Max Bupa Health Companion Policy

Brief Overview

A joint venture between Max India Ltd, a prominent multi-business corporate firm, and Bupa, the world-renowned maestros in health insurance, Max Bupa has established itself as one of the leading health insurance companies in India. The company offers an array of health insurance policies, suiting individuals and families with varied requirements. One of their most popular offerings is Max Bupa Health Companion Policy. 

Max Bupa Health Companion provides comprehensive cover as the sum insured ranges from INR 3 lakhs to INR 1 crore. The customised benefits and services surely make it a plan worth investing in for securing the health of the entire family.

The most striking feature of this practical and affordable plan is that you can cover 19 relationships in a single policy, from your grandparents to your in-laws, from your siblings to your children, this policy will everyone under its cover.

This is an all-rounder comprehensive health insurance indemnity policy, it covers the costs of your treatment including pre and post hospitalisation expenditure, daycare treatments, AYUSH treatments etc. As a well-structured plan, it gives you the option to plan as per your individual needs and the needs of your family with the individual sum insured facility. The company promises a super-fast ‘30 minute claim settlement’ in its network hospitals that are spread across the country. The plan also provides cap-free room rent on all hospital rooms, except deluxe and suite.

To know more about Max Bupa Health Companion policy, let us discuss it in detail. 

Best Features of Max Bupa Health Companion Plan 

Here are some of the top salient features of Max Bupa Health Companion Plan –

• The plan offers a cover for 19 relationships
• Daycare treatments are covered
• No age restrictions, all family members above 91 days can be included in this plan
• Claims are settled by the company directly and not through a third-party
• Organ donation as per Transplantation of Human Organs Act 1994
• Except for deluxe and special category rooms, there is no cap on room rent in plans   with INR 5 lakhs and above
• Pre and post hospitalisation both are covered
• Prescribed treatment at home, also called Domiciliary Hospitalisation is also covered
• The cost of an ambulance up to INR 3,000 is covered

Benefits of Max Bupa Health Companion Plan  

Max Bupa Health Companion Policy comes with a long list of benefits, here are a few of them:

Wide Range of Cover
Starting from INR 3 lakhs, you have the option of a cover that goes up to INR 1 crore. Not just the cover, there are 19 relations covered in this plan.

Structured Plan
The policy gives you the option to plan as per your individual needs and the needs of your family. The choices are:

1. Individual Sum Insured
   An equal sum insured over for each member of the family
2. Family Floater
   Designed for a typical Indian joint family covering 19 relationships
3. Floater Sum Insured
   Available as a pool, the cover can be used by any member if and when his individual sum insured is exhausted

• Cashless Claims
  The company promises a cashless health claim settlement in a matter of 30 minutes in a network hospital. There are over 4,500 network hospitals that have a tie-up with the company.
• No limit on Room Charges
  A hospitalisation may go on for a few days and may also require time in the ICU. Except for deluxe and special category rooms, there is no cap on room rent in plans where the sum insured is  INR 5 lakhs and above.
• Pre and Post Hospitalisation
  The expenses that are incurred before and after hospitalisation can make a dent in your savings, therefore, Max Bupa Health Companion Policy saves the money that you spend on treatment 30 days before and 60 days after the hospitalisation will also be covered.
• Refill of Sum Insured
  When the base sum insured of your policy gets exhausted after treatment, the company will refill the entire amount for a later claim. It should be noted here that the claim must be for an unrelated illness or injury. Except for Family First, this benefit is available in all variants.
• Day Care Treatment
  Some treatments require hospitalisation that is less than 24 hours, this plan covers all day-care treatments.
• Domiciliary Hospitalisation
  A doctor-prescribed home treatment that could not be done in a hospital is also covered under this plan. It should be remembered that the domiciliary hospitalisation should be for at least 3 consecutive days.
• In-Patient Care
  When the hospitalisation takes place in a network hospital, an insured member can get a cashless treatment. This benefit lets you focus on the treatment rather than running around managing finances.
• Lifetime Renewal
  With no extra loadings, the policy allows lifelong renewability.
• Alternative Treatments
  Some policyholders in some cases, get treatment from alternate medicines. Under this plan, AYUSH treatments in a government recognised hospital are also covered. AYUSH stands for Ayurveda, Unani, Sidha and Homeopathy and the charges that you incur on such treatments will also be covered.
• Living Organ Donor Transplant
  A living donor’s inpatient treatment for a transplant is covered under the Companion plan. The transplant must be in accordance with The Transplantation of Human Organs Act 1994 and amendments thereafter.  Stem cell donations are not a part of this benefit.
• Ambulance Cover
  Available for one transfer per hospitalisation, the plan covers the charges incurred in an emergency ambulance transfer.
• Animal Bites Cover
  Cost of OPD treatment for vaccinations that may be required for an animal bite will be covered. However, this benefit is available only as a reimbursement.
• Health Check-Ups
  The policyholder can avail of health check-ups at the empanelled service providers if the plan is in force for 2 consecutive years.
• Tax Benefits
  The premium paid towards a policy would be allowed as a deduction under Section 80D of the Income Tax Act, 1961. A deduction of INR 25,000 that can increase to INR 50,000 if you are 60 years or above, can be made.
• No Claim Bonus
  Not making a claim can get you the NCB. Each year the sum insured will be increased by 20%.

What is covered in Max Bupa Health Companion Plan?

