Key Features and Benefits of Aditya Birla Activ Health Platinum Premiere Plan
Given below are the key features and benefits of an Aditya Birla Activ Health Platinum Premier plan:
- Wide Range of Sum Insured – It comes with a variety of sum insured options ranging from Rs 10 lakh to up to Rs 2 crore.
- Annual Health Check-up – It provides a comprehensive medical check-up facility to the insured once every policy year.
- Value-added Benefits – The plan comes with multiple value-added benefits, including a chronic management program, HealthReturns, health assessment and expert health coach.
- Cashless Hospitalization – The Aditya Birla Health Insurance Company offers cashless hospitalization facilities to the insured at more than 8700 network hospitals.
- Premium Waiver Benefit – It offers a waiver on the premium of one year if the insured is diagnosed with a listed critical illness for the first time during the policy year, except for the premium of critical illness cover, personal accident cover and international coverage for major illness.
- Cumulative Bonus– It offers a cumulative bonus of 50% to the policyholder for every claim-free year to enhance the sum insured up to a maximum of 100%.
- Reload of Sum Insured Benefit – It comes with a sum insured reload and super reload option that recharges the sum insured up to 100% if exhausted.
- Tax Benefits– The plan offers tax-saving benefits on the paid premium as per Section 80D of the Income Tax Act, 1961.
Inclusions of Aditya Birla Activ Health Platinum Premiere Plan
The Aditya Birla Activ Health Platinum Premier plan includes the following coverage:
- In-patient Hospitalization Expenses – It covers the cost of hospitalization in case the insured is admitted to a hospital for more than 24 hours. It includes expenses, such as ICU charges, room rent, surgical appliances, nurses’ charges, etc.
- COVID-19 Hospitalization Expenses – It pays for the hospitalization expenses arising out of the treatment of COVID-19.
- Mental Illness Hospitalization – It covers the hospitalization expenses incurred by the insured for the treatment of mental illnesses, such as anxiety issues, depression, etc.
- Pre & Post-hospitalization Expenses– It pays for the medical expenses incurred before hospitalization for up to 60 days and after discharge for up to 180 days.
- Day Care Treatment – It provides coverage for day care treatment procedures that require hospitalization of less than 24 hours.
- Modern Treatment Methods – It covers the cost of availing treatment through modern and technologically advanced procedures, such as stem cell therapy, deep brain stimulation, immunotherapy, etc.
- Road Ambulance Cover – It reimburses the expenses incurred on availing ambulance services to transport the insured to the nearest hospital.
- Domiciliary Hospitalization – It pays for the necessary medical treatment taken at home for at least 3 consecutive days on the recommendation of a doctor if hospitalization is not possible.
- Organ Donor Expenses – It covers the expenses incurred by the organ donor for harvesting the donated organ during an organ transplant surgery.
- AYUSH Cover – It reimburses the medical expenses incurred by the insured on receiving treatment at an AYUSH hospital.
- OPD Cover – It covers the cost of out-patient consultations, diagnostic tests and medicines for up to Rs 1000 for a sum insured of Rs 15 lakh and more.
- Obesity Treatment – It pays for the expenses incurred on hospitalization of the insured for bariatric surgery, which is medically necessary.
- International Coverage for Major Illness – It reimburses the medical expenses incurred on the treatment of a major illness outside India. It includes hospitalization expenses, organ donor expenses, travel expenses, accommodation expenses, etc.
- Critical Illness Cover – It pays a lump sum benefit to the insured if he/she is diagnosed with a listed critical disease for the first time during the policy year.
- Post-hospitalization Physiotherapy Cover – It reimburses the expenses incurred by the insured on physiotherapy after getting discharged from the hospital on the advice of a doctor.
- Personal Accident Cover – It provides coverage against death or permanent total disability of the insured resulting from an accidental injury.
- Emergency Assistance Services – It pays for the expenses incurred on emergency medical evacuation or repatriation of the insured within India and abroad. It also includes the charges for air ambulance services.
- Home Treatment – It covers the cost of home treatment undertaken for diseases or procedures, such as dengue, chemotherapy, hepatitis, gastroenteritis, etc.
- Recovery Benefit – It provides a lump sum benefit to the insured for up to Rs 10,000 in case he/she was hospitalized due to an accidental injury for at least 10 consecutive days.
- Second E-opinion for Major Illnesses – It covers thecost of availing an online second opinion from domestic and international doctors on the diagnosis of a major illness.
- Dental Consultations & Investigations – It covers the cost of dental services, including oral evaluation, x-ray and oral prophylaxis once per policy year at a network hospital of the insurance company.
- Maternity Expenses – It provides coverage for pregnancy-related procedures, including childbirth or abortion, along with newborn baby expenses, vaccination expenses and stem cell preservation costs.
- Hospital Cash Benefit – It provides a daily hospital allowance for each day of hospitalization for up to 10 days per hospitalization and a maximum of 30 days in a policy year.
- Waiver of Mandatory Co-Payment – It enables the insured to get a waiver on the mandatory co-payment clause.
- Preferred Provider Network Discount - This cover provides the policyholder with 10% savings of premium in exchange for opting for 10% co-payment in case of hospitalization at a non-PPN hospital.
Exclusions of Aditya Birla Activ Health Platinum Premiere Plan
The medical expenses given below are excluded under the Aditya Birla Activ Health Platinum Insurance plan:
- Any accident/injury/illness due to abuse of alcohol or other intoxicants
- Infertility or sterility treatments
- Self-inflicted injury or an attempt to suicide
- Injury due to participation in hazardous or adventure sports
- Plastic or cosmetic surgery
- Sexually transmitted diseases
- Injuries sustained during a breach of law
- External congenital anomalies
- Venereal disease
- Injury or illness resulting from nuclear perils or an act of war
The above-mentioned exclusions are not exhaustive. Check out the entire list of exclusions by referring to the policy documents of Aditya Birla Activ Health Platinum Premiere plan.
Aditya Birla Activ Health Platinum Premiere Eligibility Criteria
The following table shows the eligibility criteria for the Aditya Birla Activ Health Platinum Premiere plan:
|Minimum Entry Age
||Adult – 18 years
Children - 5 years (individual cover), 91 days (family floater)
|Maximum Entry Age
||Adult – 65 years
Children – 25 years
Maternity Cover – 45 years
|Maximum Number of Family Members
||5 family members