a complete re-fill of the sum insured
4. You are eligible for up to 10 OPD-Consultation per year
5. There is no sub-limit on room rent for sum insured over INR 5 lakhs
6. There is an Early Age Advantage of 10% when you purchase the plan before the age of 35 years
7. The plan offers a Personal Accident Cover for the Primary Insured and his/her spouse
8. You have the option of talking to a Health Coach for personalised services
9. Diagnostic tests Up to INR 2,500 per year per person
10. As there is no involvement of TPAs, claims are quicker and simpler

Benefits of Max Bupa Go Active Plan

1. Wide Range of Cover
   The plan offers a range of sum insured options to choose from that starts from INR 4 lakhs and goes up to INR 25 lakhs.
2. Pre and Post-hospitalisation 
   Sometimes a lot of expenses are incurred before and after hospitalisation as well. These expenses can burn a big hole in your pocket. Max Bupa Go Active Policy covers you for 90 days before and 180 days after the hospitalisation.
3. Day-care Procedures
   Day Care procedures are treatments that require less than 24 hours of hospitalisation. Go Active Policy covers day-care treatments too.
4. Organ Donation
   The living donor’s treatment expenses for a transplant would be covered under the Go Active plan, when the procedure is under the Transplantation of Human Organs Act 1994 and amendments thereafter.
5. OPD Consultation
   Depending on the sum insured and the plan option chosen by you, you would be eligible for a specific number of OPD consultation.
6. Second Opinion
   When an insured member is diagnosed with any of the specified illness or has to undergo surgery, a second medical opinion can be arranged in his/her direction.
7. Domiciliary Hospitalisation
   When a doctor prescribes a home treatment that otherwise requires hospitalisation, the expenses of the treatment are covered. The domiciliary hospitalisation should be for at least 3 consecutive days.
8. Behavioural Assistance Programme
   Telephonic counselling sessions for support in issues such as nutrition, parenting, pre-marital counselling are provided.
9. Ambulance Charges
   Max Bupa Go Active Plan covers the transport of an insured member to a hospital in case of an emergency. This benefit is available for one transfer per hospitalisation.
10. Health Check-ups
    For insured members over the age of 18 years, an annual check-up would be arranged as per the plan option.
11. Tax Benefits
    The health insurance premium that you pay towards the Go Active Plan is tax exempted under Section 80D of the Income Tax Act, 1961.
12. Alternate Treatments 
    Under this plan, alternate treatments taken in a recognised AYUSH hospital are also covered. The treatments include Ayurveda, Unani, Sidha and Homeopathy and the charges that you incur on such treatments will also be covered.
13. i-Protect
    When you renew the policy on time, without a break you are rewarded with an increase of 10% of the base sum insured, at the time of renewal.
14. Modern Treatment 
    Modern treatments that are taken as a daycare procedure or as in-patient care, are also covered under the Go Active Plan.
15. Health Coach
    To encourage healthy habits and well-being you and your spouse would be offered personalised health coaching. The points you score will fetch you rewards at the time of renewal.
16. Personal Accident Cover
    This benefit can be opted for by the insured member and his/her spouse. The cover includes:
    1. Accidental Death
    2. Accidental Permanent Total Disability
    3. Accidental Permanent Partial Disability

Plan Details of Max Bupa Go Active Plan 

• Waiting Period
  • All treatment apart from accidental injuries have a 30-day waiting period, starting from the policy inception
  • There is a waiting period of 24-months applicable on specific diseases
  • Pre-existing diseases have a waiting period of 36 months
• Free Look Period
  The free look period is an added advantage of the Max Bupa Go Active policy. This is a 15-day period that is given to you when you buy this policy. During this period you have the option to review the terms and conditions of the policy. In case you find the policy not matching your stipulations, you can return it.

What is not Covered in Max Bupa Go Active Plan?

There are certain conditions under which the treatment is not covered, such conditions or situations are called exclusions. Listed below are some major exclusions of the Max Bupa Go Active Plan, for an exhaustive list, kindly refer to the policy document.

1. Certain diseases and treatments are not covered till the specified waiting period is over
2. Weight and weight control programmes
3. Artificial life maintenance using life support machines to sustain the insured person who has been declared brain dead
4. Maternity treatments
5. Treatment for alcohol and drug abuse
6. Behavioural and neuro-development disorders
7. Change of gender treatments
8. External congenital anomalies
9. Sterility and infertility
10. Cosmetic/ Reconstruction surgery, unless resulting from cancer/burns/injury
11. Dental and oral treatments
12. Optical services and treatments
13. Puberty and Menopause related diseases
14. Robotic-Assisted Surgery
15. Sleep disorders
16. Conditions that arise because of illegal/ malicious activities

Renewal Process - Max Bupa Go Active Plan

If you want to continue enjoying the features of the policy then you should make sure that you renew your policy. Timely payment of renewal premium will ensure that you do not miss out on any plan benefits. The renewal amount has to be paid on or before the expiry date. Once the expiry date goes by, your policy enters a grace period. The grace period continues for 30 days. However, keep in mind that you cannot make a claim during the grace period.

