Niva Bupa (erstwhile Max Bupa)
Senior First Gold
Niva Bupa Senior First Gold is an exclusive plan built for senior citizens (those above 60 and under 75) and as such, this is targeted at people who may not have the option to buy a health plan due to pre-existing conditions. The upside is that you may qualify for this plan when you may not qualify anywhere else. The downside is that like most senior citizen plans, they come with restrictions on room rent allocation, sub-limits on a few diseases and lack of bonus or restoration benefits. There's also the fact that Niva Bupa's complaints volume has been a bit of concern for prospective buyers.
What's good here?
You always have full cover irrespective of the disease
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Short waiting period for Pre Existing Diseases
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after just 2 years. It’s probably the best deal you can get to be honest.
Day Care treatments covered
If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.
Covers Alternative Medicine
Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.
Pre & Post hospitalization expenses covered
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.
Full coverage even if you are forced to hospitalize at home
The insurer will bear the costs even if you are hospitalized at home due to a condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.
What's bad here?
You will have to pay a portion of the bill
The policy will only cover 50% of the final bill. The rest is on you. They call this a co-payment.
The policy will only cover 50% of the final bill. The rest is on you. They call this a co-payment.
What's okay here?
You can only pick a shared room
Tough luck if you are thinking about opting for a single private room. Because the policy only lets you stay in a shared room. If you still want to pick a better room, then be ready to pay a lot more when the final bill shows up.
Tough luck if you are thinking about opting for a single private room. Because the policy only lets you stay in a shared room. If you still want to pick a better room, then be ready to pay a lot more when the final bill shows up.
What's lacking here?
No Restoration Benefit
Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.
Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.
No Bonus for being healthy and not claiming insurance
Some policies offer you extra cover if you go an entire year without claiming your insurance. This policy, however, offers no such benefit.
Your insurer doesn’t provide free health check-ups
If you want to get a full-body checkup just to make sure you’re in fine working condition, be ready to pay for it yourself.
Add-ons
Safeguard
With this add-on, the insurer will increase your cover in line with inflation every year, your bonus amount will not be affected if the claim is less than ₹50,000 in the entire year and you also get extended coverage for generally excluded items like syringes, gloves, PPE kits etc.
Co-payment Modifier
This benefit helps to modify the co-payment from 50% to 0%, 20%, 30% or 40%. But remember, you need to pay extra premiums to reduce the co-payment.
Deductible
Deductible will be 1/5th of the base sum insured chosen. If deductible is opted, then co-payment will NOT apply except for treatment taken in higher than eligible category of room.
Frequently Asked Questions
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