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Max Bupa Heartbeat Policy
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Established in 2010, Max Bupa Health Insurance Company has emerged as one of the most trusted brands among its customers. Over the years, the company has witnessed phenomenal growth. It has launched various innovative health insurance plans and products that offer unique benefits to its customers.
Max Bupa Heartbeat Policy has been a flagship product that is one of the most wide-ranging health insurance plans available in the market today. Max Bupa understands the importance of a good health insurance plan and helps its customers get access to excellent medical care. The Heartbeat plan is not just an all-inclusive policy, it is also very easy to understand.
Brief Overview of the Policy
A health insurance plan that offers wide coverage, the Max Bupa Heartbeat Policy also covers international emergency hospitalisation too. You can get cashless cover for all the insured members in your family at the network hospitals that are spread all over the country. The pre and post hospitalisation cover offered by Heartbeat is also more than other similar plans. You can claim the expenses 60 days prior and 90 days post hospitalisation.
If in case you overshoot the base sum insured during a similar or a different treatment, the company offers a 100% refill of the sum insured. A few riders further increase the scope of this affordable and hassle-free health insurance plan. Another striking feature of this plan is that it would also provide a cover for your ENT and dental procedures. Ayurveda, Unani, Siddha and Homeopathy treatments at a recognised centre will also be covered.
To know more about the Heartbeat Policy, read on.
Best Features of Max Bupa Heartbeat Policy
Max Bupa Heartbeat Policy comes with various unmatched features, let us take a look at a few –
- The plan offers coverage that ranges from INR 5 lakhs to INR 1 crore
- 19 relationships are covered in a single policy
- The plan also comes with Maternity benefits
- Emergency Ambulance charges are covered
- There are no third-party involved and so the Claim process is quick and easy
- The plan helps you reduce your income tax under Section 80D of the Income Tax Act
- Under the Heartbeat plan, specific illness and emergency hospitalisation and evacuation outside India are also covered
- After a specified waiting period, Inpatient treatment of Mental Disorders and HIV/AIDS are also covered
- Unlike many other health insurance plans, Heartbeat covers day-care treatments
- The company promises a 30-minute cashless facility at its 4,800+ network hospitals
Benefits of Max Bupa Heartbeat Policy
- An all-inclusive Plan
The plan has all the features that make a great shield to cover you against all medical emergencies. Unlike many other health insurance plans, the Heartbeat policy covers all kinds of treatments too for all your family members. - Cashless Claims
Being in a hospital can be a crucial time, but a cashless facility makes hospitalisation hassle-free. There are over 4,800 network hospitals that work in collaboration with the company and provide a claim settlement in 30 minutes. - One-Policy for the Whole Family
You can cover 19 of these relationships in this particular plan. The family will get a cover at two levels-- Individual Sum Insured - An individual sum insured for each member
- Floater Sum Insured - Shared among the members, the available cover can be used by any member when his/ her individual sum insured gets exhausted.
| Self | Spouse | Son | Daughter | Son-in-law |
| Daughter-in-law | Sister | Mother | Father-in-law | Mother-in-law |
| Grandfather | Grandmother | Grandson | Granddaughter | Brother |
| Brother-in-law | Sister-in-law | Sister | Nephew | Niece |
- Maternity and Newborn Baby Benefits
Under the family first and family floater variants, the Heartbeat policy offers maternity cover for up to 2 deliveries. It should be noted that this facility will be available after continuous coverage of 2 years only.
