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Aditya Birla Activ Health Enhanced Health Insurance

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Aditya Birla Health Insurance
Activ Health Enhanced
Cashless Approval TAT2 hr Cashless Claim Processing
Claim Settlement Ratio96%
Network Hospitals10,500+
Pre-existing Disease Coverage Starting FromDay 1
Special BenefitsIncentivized Wellness
Starting Premium for Rs. 5 lakh CoverageRs. 270/month

About Aditya Birla Activ Health Enhanced Health Insurance

The Activ Health Platinum Enhanced plan is an upgraded version of the regular Activ Health Plan from Aditya Birla Health Insurance. This health insurance plan not only takes care of your health but also offers rewards. Created to support your journey to well-being, the Activ Health Platinum Enhanced Plan provides coverage of up to Rs. 2 Crore. What's even better is that it rewards you with health returns.

Consider this insurance policy as a significant step towards a healthier life. Activ Health Platinum Enhanced plan covers specific chronic illnesses like high cholesterol, diabetes, hypertension, and asthma right from the beginning. You get to choose your hospital room at the start of the policy. Additionally, you can receive up to 30% of your annual health insurance premium as HealthReturns. In case of unrelated illnesses or accidents within the same year, the plan reloads your coverage by 100%. Read more about this health insurance plan below.

Activ Health Platinum Enhanced Health Insurance At a Glance

Coverage

Both Individual Basis and Family Floater

Riders

Outpatient Coverage, Maternity Coverage, etc.

Policy Period

1, 2 and 3 Years

Key Features

Comprehensive Dental Coverage, HealthRewards, and more

Inclusion

Pre and post Hospitalisation, Day Care Treatment, etc.

Exclusion

Self Inflicted Injuries, Alcohol or Drug Abuse, etc.

Riders Available With Activ Health Platinum Enhanced Health Insurance

Mentioned below are the riders or add-ons available with Activ Health Platinum Enhanced Health Insurance plan:

  • Outpatient Coverage: This part of the insurance covers the costs when you visit the doctor without being admitted to the hospital. It pays for necessary consultations, tests, and medicines. This includes regular check-ups, tests suggested by your doctor, and the medicines they prescribe in writing. Even alternative treatments are covered.
  • Deductible: If you choose a deductible option, it means you agree to pay a certain amount each year before the insurance kicks in. This amount is applied to the total of all valid claims you make in that year.
  • Maternity Coverage: This extra coverage is for maternity-related expenses. After waiting for 24 months, it covers costs for delivering a child, necessary treatments related to maternity, and lawful medical termination of pregnancy. You can use this for up to two events, which can include two deliveries, two terminations, or one of each. This is available for individuals between 18 and 45 years old.
  • Hospital Cash Benefit: With this addition to your insurance, you get paid a daily benefit for each full day you spend in the hospital for treatment due to illness or injury. The payment is made for a maximum of 30 days in a year, with a limit of 10 days for each claim.

Key Features of Activ Health Platinum Enhanced Health Insurance Plan

The following are the critical features of the Activ Health Platinum Enhanced plan:

  • HealthRewards for Healthy Choices: Earn up to 100% of your premium back through our HealthRewards program. Stay Activ and maintain your health to reap financial benefits.
  • Personalised Guidance from a Health Coach: With the Activ Health Platinum Enhanced plan, enjoy the services of a dedicated Health Coach. Receive personalised workout and nutrition plans, along with expert guidance on mental health, all included in your plan.
  • Double Coverage for Claim-Free Years: Experience a doubling of your coverage at no additional cost after two consecutive claim-free years. It's a reward for consistent health and timely premium payments.
  • 100% Sum Insured Reload: In times of uncertainty, the plan offers a 100% refill of your Sum Insured during the policy year, providing comprehensive coverage when you need it most.
  • Comprehensive Dental Coverage: The Activ Health Platinum Enhanced plan ensures cashless coverage for listed dental treatments, enhancing the scope of your health insurance.
  • Coverage for Mental Health Hospitalisation: Recognising the significance of mental well-being, Activ Health Platinum Enhanced extends coverage for both pre and post hospitalisation expenses related to mental illnesses, offering peace of mind during challenging times.

