Niva Bupa (erstwhile Max Bupa)
Senior First Gold
Niva Bupa’s Senior First Gold plan is a specialized health insurance offering tailored exclusively for senior citizens aged 61 to 75 years. It provides coverage for pre-existing conditions after only 2 years, along with benefits like AYUSH treatments and organ donor expenses. However, coverage options range from ₹5 lakhs to ₹10 lakhs, which is quite limiting compared to standard health insurance plans.
What's good here?
Has disease wise sub-limits
Your insurance cover won’t be fully available in case you are treated for Few robotic surgeries up to 1L and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
Your insurance cover won’t be fully available in case you are treated for Few robotic surgeries up to 1L and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
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.
Gym benefits aren't included in this policy
Gym benefits aren't included in this policy.
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.
Maternity benefits not offered
The insurer does not cover expenses related to maternity
Consumables aren't covered in this policy
Consumables aren't covered in this policy.
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.
Doctor consultations are not covered
Doctor consultations are not covered.
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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