For the newborn baby also, all the first-year vaccinations are covered. The baby automatically comes under the cover from the day he/she is born. - Room Charges
Except for the suite and above, the plan would cover the room rent for Gold and Platinum variants. - Pre and Post Hospitalisation
For 60 days before and 90 days after your hospitalisation, the expenses that you have incurred for the particular treatment will be covered under this plan. - Health Check-Ups
Depending on the type of plan you have, the company offers a list of diagnostic tests from which you can select the tests that you want, provided, the policy is renewed break-free in the second policy year. - Emergency Ambulance
You can also make a reimbursement claim if you made use of an ambulance for transporting an insured member in a medical emergency. - Organ Transplant
Expenses incurred during the treatment of an organ donor for the harvesting of the organ would also be covered. - OPD Treatment
The medically required treatments that are taken as an outpatient would be compensated by the company. This feature is available with the Platinum Plan. - Domiciliary Hospitalisation
Sometimes hospitalisation is not possible due to the unavailability of rooms in the hospital or on the doctor’s advice. In such a case the treatment can be taken at home. The medical expenses that are incurred for the medical treatment that had to be taken at home, will be reimbursed under the policy. - Alternative Treatments
If an alternate treatment requires hospitalisation for in-patient care, the policy would cover the expenses. Alternate treatment includes Homeopathy, Unani, Siddha and Ayurveda. - Day-Care Treatment
Max Bupa Heartbeat Policy covers a long list of day-care procedures. - Lifetime Renewal
Without any extra loadings on the basis of the claims that you have made, you can get assured renewal of your policy. - Refill Benefit
If you exhaust the sum insured, you can get 100% of the same amount refilled. This refill is available for the same as well as different illnesses. - Second Medical Opinion
Under specified illness covered under the Platinum Plan, you will be able to seek a second medical opinion. You can take one opinion per insured member per illness or surgery. - In-patient Care
When you get hospitalised in a network hospital, you can avail of the cashless facility for all the members of your family who are insured. - International Coverage
Under this plan, specific illness and emergency hospitalisation and evacuation outside India are also covered. - Loyalty Benefits
- At the end of each policy year, you will receive a 10% of the expired base sum insured
- The sum insured that is additional can be accumulated to 100% of the base sum insured in the case of the Gold and Platinum plan and up to 50% in the case of the Silver plan.
- Tax Benefit
The premium paid for buying this policy would be allowed as a deduction under Section 80D of the Income Tax Act, 1961. You can claim a maximum deduction of INR 25,000 which would increase to INR 50,000 if you are aged 60 years and above. Moreover, if you buy a separate health plan for your dependent senior citizen parents, you can claim an additional deduction of up to INR 50,000 on the premium paid for their policy. - Refill Benefit
When a different or the same illness hits you in the same policy year, the base sum insured will be refilled for your future use. - Discounts
A 12.5% discount can be availed on the premium for the second year if you take the policy for a period of 2 years. - Zonal Coverage
Healthcare costs differ all over the country. Opt for Zone 1 pricing if you wish to get treated anywhere in the country. However, if you live in any city except- Mumbai, Delhi, NCR, Kolkata and Gujrat, zone 2 pricing will get you a lower premium if you opt for a 20% co-payment in the listed cities. Under Silver and Gold Plans the option of Zonal co-payment is applicable. Co-payment helps in making the premium affordable. - Additional Benefits
- Hospital Cash - to cover the non-medical expenses
- Personal Accident Cover - a lump sum amount is paid in case of accidental death, permanent total and partial disability.
- Critical Illness Cover - for almost 20 terminal illnesses
- Premium Waiver - if the policyholder dies or is detected with a specific illness, then the premium for the coming year will be dropped. This benefit is not available in the Individual variant.