Eligibility Criteria of Activ Health Platinum Enhanced Health Insurance Plan

The eligibility criteria for Activ Health Platinum Enhanced plan are as follows:

Parametres

Eligibility Criteria

Minimum entry age

Individual Policy: 5 Years

Floater Policy: 91 Days

Maximum entry age

No Restriction

Sum insured

Up to Rs. 2 Crore

Benefits of Activ Health Platinum Enhanced Health Insurance Plan

The benefits of this health insurance plan are as follows:

  • Affordable Pricing: Activ Health Platinum Enhanced insurance policy offers fair pricing compared to other products in the market, ensuring you get comprehensive coverage without breaking the bank.
  • Freedom to Choose Room Type: Enjoy the flexibility to choose the type of hospital room you prefer, without any restrictions. Whether it's a shared room or a private A/C room, the choice is yours.
  • Coverage for Outpatient Costs: The policy covers outpatient department costs, including medications, tests, and consultations, providing comprehensive coverage for your medical needs.
  • Pregnancy-Related Expenses Covered: The Activ Health Platinum Enhanced policy covers expenses associated with pregnancy, ensuring comprehensive support during this crucial time.
  • Coverage for Bariatric Surgery: If weight loss is a goal, the Activ Health Platinum Enhanced policy has you covered. Bariatric surgery expenses are included, supporting your journey to a healthier weight.
  • Management of Chronic Conditions from Day 1: For chronic conditions like diabetes, hypertension, high cholesterol, and asthma, management expenses are covered from day 1, ensuring continuous support right from the start.

Inclusions of Activ Health Platinum Enhanced Health Insurance Plan

Listed below are the inclusions of the Activ Health Platinum Enhanced policy:

  • In-patient Hospitalisation: All expenses related to being admitted to the hospital, including room charges, nursing fees, and other associated costs, are covered under this plan.
  • Pre-hospitalisation Medical Expenses: Medical expenses incurred before your actual hospital stay, such as diagnostic tests or consultations, are included in the coverage.
  • Post-hospitalisation Medical Expenses: Costs for medical treatments and follow-up care after your hospital stay, like medication or additional tests, are covered under this plan.
  • Day Care Treatment: Even for treatments that don't require a prolonged hospital stay but are necessary, like certain surgeries or procedures, the plan provides coverage.
  • Domiciliary Hospitalisation: If circumstances require you to be treated at home instead of the hospital, the plan covers the associated medical expenses.
  • Road Ambulance Cover: The plan provides coverage for the expenses incurred for using road ambulance services to transport you to the hospital.
  • Organ Donor Expenses: In the case of organ transplantation, the plan covers the medical expenses for the organ donor, ensuring comprehensive support.
  • ICU charges covered up to the Sum Insured: Expenses related to ICU stay, up to the sum insured, are covered, providing financial support during critical medical conditions.
  • AYUSH Cover: The plan covers medical treatments under Ayurveda, Yoga, Unani, Siddha, and Homeopathy, ensuring a holistic approach to healthcare.
  • Mental Illness Hospitalisation: Medical expenses related to hospitalisation for mental illnesses are covered under the plan, recognising the importance of mental health.
  • Obesity Treatment: The plan covers expenses for the treatment of obesity up to the sum insured, supporting efforts to address this health concern.
  • Home Treatment: Medical expenses incurred for treatment at home are covered under the plan, offering convenience and support for certain health conditions.
  • Modern Treatment Methods and Advancement in Technologies: The plan covers the costs of advanced and modern medical procedures and technologies, ensuring access to cutting-edge healthcare options.

Exclusions of Activ Health Platinum Enhanced Health Insurance Plan

Following are the exclusions of Activ Health Platinum Enhanced Health Insurance plan:

  • Self-Inflicted Injuries: Injuries intentionally caused by oneself are not covered. The policy excludes expenses related to self-harm.
  • Criminal Activities or Breach of Law: Any injuries or incidents resulting from criminal activities or intentional violations of the law are not covered by the policy.
  • Alcohol or Drug Abuse: The policy does not support treatments related to substance abuse.
  • War, Mutiny, or Nuclear Threat: Injuries or damages resulting from war, mutiny, or nuclear threats are excluded from coverage under the policy.
  • Cosmetic Treatments or Alterations: The policy does not cover expenses for cosmetic treatments or procedures aimed at altering one's aesthetic appearance.
  • Unproven Treatments: Treatments that are not established or proven as effective for a particular illness or injury are excluded from coverage.
  • Any Mental Disorder: Expenses related to the treatment of mental disorders are not covered under the policy.
  • Congenital Abnormalities: The policy does not cover medical expenses associated with congenital abnormalities or conditions present at birth.
  • Cost of Hearing Aids, Lenses, and More: Expenses for items like hearing aids, lenses, spectacles, and crutches are not covered by the policy as these are considered personal expenses by the insurer.

