Aditya Birla Health Insurance Top Up Plan

A top-up health insurance policy is an incremental coverage for persons with an existing individual or family health insurance cover. This policy comes in when a specific policy limit is breached during a hospitalisation emergency.

Aditya Birla Super Health Plus Top Up plan is among the most popular top up plans, which provides additional coverage over and above the regular health insurance plan. With the regular Aditya Birla Activ Assure Diamond Plan, it offers additional coverage up to Rs 1 crore.

Aditya Birla Health Insurance Top-up Plan: Key Highlights

Features	Highlights
Sum Insured & Deductible	a. Sum Insured: Rs 3/4/5/7/ 10 Lakh Deductible: Rs 1/2/3 Lakh b. Sum Insured: Rs 5/7/10/15/20/25/30/40/50 Lakh Deductible: Rs 4/5/7/10 Lakh c. Sum Insured: Rs 85 Lakh Deductible: Rs 15 Lakh d. Sum Insured: Rs 90 Lakh Deductible: Rs 10 Lakh e. Sum Insured: Rs 95 Lakh Deductible: Rs 5 Lakh
Pre-policy Health Check-Up	Required for the age above 45 years or Sum insured above Rs 25 lakh
In-patient Hospitalisation	Up to Sum Insured
Pre and Post Hospitalisation	Yes
Day Care Treatments	586 procedures covered up to Sum Insured
Room Category	Single Private AC Room

Prospective policyholders should make use of the Aditya Birla Health Premium calculator in order to estimate the amount of premium payable. For further details of the policy, please refer to Aditya Birla Health Top-Up Policy Brochure.

Aditya Birla Health Insurance Top Up Plan: Key Features & Benefits

The key benefits & features of the Aditya Birla Health Insurance Top-up Plan are:

Provides coverage over and above the base plan.
Helps in combating rising healthcare cost inflation.
Coverage against pre-existing diseases is available.
Covers 586 Day care procedures even if hospitalization is less than 24 hours.
More than 6000 network hospitals in over 65 cities where cashless services can be availed.
Health and Wellness benefits are available.
Tax benefits available under Section 80D of Income Tax Act, 1961
Aditya Birla Health claim settlement ratio of 94% indicates towards a faster and satisfactory claim settlement experience.

Aditya Birla Super Health Plus Top Up Plan Inclusions

The policy covers the insured for the following:

Room Rent Charges for accommodation in the Hospitalroom and other boarding charges up to the prescribed limits
ICU Charges
Operation theatre expenses
Medical Practitioner’s fees including fees of specialists and anesthetists treating the Insured Person
Qualified Nurses charges
Medicines and certain consumables
Organ donor expenses up to the Sum Insured
Diagnostic procedures or investigative tests directly related to the illness
Anesthesia, blood, oxygen and blood transfusion charges
Surgical appliances and allowable prosthetic devices
AYUSH (In-patient Hospitalisation)
Emergency Assistance Services (including Air Ambulance)
Domiciliary Hospitalisation up to the Sum Insured

Exclusions of the Policy

Aditya Birla Super Health Plus Top Up policy doesn’t cover the following conditions:

War, riots, uprising, civil wars, military or usurped acts
Any unlawful or criminal activity, intentional self-injury or attempted suicide
Any illness due to abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol
Contact lenses, spectacles, optometric therapy or hearing aids
Treatment for baldness, alopecia, wigs or similar treatment
Aesthetic, cosmetic, and re-shaping treatments and surgeries
Diagnostic tests, investigative procedures and treatment not related to illness for which hospitalization has been done

*For a complete list of exclusions, please refer to the Activ Assure Diamond – Super Health Plus Top-Up Policy Terms and Conditions

Eligibility Criteria

To avail this policy, one has to fulfil the below eligibility conditions:

Minimum Entry Age	5 years (Individual Policy)/ 91 days (Floater Policy)
Maximum Entry Age	65 years for adults 25 years for dependent children
Renewal Terms	Annual (or at end of policy period, if period higher than 1 year)
Cooling off Period	30 days
Wait Period for Named Elements	24 months for specific illnesses 48 months for mental illnesses
Pre-existing Diseases	36 months for pre-existing diseases
Sum Insured Modification	NA
Grace Period	Not later than 30 days from the expiry date of policy
Underwriting	As per insurer underwriting norms
Savings	Long term ● 7.5% on 2-year policy ● 10% on 3-year policy Long term savings will be applicable only in case of Single Premium Policies.

*All savings are as per the IRDAI approval. Standard T& C apply.

* For a specific list of waiting periods, please refer to the Aditya Birla Health Top-Up Policy Terms and Conditions.

Prospective policyholders should evaluate the Aditya Birla Health Super Top Up premium chart meticulously and peruse through the exclusions to assess the appropriate top-up cover option for them before finalizing the top-up plan.

FAQs

Q. Does Aditya Birla Health Insurance Top-up plan cover Organ Donor expenses?

Ans: Yes. Medical expenses up to the prescribed limits incurred in respect of the organ donor towards the harvesting of the organ donated is covered.
Q. Does the Aditya Birla Health Top-up plan cover AYUSH (In-patient Hospitalization) expenses?

Ans: Yes. Medical expenses up to the prescribed limits towards In-patient Hospitalization undertaken in Government hospitals or Government recognized teaching hospitals of recognized AYUSH colleges are covered only on a reimbursement basis.
Q. Does the Aditya Birla Health Top-up plan cover Home Treatment expenses?

Ans: Medical Expenses up to the prescribed limits incurred on treatment at policyholder’s own place of residence for any illness such as chemotherapy, dengue, gastroenteritis, hepatitis covered on a cashless basis only if availed through the Aditya Birla Health Insurance network provider or empanelled service providers providing such facility. Pre-authorisation is required from Aditya Birla Health Insurance. OPD treatment is not covered.