What is Covered in Max Bupa Heartbeat Policy?
Here are the coverage details of Max Bupa Heartbeat Policy –
Heartbeat Family First
| Coverage Details & Benefits | Silver Plan | Gold Plan | Platinum Plan |
Base Sum Insured (Per Person) | INR 1 Lakh, INR 2 Lakhs, INR 3 Lakhs, INR 4 Lakhs & INR 5 Lakhs
| INR 1 Lakh, INR 2 Lakhs, INR 3 Lakhs, INR 4 Lakhs, INR 5 Lakhs, INR 10 Lakhs & INR 15 Lakhs
| INR 5 Lakhs, INR 10 Lakhs & INR 15 Lakhs |
| Floater Sum Insured (available on floating basis over base SI) | INR 3 Lakhs, INR 4 Lakhs, INR 5 Lakhs, INR 10 Lakhs & INR 15 Lakhs
| INR 3 Lakhs, INR 4 Lakhs, INR 5 Lakhs, INR 10 Lakhs, INR 15 Lakhs, INR 20 Lakhs, INR 30 Lakhs & INR 50 Lakhs | INR 15 Lakhs, INR 20 Lakhs, INR 30 Lakhs & INR 50 Lakhs |
| Inpatient Care | Covered up to Sum Insured | ||
| Day Care Treatment | Covered up to Sum Insured | ||
| Health Check-Up | Once in 2 years | Yearly, Tests covered up to INR 2,500 per Insured Person
| Yearly, Tests covered up to INR 5,000 per Insured Person
|
| Alternate Treatment | Covered up to Sum Insured | ||
| Maternity Benefit | Up to INR 35,000 per Policy Year | Up to INR 50,000 per Policy Year | Up to INR 1 lakh per Policy Year |
| Pharmacy and Diagnostic Facilities | Through empanelled service provider | ||
| Pre and Post Hospitalisation | Covered up to Sum Insured | ||
| Domiciliary Hospitalisation | Covered up to Sum Insured | ||
| Emergency Assistance Services | Covered up to Sum Insured | ||
| Room Rent | INR 3,000 per day or Shared Room
| Covered up to Sum Insured | Covered up to Sum Insured |
| Mental Disorder Treatment | Covered up to Sum Insured | ||
| New Born Baby | Covered up to Sum Insured | ||
| Vaccination for New Born Baby | Till baby completes 1 year, vaccines as per the defined list |
Heartbeat Individual and Family Floater - PLATINUM PLAN
Base Sum Insured (INR) | 15 Lakhs | 20 Lakhs | 50 Lakhs | 1 Crore |
| Inpatient Care | Covered up to Sum Insured | |||
| Day Care Treatment | Covered up to Sum Insured | |||
| Health Check-Up | Annual Tests up to INR 3,750 | Annual Tests up to INR 5,000 | ||
| Alternate Treatment | Covered up to Sum Insured | |||
| Maternity Benefit | Up to INR 1.2 Lakhs | Up to INR 1.6 Lakhs | Up to INR 2 Lakhs | Up to INR 2 Lakhs |
| Pharmacy and Diagnostic Facilities | Through empanelled service provider | |||
| Pre and Post Hospitalisation | Covered up to Sum Insured | |||
| Refill Benefit | Reinstated Up to Base SI | |||
| Domiciliary Hospitalisation | Covered up to Sum Insured | |||
| Emergency Assistance Services | Covered up to Sum Insured | |||
| Room Rent | Covered Up to | |||
| Mental Disorder Treatment | Covered up to Sum Insured (Sub-limit Applicable) | |||
| New Born Baby | Covered up to Sum Insured | |||
| Vaccination for New Born Baby (defined) | Till baby completes 1 year | |||
| Child Care Benefits (defined) | Covered up to Sum Insured | |||
| OPD Treatment and Diagnostic Services | Up to INR 15,000 | Up to INR 20,000 | Up to INR 35,000 | Up to INR 50,000 |
| Specific Illness Cover (except US, Canada & India) | Covered Up to Sum Insured |
Heartbeat Individual and Family Floater - GOLD PLAN
Base Sum Insured (in INR) | 5 Lakhs | 7.5 Lakhs | 10 Lakhs | 15 Lakhs | 20 Lakhs | 30 Lakhs | 50 Lakhs |
| Inpatient Care | Covered up to Sum Insured | ||||||
| Day Care Treatment | Covered up to Sum Insured | ||||||
| Health Check-Up | Annual- Up to INR 1,250 | Annual- Up to INR 1,875 | Annual Tests up to 2,500 | ||||
| Alternate Treatment | Covered up to Sum Insured | ||||||
| Maternity Benefit | Up to INR 40,000 | Up to INR 60,000 | Up to INR 70,000 | Up to INR 75,000 | Up to INR 80,000 | Up to INR 1 Lakhs | Up to INR 1 Lakhs |
| Pharmacy and Diagnostic Facilities | Through empanelled service provider | ||||||
| Pre and post Hospitalisation | Covered up to Sum Insured | ||||||
| Domiciliary Hospitalisation | Covered up to Sum Insured | ||||||
| Emergency Assistance Services | Covered up to Sum Insured | ||||||
| Room Rent (except Deluxe/ Above Average) | Covered Up to the Sum Insured | ||||||
| Mental Disorder Treatment | Covered up to Sum Insured (Sub-limit Applicable) | ||||||
| New Born Baby | Covered up to Sum Insured | ||||||
| Vaccination for New Born Baby | Till baby completes 1 year, |
What is not covered in Max Bupa Heartbeat Policy?