Documents Needed for Activ Health Platinum Enhanced Health Insurance

To get the Activ Health Platinum Enhanced Insurance plan, you will need to provide the below-listed documents:

  • A duly filled Application Form.
  • Identity Proof (Aadhar card, Passport, Voter ID, or Driver's license).
  • Age Proof (Birth Certificate, School Leaving Certificate, or Passport).
  • Address proof (Utility Bills, Rental Agreement, or Aadhar Card).
  • Passport-sized photos
  • Pre-policy health check-up reports might be required in some cases
  • Any other documents requested by the insurance company.

How to Buy Activ Health Platinum Enhanced Health Insurance Plan?

Buying the Activ Health Platinum Enhanced Health Insurance Plan through InsuranceDekho is pretty simple. You just need to follow the steps mentioned below:

Step 1: Visit the InsuranceDekho website and tap on "Health Insurance" in the Insurance section.

Step 2: Click on "Aditya Birla Health Insurance" from the list of Health Insurance Companies.

Step 3: Select the "Activ Health Platinum Enhanced" plan from the available options.

Step 4: Review the terms and conditions in the Activ Health Platinum Enhanced policy document.

Step 5: Upload all the required documents to complete the KYC process.

Step 6: After KYC, pay the premium online.

Step 7: You will receive the policy document in your email.

Claim Process for Activ Health Platinum Enhanced Health Insurance Plan

You can claim the Activ Health Platinum Enhanced Health Insurance Plan in two different ways that are as follows:

Cashless Claim

  • Visit a hospital in the Aditya Birla Health Insurance network.
  • Provide your Aditya Birla Activ Health Platinum Enhanced plan details and necessary information.
  • Submit the required documents, and the insurance company will approve the expenses.
  • The insurance company will directly pay the hospital after reviewing the claim.

Reimbursement Claim

  • Choose a nearby hospital in the Aditya Birla Insurance network.
  • Pay your medical bills at the hospital.
  • Request a reimbursement claim on the insurance company's website.
  • Submit the Aditya Birla claim form and all plan-related information.
  • After the insurance company checks your claim, they will reimburse you for the medical expenses.

Health Insurance Calculator

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  • You

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Choose required Coverage for yourself?

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Disclaimer : Actual Premium might vary basis your location, age and number of members
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Key Inclusions and Exclusions of the Plan

What's Included

  • Coverage of costs incurred on transportation to a network hospital as per actuals
  • Organ harvesting expenses caused to the donor are covered
  • Post-hospitalisation expenses covered till 180 days after hospitalisation
  • Pre-hospitalisation expenses covered for 60 days prior to hospitalisation
  • Coverage for in-patient hospitalisation without any limitations of diseases covered or room rent

What's Not Included

  • Weight management programs or treatments
  • Accidents caused due to wars, riot, strike, nuclear weapons
  • Medical expenses incurred in AIDS and/or infection with HIV
  • Treatment taken outside India is not covered under the policy
  • An insured person committing or attempting to commit an intentional self-injury or attempt suicide sane or insane

Activ Health Enhanced Plan Details

Features/PlanEnhanced
Restoration Benefit
100% of SI
No Claim Bonus
Up to 100% of SI, non-reduction basis
Room Rent
Any room, Single private room, Shared room
ICU Charges
Actual
Pre and Post Hospitalization
60 & 180 days
Day Care Procedure
Available
Free Health Checkup
Available
Ambulance Cover
Network providers, actual expenses; Non-network providers, reimbursed up to max of Rs. 5000 per hospitalization
Second Opinion
Available on critical illnesses
Worldwide Emergency Cover
Available
Co-Pay
Higher zone: Zone II-I: 10%; III-II: 15%; III-I: 25%. Higher room: Shared Room-Single Pvt. 15%; Shared Room-Any Room 40%; Single Pvt.-Any 25%
Initial Waiting Period
30 days
Specific Illness Waiting Period
2 years
Waiting Period of PED
3 years
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Activ Health Enhanced User Reviews

Write your review
What users are saying
  • All
  • Unique features

    Unique features like rapid quote generator and premium calculator make InsuranceDekho stick out among the crowd. Using these tools, I issued Aditya Birla Health Insurance’s Activ Health Enhanced plan. It was the quickest affair.

