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Max Bupa Health Insurance

Max Bupa Health Insurance Company Limited is a joint venture between UK based company Bupa and Max India Ltd. It is one of the most admired health insurance companies in India. Max Bupa has a network in 190 countries across the world with a customer base of more than 29 million. Basically, building a concrete and long-lasting relationship with the customers is the paramount focus in the company.

Max Bupa has been in the healthcare industry for more than 60 years and has branches all over the world. Also, it is one of the leading health insurance companies in India. Additionally, this insurance company offers insurance services that are tailored to suit individual-specific needs. They include health insurance services and products for couples and extended as well as nuclear families.

The insurer brings together local and global expertise in the insurance and healthcare sector, thus making it a perfect choice to secure your family’s health and wellness. The company offers a range of health insurance plans to address all your health concerns in a comprehensive manner.

Max Bupa Health Insurance Overview:

Key Features Highlights
Incurred Claim Ratio 51.96%
Network Hospitals 3500+
Discount Multiple policies
Renewability Lifelong

Features of Max Bupa Health Insurance

Listed below are the salient features of Max Bupa mediclaim policies-

  • Max Bupa has a global network in 190 countries
  • Direct Claim Settlement without TPA
  • Claim Settlement Ratio of 89%
  • Cashless claim pre-authorization is given in 30-minutes
  • Comprehensive health insurance plans at an affordable premium
  • Discount on purchase of multi-year policies
  • Both Individual and family floater plans available

Max Bupa Health Insurance Plans Comparison Table

Plan Name Sum Assured (in Rs.) Renewability Pre-existing Diseases Coverage Type
Max Bupa GoActive Family Floater Health Insurance Plan- 4 to 25 Lacs. Lifelong 36 months Family Floater
Max Bupa Heartbeat Family Floater Health Insurance Plan- Gold: 5, 7.5, 10, 15, 20, 30, 50 Lacs.

Platinum: 15L, 20L, 50 L, 1 cr

Lifelong Silver Plans: 48 months

Platinum & Gold Plans: 24 months

Individual/Family Floater
Max Bupa Health Companion Floater Health Insurance Plan- Variant 1- 3 & 4 Lacs

Variant 2- 5, 7.5, 10, & 12.5 Lacs.

Variant 3- 15, 20, 30, 50 &  1 Crore

Lifelong Variant 1- 48 months

Variant 2 & 3 -36 months

Family Floater
Max Bupa Health Recharge Plan- Up to 5 Lacs Lifelong 36 months Individual/Family Floater
Max Bupa Criticare Health Insurance Plan- 3 Lacs to 2 Crore Lifelong 48 months Individual
Max Bupa AccidentCare Plan- 5 Lacs to 2 Crore Lifelong N/A Individual/Family Floater

Types of Max Bupa Health Insurance Plans

  1. Max Bupa GoActive Family Floater Health Insurance Plan- It a comprehensive plan for families that covers hospital treatment expenses, home health care services, organ transplant cost, day care treatment and OPD consultations, I-Protect and Health Coach.
  2. Max Bupa Heartbeat Family Floater Health Insurance Plan- The plan offers coverage up to 1 crore rupees. There is no limit on the hospital room category, covers overseas treatment in USA and Canada for specific dread diseases.
  3. Max Bupa Health Companion Floater Health Insurance Plan- The plan comes in 3 variants and there is no age criterion for enrolment. You can cover and spouse and up to 4 children in one plan. There is 12.5 % of discount on the purchase of a 2-year policy term.
  4. Max Bupa Health Recharge Plan- It is a pocket-friendly mediclaim policy under which you can cover you, your spouse and 4 children. Moreover, there is an option to opt for critical illness cover and personal accident cover along with the basic plan. You can avail a 12.5 % discount on a 2-year plan.
  5. Max Bupa Criticare Health Insurance Plan- It offers coverage against 20 major critical illnesses and offers direct claim settlement facility. You can either take payment in lump sum or opt for lump sum payment with 10 percent of SI for subsequent 5 years after payment of lump sum amount.
  6. Max Bupa AccidentCare Plan- The plan covers permanent and total disabilities. It provides child education benefit, funeral expense cover and worldwide cover.

Max Bupa Health Insurance Claim Procedure

To file a claim for a planned treatment you should inform the insurer 2 days prior to the hospitalization. If it is an emergency hospitalization inform the insurance company at least 24 hours after the hospitalization.