- Pre-Existing Diseases
Pre-existing conditions are not covered unless in the policy:- Platinum & Gold Plan- Till 24 months of continuous cover from the date of purchase of the first policy
- Silver Plan - Till 48 months of continuous cover from the date of purchase of the first policy
- Waiting Period
No claims can be made during the first 30 days from the date of purchase. However, if treatment is required due to injury or an accident, it will be covered. - Specific Waiting Period
For people who are under 45 years of age there is no specific waiting period. For people who are above 45 years of age certain conditions are subject to a 24-month waiting period. - HIV/AIDS
A waiting period of 48 months, since inception, is levied provided the renewal has been continuous. - Mental Disorders
A waiting period of 36 months, since the beginning of the plan, is set for the treatment of mental disorders. - Permanent Exclusions:
- Artificial maintenance of life
- Circumcision
- Cosmetic or plastic surgery unless resulting from cancer or burns or an injury
- Dental Treatment
- Sexually Transmitted Diseases
- Robotic-Assisted Surgery
- Sleep Disorders
- Unrecognised Doctor or Hospital
Renewal of Max Bupa Heartbeat Policy
Max Bupa Heartbeat Policy comes with lifelong renewability but keep in mind that the policy will be terminated when the policy tenure finishes. However, if you wish to continue the benefits of the policy, you should make a request for Policy Renewal. The payment of renewal premium would ensure that you do not miss out on any policy benefits. The renewal amount can be made on or before the expiry of the grace period. The grace period starts immediately after the premium due date is over, and continues for a period of 30 days. But remember, that No claim can be made till the time payment of renewal is made.
Here are a few points which you should remember at the time of renewal of policy –
- If the renewal is not done within the coverage expiry date, the policy will lapse
- Claims during the Grace Period will not be accepted
- In case of any change in medical condition or a geographical location of any of the insured members, it is your duty to make a disclosure at the time of renewal of the policy
- If an insured child completes 22 years of age at the time of renewal, a separate policy based on company guidelines would be required
- Any changes in sum insured or addition of Insured Members can be made at the time of renewal
Max Bupa Heartbeat Policy Claim Process
In case of an injury of the onset of a disease, you may require treatment/ hospitalisation. When making a claim, you are supposed to follow certain guidelines and instructions laid out by the insurance company. Let us take a look at how you can avail a hassle-free claim.
- Cashless Claim
- For a cashless claim, you have to be in a network hospital only. In case of planned admission, inform the company at least 72 hours before and in case of an emergency, within 48 hours of hospitalisation.
- In a planned hospitalisation, remember, once you receive the authorisation, the treatment must be done within 15 days of the pre-authorisation date.
- Reimbursement Claim
For claims that were not taken after pre-authorisation or that were not taken at a non-network hospital, reimbursement may be claimed. Ensure that you inform the company and raise a request for the same within 48 hours of hospitalisation.
Required Documents:
Keeping your treatment documents safely and carefully will be a great help in speeding up the claim process. Also, ensure that you keep the Certified True Copies of all the treatment-related documents. At the time of hospitalisation you need:
- 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 above-listed documents, you may require the following documentation for a reimbursement claim :
- Valid Photo Identification document
- Duly filled and signed Claim Form
- Cancelled Cheque
- Original discharge summary
- All bills, receipts issued by the hospital
- Original ambulance receipt
- Police FIR or Medico-Legal Certificate in case of accidental injuries
- All diagnostic and pathological Reports
Max Bupa Heartbeat Policy Network Hospital
When you visit a network provider hospital, you can opt for a cashless claim for all the expenses, up to your base Sum Insured, that would be incurred due to your treatment. On the other hand, in a non-network hospital, you would first have to pay for the whole treatment and then you can claim a reimbursement. If you have the benefit of making a cashless claim, it is only prudent to go to a network hospital only.
Max Bupa health insurance company has a long list of network hospitals. With a network of over 4800 hospitals all over the country, the company promises a claim settlement in 30 minutes. See to it, that you and the other insured members of your family have a list of the hospitals under the network, especially the ones that are in close proximity to your residence.
Max Bupa Health Insurance Contact Details
| Website Address | www.maxbupa.com |
| Phone numbers | 1800-3010-3333 |
| Customer Helpline | 1860-500-8888/1860-500-1000 |
| Fax Number | 011-30902010 |
| Email ID | customercare@maxbupa.com |
| Company Corporate Office Address | Customer Services Department, Max Bupa Health Insurance Company Limited, B-1/I-2, Mohan Cooperative Industrial Estate MathuraRoad, New Delhi - 110044 |
| Registered Office | Max House, 1, Dr Jha Marg, Okhla, New Delhi - 110020 |
Review of Max Bupa Heartbeat Policy
Max Bupa Heartbeat Policy is considered to be one of the most comprehensive health plans by Max Bupa. With a wide coverage that ranges from INR 5 lakhs to INR 1 crore, you can cover 19 of your relations in this single plan. The plan comes with numerous services like maternity benefits, day-care procedures, alternate treatments and health check-ups.