    D
    By Debadrita Ghoshal
    On: Mar 01, 2021
  • Hassle-free claim settlement

    I made a claim under Aditya Birla Health Insurance’s Activ Health Enhanced plan on InsuranceDekho. The claim settlement formalities were simplified and hassle-free on the website. Since I never made an online claim earlier, I had no clue that online claim settlement was this easy.

    A
    By Akhil Khurrana
    On: Feb 23, 2021
  • Genuine policy overviews

    The policy overviews on InsuranceDekho are genuine. Information on claim settlement ratios, renewability, business volume, number of network hospitals, everything is liable. It convinced me to issue Aditya Birla Health Insurance’s Activ Health Enhanced plan. Can not wait for future dealings.

    S
    By Shouvik Biswas
    On: Feb 18, 2021
  • Digital insurance services

    This year we all have learned the importance of digital services in every aspect of our lives. I would like to compliment InsuranceDekho for making digital insurance services flawless. I did not have to go to the insurance office or submit a paper pile. Very happy with the issuance of Aditya Birla Health Insurance’s Activ Health Enhanced.

    S
    By Soumili Chatterjee
    On: Feb 05, 2021
  • Got to know about Arogya Sanje...

    I visited insurancedekho and got to know about Arogya Sanjeevani Policy. I learned the types and eligibility criteria for issuing the policy. I chose Aditya Birla Health Insurance’s Activ Health Enhanced plan. The standard plan has a wide coverage and affordable premium.

    R
    By Ribhu Chandra
    On: Feb 02, 2021

Add-ons to Enhance Benefits

  • OPD Expenses

    Costs incurred for medically necessary consultations, diagnostic tests and pharmacy expenses on an outpatient basis up to the amount specified in the policy schedule are covered. 

     

    Expenses covered include:
    (i) Outpatient consultations by a general medical practitioner.
    (ii) Outpatient diagnostic tests prescribed by a medical practitioner.
    (iii) Pharmacy–Medicines prescribed in writing by a medical practitioner.

     

    Alternative treatments shall also be covered under this benefit. Furthermore, reimbursement claims can be submitted quarterly in a policy year. In case, in a policy year, the insured individual does not utilize the full limit, the un-utilized amount will be carried forward to the next policy year and shall be available for utilization under HealthReturns™. 

  • Deductible

    Wherever a deductible option is selected, the deductible amount is applied on each policy year on the aggregate of all admissible claims in that policy year.

  • Maternity Expenses

    The add-on includes maternity expenses up to the Maternity Sum Insured specified in the policy schedule after a waiting period of 24 months, for the delivery of a child and/ or Maternity Expenses related to a medically necessary treatment and lawful medical termination of pregnancy up to a maximum of 2 events including 2 deliveries (including twins) or 2 terminations or 1 delivery (including twins) and 1 termination during the lifetime of an insured person between 18 years to 45 years of age. 

  • Hospital Cash Benefit

    Under this add-on, you get paid for the Hospital Cash Benefit specified in the policy schedule, for each continuous and completed period of 24 hours of hospitalization, during the policy period for treatment of an illness or injury. This benefit shall be payable for a maximum limit of 30 days in a policy year and 10 days for each claim.

Aditya Birla Activ Health Enhanced Expert Review

  • Expert Review

    Health insurance plans have become a necessity for all of us. It doesn’t just help beat the soaring medical expenses, rather enhance the savings of policyholders by offering tax benefits. Activ Health Enhanced Plan by Aditya Birla Health Insurance is framed to make people achieve the state of well-being and move towards a healthier life. The policy tends to focus on providing the overall healthcare to the customers by offering a wide range of benefits.

    Be it an individual or a family, Activ Health Enhanced Plan serves both. Under the family floater plan, up to 9 members can be covered. People from the age of 91 days and above can avail Activ Health Enhanced Plan as there exists no maximum age of entry. With a wide range of coverage up to Rs. 2 Crore, the plan promises to offer an advanced and extensive coverage without any hassle.