To lodge a claim, you can call at their 24×7 helpline number i.e. 1860-3010-3333. You can also write a mail to them at customercare@maxbupa.com.

However, the procedure for cashless and reimbursement claims is elucidated below-

Cashless Claim Procedure

You can avail cashless treatment at a network hospital only. Please follow the process described below-

  • Firstly, take admission in a network hospital. You can check the list of network hospitals on their site.
  • For easy identification, you use your Max Bupa Health Card/PAN card/Policy Number/ Voter
  • Hospital authorities will validate your identity proof. After that, the pre-authorization request will be submitted to the Max Bupa medical insurance team.
  • A confirmation email or fax will be sent to the hospital team. You will receive the confirmation on SMS also.
  • Once all the formalities are completed, the claim will be settled

Reimbursement Claim Procedure

  • Whether you take the treatment in a non-network hospital or a network hospital notify the insurer within 48 hours of the treatment.
  • Pay all the bills to the hospital for the treatment
  • Before the discharge do not forget to collect the medical reports, documents, discharge certificate, and original invoices
  • Now fill the claim form and sign it before sending it to the insurer. All attach all the documents with your age proof and valid ID proof. The claim form is available in the policy documents and on the insurer’s site.
  • Once all the formalities are completed, your claim request will be reviewed and on the basis of the same your Reliance medical insurance claim will be accepted or rejected.
  • If approved, your claim will be settled and the amount will be reimbursed.

Max Bupa Health Insurance Renewal

To avail the continuous benefits of a Max Bupa mediclaim policy it has to be renewed annually in the stipulated time. However, there is a grace period of 30 days for you to renew your mediclaim policy. The policy benefits will not apply during the grace period.

The policy will lapse if you fail to renew it during the grace period.  Max Bupa Health Insurance Renewal can be done online from the insurer’s site.

Simply provide your policy number to know the cost of renewal premium and make the payment online via debit card, credit card, and internet banking.

Inclusions- What is covered in Max Bupa Health Insurance Plans?

  • Hospitalization expenses without any limit on room rent expenses
  • Under this Max Bupa Health Insurance plans, expenses incurred 30 days before hospitalization and 60 days after hospitalization are recompensed.
  • All the daycare expenses are covered provided the procedure is not taken in the outpatient departments.
  • If you buy a 2-year policy, you can avail a 12.5 percent discount on the 2nd-year premium.
  • Maternity benefits and newly born baby cover in certain plans
  • Optional critical illness cover, personal accident cover, education allowance, and international treatment cover

Exclusions-What is not covered in Max Bupa Health Insurance Plans?

Your health insurance claim will be invalidated under the following circumstances-

  • Any treatment which is taken overseas
  • Reconstructive and cosmetic surgeries
  • HIV and AIDS treatment
  • Unproven or experimental treatments
  • Inconsistent diagnostic procedures
  • Treatment required for psychiatric conditions and mental disorders
  • Obesity and weight control programs
  • Off-label drug or treatment
  • Puberty and menopause-related disorders
  • Reproductive medicine & other maternity expenses
  • Sexually transmitted infections & diseases
  • Sleep disorders
  • Unlawful activity
  • Unrecognized physician or hospital
  • Suicidal attempts and self-inflicted injuries
  • Any injury or illness directly or indirectly related to war conditions, nuclear radiations and radiological emissions
  • Any diseases or illness caused after the consumption of alcohol and drugs
  • Involvement in adventure sports or activities

Benefits of Max Bupa Health Insurance Plans

Here are the advantages of buying a Max Bupa mediclaim policy-

  • Worldwide accidental personal accident cover
  • Lifetime renewability is available in all the plans
  • International coverage is available
  • 20-major critical illnesses are covered
  • All the plans come with lifelong renewability option
  • Sum Insured option up to 2 crore rupees
  • A number of add-on benefits are available
  • Cashless hospitalization at the network hospitals

How to Calculate Max Bupa Health Insurance Premium?

Max Bupa medical insurance premium is derived after considering the following factors-

  • Age of the eldest member
  • Amount of Sum Insured
  • of family members insured
  • Coverage type

However, to know the premium instantly, you can use Max Bupa health insurance premium calculator online. Just select a plan chose the sum insured amount, your personal details like your name, city, date of birth, email id, and phone number.

