Max Bupa Heartbeat Policy

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 

1. 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.
2. 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.
3. 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.

1. 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.
2. Room Charges
   Except for the suite and above, the plan would cover the room rent for Gold and Platinum variants.
3. 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.
4. 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.  
5. 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. 
6. Organ Transplant
   Expenses incurred during the treatment of an organ donor for the harvesting of the organ would also be covered.
7. 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. 
8. 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.
9. 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.
10. Day-Care Treatment
    Max Bupa Heartbeat Policy covers a long list of day-care procedures.
11. Lifetime Renewal
    Without any extra loadings on the basis of the claims that you have made, you can get assured renewal of your policy.
12. 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.
13. 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.
14. 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.
15. International Coverage
    Under this plan, specific illness and emergency hospitalisation and evacuation outside India are also covered.
16. 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.
17. 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.
18. 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.
19. 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.
20. 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.
21.  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

Heartbeat Individual and Family Floater - PLATINUM PLAN

Heartbeat Individual and Family Floater - GOLD PLAN

What is not covered in Max Bupa Heartbeat Policy?

1. 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
2. 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.
3. 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.
4. HIV/AIDS
   A waiting period of 48 months, since inception, is levied provided the renewal has been continuous.
5. Mental Disorders
   A waiting period of 36 months, since the beginning of the plan, is set for the treatment of mental disorders.
6. 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.

1. 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.
2. 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

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.