Aditya Birla Activ Health Essential Plan
For quality healthcare throughout life, an effective health plan becomes a necessity. The
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Aditya Birla Activ Health Essential: Key Highlights
Plan Type
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Individual/Floater
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Sum Insured
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Rs 50,000- 10 lakh
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Policy Tenure
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1, 2, 3 years
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Day Care Procedure cover
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527
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Chronic Disease Cover
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From day 1
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Eligibility Criteria
The minimum eligibility conditions to fulfil to buy this policy are:
Minimum Entry Age
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91 days
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Maximum Entry Age
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No limit
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Number of people covered
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9 members: 6 Adults + 3 children; Individual, spouse, dependent parents, dependent parents-in-law, children up to 25 years old
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Residential Status
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Indian Citizens and Permanent Residents
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Coverage Offered
One can buy an Aditya Birla Activ Health Essential Insurance Policy plan, which offers a sum insured from Rs 50,000 up to Rs 10 lakh with an Individual plan or a Family floater with a policy term from 1-3 years.
The following basic coverage is offered under the Aditya Birla Activ Health Essential plan:
- Inpatient Hospitalization - All expenses such as room rent, doctor's fee, medicine, etc., are covered as per the policy. One can also choose the hospital room category from economy to a single private room.
- Pre-hospitalization Medical Expenses - Medical expenses incurred up to 30 days before hospitalization are covered as per the policy.
- Post- hospitalization Medical Expenses- Up to 60 days, post-hospitalization medical expenses are covered as per the policy.
- Daycare treatment- A daycare hospitalization is covered for the treatments that do not require a 24-hour hospitalization up to 527 procedures.
- Domiciliary Hospitalization- If one cannot be admitted to the hospital, medical expenses during a home treatment are covered.
- Road Ambulance Cover- Ambulance charges incurred during an emergency are reimbursed fully if availed from network providers and up to Rs 2,000 per hospitalization if availed of from non-network providers.
Aditya Birla Activ Health Essential plan: Inclusions
Apart from the basic coverage, the following benefits are included in the Aditya Birla Activ Health Essential plan:
- Cumulative Bonus for every policy year that is free from claims
- Free annual Health Check-up Program, customized as per the individual's age.
- Chronic Management Program with doctors for diseases like diabetes, high cholesterol, and asthma
- Health Returns in the form of accumulated rewards that can be used for any medical expense not covered in the policy or to pay the premium of the policy renewal
- Wellness Coach to suggest a diet and fitness routine to keep track of one's health
- Second E-opinion on critical illness by international professional specialists for critical heart attack or cancer
- Deductible options to be opted for Rs 25000, Rs 50, 0000, Rs 1 lakh, or Rs 2 lakh as per the plan chosen.
- Hospital Cash benefit as an optional per day allowance with a deductible of 24 hours. This benefit can be availed up to 10 days per claim and maximum 30 days in a policy year.
The List of Exclusions
Given below is the list of treatment expenses that are excluded from the Aditya Birla Activ Health Essential Plan:
Wait-period diseases:
- Diseases encountered before the initial 30-days waiting period
- Conditions specified in the 24-months waiting period
- Pre-existing disease before the waiting period
- 24-month Maternity waiting period
Permanent Exclusions:
Following treatments/conditions/expenses are not covered:
- Self-injury
- Participation in criminal and unlawful activities
- Participation in Adventure sports
- Drug and alcohol abuse
- Obesity-related issues
- Congenital diseases or anomalies, etc.,
*For a detailed list of exclusions, please refer to the policy document.
Features and Benefits of the Aditya Birla Activ Health Essential Plan
Following are the benefits and features of the Aditya Birla Activ Health Essential Plan:
- Day 1 cover is provided under Chronic Management Program.
- Health Returns can be claimed up to 30%
- Option to choose any desired room category
- Tax benefits can be availed as per section 80 D of the income tax act.
- Second e-opinion is available in case of critical illness.
- The policy offers 30% of the premiums as Health Return as a reward for staying healthy
Cancellation of Policy
The Aditya Birla Activ Health Essential Plan Insurance policy has the following rules for cancellation:
- If the policy is cancelled within 15 days of offline policy or the first 30 days of online policy (free look period), 100 % of the policy coverage is refunded. The number of days the policyholder was insured, any expenses made by the insurer, and stamp duty charges will be deducted from the premium payment.
- If cancelled after the free-look period, such as within a period of 1 month, 3 months, and 6 months, the premium refunded will be 75%, 50 %, and 25%, respectively.
- No refund will be provided if the policy is cancelled after 6 months.
FAQs
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Ans: If one buys Aditya Birla Health Insurance for more than a year, one can save 7.5 % and 10% on the 2 and 3 years premium, respectively.
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Ans: In an Individual cover, coverage is offered to each individual in the family separately. In a Family Floater health insurance plan, each family member is covered based on a floater sum insured.
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Ans: This benefit is covered on payment of an additional premium. Therefore, any mandatory co-payment that is applicable under the Aditya Birla Activ Health Essential Plan will be waived off.
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Ans: A pre-existing condition is any health-related issue that the policyholder might be having within 48 months before buying the current health policy.
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Ans: Medical Expenses incurred abroad are not covered.