Here are the coverage details of Max Bupa Health Companion Plan variants –

Individual Cover

Family Cover

Details of Family First Benefit

• Base sum insured- INR 1, 2, 3, 4, 5 and 10 lakhs per Insured
• Floater base sum insured which is available on a floating basis over base sum insured - 3, 4, 5, 10, 15 and 20 lakhs

What is not Covered in Max Bupa Health Companion Plan?

1. Pre-Existing Diseases will not be covered for plans that have up to INR 4 lakhs as Sum Insured, for a period of 48 months. In plans with Sum Insured over INR 5 lakhs, the benefits will be made available after 36 months.
2. Artificial life maintenance using life support machines to sustain the insured person who has been declared brain dead
3. Behavioural and neuro-development disorders
4. External congenital anomalies
5. Cosmetic/ Reconstruction surgery, unless resulting from cancer/burns/injury
6. Dental and oral treatments
7. Optical services and treatments
8. Weight control programmes
9. Puberty and Menopause related diseases
10. Robotic-Assisted Surgery
11. Sleep disorders
12. Conditions that arise because of unlawful activities
13. Treatment outside India
14. Maternity treatment expenses, expenses towards miscarriage and lawful medical termination of pregnancy during the policy period.
15. Hormone Replacement Therapy
16. Sexually transmitted infections & diseases (other than HIV/AIDS)

Plan Details of Max Bupa Health Companion Plan

• Free Look Provision
  Under this provision, a period of 15 days from the date of purchase is given to the policyholder to review the terms of the plan. In case you are not satisfied with the policy, you can return/cancel the plan, provided that you have not made any claims within this period. The company will deduct the amount spent on medical check-ups (if any were conducted), proportionate risk premium and the stamp duty charges, from the premium amount paid by you and return the money in your bank account.
• Cancellation
  You can terminate/cancel the plan with a 30-day written notice. The policy will be cancelled for the remaining part of the tenure, and a refund will be initiated for the unexpired period. It should be noted that the refund will be made, on the condition that no claim has been made.
• Change of Policyholder
  For reasons like emigration, divorce or death, if you want to change the policyholder, you can do that at the time of renewing the plan. However, the new policyholder should be a member of your immediate family.

Renewal of Max Bupa Health Companion Plan

A policy renewal refers to the conditions on which the contract of the health insurance plan can be renewed with mutual consent. The renewal of the Max Bupa Health Companion Plan is generally not denied by the company, except if any discrepancy or fraud is found on the part of the policyholder. With this plan, you have the option of lifelong renewability with no extra loadings.

The company offers a period of 30 days, as a Grace Period, that starts from the day after the date of expiry. Keep in mind that a claim made in the grace period will not be accepted by the company. If the renewal is not done within the grace period, the policy will be terminated automatically.

Max Bupa Health Companion Plan Eligibility

Max Bupa Health Companion Plan Claim Process

When you discover any illness or get injured that may require you to file a claim, there is a certain procedure that needs to be followed.

Cashless Claims 

Cashless facilities can be availed only at the network hospitals. The list of network providers is given on the company website and also at all branches.

For a planned treatment, you must pre-authorise a Cashless facility at least 72 hours before treatment. Once the pre-authorisation is received, the treatment procedure must be carried out within 15 days.

In case of emergency treatment,  for pre-authorising the cashless facility, the company must be informed within 48 hours of hospitalisation, or before discharge (whatever is earlier)            

Reimbursement Claims
For the treatment that was not received at a network hospital or that could not be pre-authorised for cashless claims, the company must be informed about the same within 48 hours of hospitalisation or before discharge (whatever is earlier).

Documents Required: 

• Health Card issued by Company, along with KYC papers
• Policy number
• Name and address of policyholder and/or Insured person
• Nature of Illness and the Treatment required
• Name and Address of Doctor and the Hospital
• Date of Admission
• Consultation Papers
• Original ambulance receipt
• Police FIR or Medico-Legal Certificate in case of accidental injuries

Apart from the list of documents given above, for a reimbursement claim the following documentation is also required:

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

Before leaving the hospital, make sure you ask for Certified True copies of all the documents and make a set of these documents for your record.

Max Bupa Health Insurance Cashless Network Provider

The hospitals or healthcare providers that are enlisted by a health insurance company or by TPA and the company together are called network providers. At these centres only can the policyholders enjoy the cashless facilities. 

Hospitalisation at a network provider hospital can be very convenient as you get an instant treatment facility. You do not have to pay any money out of your pocket even for the best of services and treatments. Max Bupa Health Insurance has tie-ups with hospitals/chain of hospitals that are spread across the country, therefore, whether you are at your house or are travelling, you will be under the shield of the Max Bupa Health Companion Plan.

Max Bupa Health Insurance Customer Care Details

Health Insurance offers different modes of contacting the company for your queries or complaints. These modes are as follows –

Review of Max Bupa Health Companion Plan

An extremely comprehensive plan Max Bupa Health Companion Plan is loaded with facilities not just for its family floater but also individual variants. The policyholder offers a wide range when it comes to Sum Insured as it starts from INR 3 lakhs and goes up to INR 1 crore. 

The plan also comes without a cap on room rent, which can help the policyholder get his treatment comfortably, without the constant worry of increasing room charges. 

The Family Floater variant seems to be tailor-made for a typical Indian joint family and covers 19 relationships in a single plan. Pre and post hospitalisation, domiciliary treatments, no claim bonus, automatic refills, AYUSH treatments etc, make Max Bupa Health Companion Plan an extremely customer-centric health insurance plan.

With the medical inflation soaring all the more since COVID-19, investing in such a plan is not just a smart choice but also a fundamental requirement.