The process of Policy Renewal is simple and does not take more than a few minutes. You can follow any of the two ways given below:

• Online Method
  Follow the steps given below:
  • Go to the company website or click https://transaction.maxbupa.com/pages/renew.aspx
  • Enter the 14 digit policy number along with your date of birth and click ‘Submit’
  • Your Payable Premium would be displayed. You can pay through your debit/ credit card, UPI wallet or net banking
  • You would receive your policy transaction number
  • Your New Policy Kit would reach to you within 48 hours
  • You can also renew the policy through an insurance aggregator website
• Offline Method 
  If you wish to renew the policy offline, you have to visit any Max Bupa Office. Here you can make the payment via cheque/ demand draft.

Claim Process - Max Bupa Go Active Plan

Max Bupa Health Insurance Company has its own in-house claim settlement cell. The company undertakes to settle all claims within half an hour. Recently the company recorded a Claim Settlement Ratio of 92%. 

However, when making a claim it is also imperative that you follow all instructions carefully. Doing so will result in a much easier and quicker claim settlement. Informing the company about the hospitalisation is the first important step to be taken. In case of planned admission, you have to inform the company at least 72 hours before and in case of an emergency, within 48 hours of hospitalisation. 

Keep it in mind that in case of planned hospitalisation, once the authorisation has been received the treatment must be done within a period of 15 days from the pre-authorisation date. 

• Cashless Claim 
  You can get the facility of cashless health insurance treatment when you choose to get admitted to a network hospital for your treatment. When you reach the hospital, at the time of admission you would have to show your Health Card and submit the Pre-Authorisation Form with the hospital help desk. Once the documents are verified by the company, the treatment would begin. The company would settle your bills directly. Keep in mind that the treatment expenses would be covered up to the sum insured only. You would have to pay for the uncovered expenses from your pocket.
• Reimbursement Claim 
  If you are seeking treatment at a non-empanelled hospital, ensure that you inform the company about the same at the earliest. When the treatment is complete, you would have to pay the dues yourself, and then file for a reimbursement claim. Within 7 days of your discharge, you would have to submit all the treatment-related documents, bills and receipts along with the claim form. Once all the paperwork is authenticated by the company, the reimbursement will be done within a few days.
• Required Documents
  The following documents would be required when making a claim:
  • Company issued Health Card, along with KYC papers
  • Policy Papers
  • Name and address of policyholder and/or Insured person
  • Date of Admission
  • Nature of Illness and the Treatment required
  • Name and Address of Doctor and the Hospital
  • Consultation Papers
  • Original ambulance receipt if used
  • Police FIR or Medico-Legal Certificate in case of accidental injuries

You may require the following documentation  for a reimbursement claim :

• Valid Photo Identification document
• Duly filled and signed Claim Form
• All bills, receipts issued by the hospital
• All diagnostic and pathological Reports
• Cancelled Cheque
• Original discharge summary
• Original ambulance receipt, if used
• Police FIR or Medico-Legal Certificate in case of accidental injuries

Policy Network Hospitals - Max Bupa Health Insurance Company

When you invest in Max Bupa Go Active plan, you get access to over 5,000 network hospitals. At a network provider hospital, you can get the facility of seeking a cashless claim for all the medical expenses. The covered expenses would be paid by the company up to your base sum insured. The company strives to settle claims within 30 minutes.  

Review of Max Bupa Go Active Plan

Max Bupa Health Insurance Company was established in the year 2010. Over the years the company has developed itself as one of the most reliable insurance companies. The company has witnessed remarkable growth and has launched multiple health insurance plans and products that offer exclusive benefits to all its customers. 

Today the whole world is struggling to deal with COVID-19. In such a time having a comprehensive health insurance plan is nothing short of a basic necessity. Max Bupa concedes the value of a good health plan and supports its customers in getting access to high-quality medical care. With cashless treatment available in more than 5,000 hospitals across the country, you as a policyholder can never be far from healthcare. 

Max Bupa Go Active Plan is a health insurance plan that offers a very comprehensive cover. The plan can be purchased on an individual or family floater health insurance basis. As the policy offers a wide range of sum insured, you can choose a plan option that suits your budget as well as your medical needs.

Max Bupa Health Insurance - Customer Care Details