Why Buy Max Bupa Health Insurance Policy?

Any emergency situation, where you or any of your family members would require immediate health treatment (which has a huge financial cost attached to it); buying a Max Bupa mediclaim policy can be a lifesaver. You can also buy plans that provide yearly medical checkups facility and precautionary medical screening to ascertain your medical conditions in advance.

You can choose from various plans as per your needs such as critical illness plan, personal accident cover plan, top-up plan, and family floater plans. Apart from India, you can opt for overseas cover as well.

Documents Required for Max Bupa Health Insurance Claims

All the documents need to be sent to Max Bupa Health Insurance Co. Ltd. at B-1/I-2, Mathura Road, Mohan Cooperative Industrial Estate, New Delhi-110044.

  • Duly filled and signed claim form
  • KYC form
  • Hospital discharge certificate
  • Medical reports/ receipts/bills
  • Doctor’s prescription and consultation letter
  • Copy of Max Bupa medical insurance policy
  • Copy of PAN Card and address proof
  • Death certificate/post-mortem report ( accidental death)
  • I.R report ( accidental cases)

Max Bupa Health Insurance FAQs

Q1. What are the ways to buy a Max Bupa mediclaim policy?

There are various ways in which you can purchase this policy:

  • Max Bupa Health Insurance Online Purchase- Buy a policy online instantly, without running from pillar to post. It is only applicable to cases where pre-medical screening is not required.
  • Over the Call- You can speak to their health insurance agent on their helpline number to buy a Max Bupa health insurance plan.
  • Visit the Branch Office- Visit the nearest branch office to buy a mediclaim policy from Max Bupa. You can check the list of branch office from their website.

Q2. If my family stays in another city can I still get then covered under one plan?

Yes, it is possible to get coverage for your family under one plan. All the plans offer PAN India coverage. To avail cashless claims, you can check the list of Max Bupa network hospitals and avail treatment in a hospital in your vicinity. Whereas, in a non-network hospital you can get reimbursement of the hospitalization expenses.

Q3. Is there any tax benefit that one can avail of while purchasing a Max Bupa health insurance policy?

You are entitled to avail tax benefits against the health insurance premium that you pay annually for under the purview of the Sec. 80D of the Income Tax Act 196.

Q4. What is the policy duration option for Max Bupa mediclaim policies?

Max Bupa health insurance policies are available for a period of one year and extendible to 2 and 3 years there are special discounts on purchase of a multi-year policy.

Q5. What all illnesses are covered in heartbeat family floater plan?

International treatment is available for the below-mentioned illnesses-

  • Heart Attack (Myocardial Infarction)
  • Cancers such as sarcoma, lymphoma, and leukemia
  • Coronary Artery Bypass Graft (CABG)
  • Stroke
  • Aorta graft surgery/ stent insertion/ endovascular repair
  • Major Organ Transplant for lung, heart, kidney, liver, pancreas
  • Brain Surgery
  • Coronary Angioplasty followed by an angina attack
  • Primary Pulmonary Arterial Hypertension

Q6. What is the process of Max Bupa mediclaim policy renewal?

The renewal process of Max Bupa mediclaim policy is as follows-

  • Go to their website
  • Click on the policy renewal option
  • Provide your Max Bupa medical insurance policy number
  • Click on the submit option
  • You will know the amount of premium renewal
  • Go to pay now option and make the payment online for your policy renewal

Q7. Is cashless facility available for Max Bupa mediclaim policies?

Yes, you can avail cashless treatment in all the registered networks PAN India.

Q8. Is there a special plan for critical illnesses?

Yes, Max Bupa Criticare Health Insurance Plan provides coverage against 20 critical illnesses and the sum assured limit is 2 crore rupees.

Q9. Do you need to undergo pre-policy medical examination before buying Max Bupa Health Insurance Policies?

Yes, you need to undergo a pre-policy medical examination before buying any Max Bupa Health Insurance Policies. However, in case you are renewing your existing policies, you don’t have to undergo any medical checkup.

Q10. For How long Max Bupa Health Insurance Policies are valid?

Usually, these health policies are valid for 1-2 years after which renewal is essential. Buying a policy that is valid for 2 consecutive years can help you get some discount. However, this feature is applicable to Heartbeat and Health Companion policies only.