The refill benefit is a striking feature of the plan that helps you manage finances for your hospitalisation even after using your base sum insured. Apart from this, notwithstanding the claim history, you can avail of san increase of 10% of the expired Sum Insured every year. This facility, however, is subject to a limit of 100% of the base sum insured.
After the age of 65 to 70 years, most health insurance plans do not offer a renewal, whereas, with a Heartbeat plan, you get lifelong renewability.
Over the past few years, there has been an unabated rise in lifestyle diseases, and with COVID-19 almost everyone has understood the imperativeness of having a good health insurance plan. In such circumstances, investing in Max Bupa Heartbeat Health Insurance Policy is indeed a step in the right direction.
Max Bupa Heartbeat Policy FAQs
1. Is there maternity coverage under the Heartbeat health insurance plan?
Yes, maternity coverage is provided in this plan, provided there has been a continuous coverage of 24 months from the beginning of the first policy. Remember, that this cover can be taken only twice, either for delivery or for lawful terminations.
2. What is the entry age for the Max Bupa Heartbeat plan?
- For adults, the entry age is from 18 to 65 years of age
- For dependent children - 91 days to 21 years
3. Will Max Bupa Heartbeat policy cover COVID hospitalisation?
As per the guidelines issued by IRDA, all indemnity based health insurance policies, including Max Bupa Heartbeat Health Insurance Policy will cover COVID-19 hospitalisation.
4. How does co-payment work in Max Bupa Heartbeat Policy?
In case a pre-fixed percentage of the claim amount, subject to the option chosen by the policyholder, is paid by the policyholder it is called a co-payment. In Max Bupa Heartbeat Policy, if you want, you can opt for Zone 1 pricing if you wish to get treated anywhere in the country. However, if you live in any city except- Mumbai, Delhi, NCR, Kolkata and Gujrat, zone 2 pricing will get you a lower premium if you opt for a 20% co-payment in the listed cities. Under Silver and Gold Plans the option of Zonal co-payment is applicable. Co-payment helps in making the premium affordable.
5. Who can be covered under a family floater policy?
Under the family floater option you have the option to cover 19 relationships that include:
Self Spouse Son Daughter Son-in-law Daughter-in-law Sister Mother Father-in-law Mother-in-law Grandfather Grandmother Grandson Granddaughter Brother Brother-in-law Sister-in-law Sister Nephew Niece 6. Is coverage allowed during the grace period?
The grace period starts immediately after the premium due date is over, and continues for a period of 30 days. No claim can be made till the time full payment of renewal charges is made.
7. What is the meaning of the Portability Option?
Health insurance plans are portable. It is the right accorded to a policyholder, to transfer the credit gained for Pre-existing conditions and time-bound exclusions, from either one insurance company to another or from one plan to another plan of the same insurance company.
To port to another insurance company, you need to approach it 45 to 60 days before the policy renewal date. This will help you avoid a break in the coverage.8. What is e-Consultation?
An add-on benefit, e-Consultation means taking medical guidance from a Government registered Doctor and is entitled to practice medicine in the government’s jurisdiction.
9. What special features are offered under the Platinum plan of Max Bupa Heartbeat Policy?
Under the Platinum plan, you get :
- International coverage of specific illnesses
- Emergency Medical evacuation and Hospitalisation outside India
- Diagnostic Services and OPD Treatments
- Second Medical Opinion
10. What is the meaning of the Free Look provision?
Available only at the time of purchase of the policy, the free look is a 15 day period (30 days if the Policy has been sold through distance marketing). In case you have any objections to the terms of the policy, you can state your reasons for the same and cancel the policy. Remember, in order to cancel a policy it is fundamental that no claims would have been made so far. A refund of the amount you had paid will be made once the necessary deductions have been made.
11. How do I download the Heartbeat health insurance Claim Form?
To download the Claim Form, you can visit the company website or simply click https://www.maxbupa.com/content/dam/maxbupa/PDF/Heart-Beat/Claims%20Form.pdf