  • Major Attractions

    The Activ Health Enhanced Plan is designed to offer every possible coverage to the insured individuals. Though everyone needs to undergo a medical examination to get enrolled under the plan, the policy holds a lot worth going through that as well. The customers widely appreciate the plan due to its several attractive features. However, here are some offerings of the policy:

    • In-patient hospitalisation coverage
    • Pre and post hospitalisation expenses
    • Availability of worldwide emergency cover
    • 527 listed day care procedures are covered
    • Coverage related to road ambulance is offered
    • 100% restoration of the sum insured is available
    • A cover is offered related to organ donor expenses
    • Second opinion option is provided in the case of critical illness 
  • What’s More?

    The Activ Health Enhanced insurance policy owns a lot more than its coverage features. In addition to providing essential coverage, the plan offers some beneficial components in terms of discounts and rewards too, with which customers can earn some benefits. Here are some of those benefits:

    • Availability of lifelong renewability option
    • Tax benefits can be gained on the amount of premium
    • Earn a cumulative bonus of 20% up to 100% of the sum insured
    • Option to earn up to 30% of the premium amount as HealthReturns
    • A discount of 7.5% and 10% is available on the purchase of a policy for 2 and 3 years respectively
  • Conclusion

    These many features and benefits can easily corroborate the point that Activ Health Enhanced Plan is the right choice to opt for while selecting a health insurance plan for an individual or family. Besides offerings, the plan is an excellent product by Aditya Birla health insurance, which is available at an affordable rate and that too, with the utmost customer satisfaction.  

    To buy an insurance policy online, one needs to find the right platform first. In the insurance sector, there exist several authentic broker organisations that function online. One of the best among them is insurancedekho.com as it provides the best possible services with less or no paperwork. Also, the firm’s team offers after sale services too, where they assist in the claim settlement process. Therefore, visit the website and grab the perfect plan for you and your family at a click.

Aditya Birla Activ Health Enhanced Brochure

  • 1.97 MB
  • PDF Document
  • Apr 04, 2019

Claim Process at Aditya Birla Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 48 hours and for planned hospitalisation intimate within 3 days prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 48 hours and for planned hospitalisation intimate within 3 days prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

FAQs on Activ Health Enhanced Health Insurance Plan

  • What is the maximum age to buy Activ Health Enhanced policy?

    There is no maximum entry age limit to purchase Activ Health Enhanced policy. However, the minimum entry age limit is 91 days.

  • What is the pre-existing waiting period for Activ Health Enhanced policy?

    The pre-existing waiting period for Activ Health Enhanced is 3 years.

  • Does Activ Health Enhanced offer tax benefits?

    Yes! The premium paid for Activ Health Enhanced policy is liable to get tax benefits under section 80D of the Income Tax Act. You can claim health insurance tax benefits with a deduction of up to Rs. 25000 from your taxable income each year.

  • Does Activ Health Enhanced policy provide ambulance cover?

    Yes. The policy cover costs incurred on transportation to a hospital as per the actuals in an emergency situation, if the services are availed in a network hospital. You get a max. of Rs. 5000 per hospitalisation in case of a non-network hospital.

  • What are the additional discounts with the Aditya Birla Activ Health Enhanced Plan?

    You can avail a family discount of 5% if 2 or more family members and 10% if 3 or more family members are insured. Moreover, you are eligible to get a long term discount of 7.5% and 10% on selecting 2 and 3 policy terms respectively.

  • Is maternity benefit covered under Activ Health Enhanced plan?

    Once you opt for maternity benefit cover, you get covered for newborn baby expenses, vaccinations, medically necessary treatments and lawful medical termination of pregnancy.

  • Does Activ Health Enhanced plan cover chronic diseases?

    Chronic diseases like hypertension, diabetes, asthma, and high cholesterol are covered under Chronic Management Program of Aditya Birla Health Insurance.

  • Is cashless facility provided under Activ Health Enhanced plan?

    Yes, you can avail cashless facility under Activ Health Enhanced plan. However, the health care center or hospital should fall under the network hospitals of Aditya Birla Health Insurance.

  • Is there a No Claim Bonus under Activ Health Enhanced plan?

    Yes, you can get 20% of basic Sum Insured per year up to a maximum of 100% for each unclaimed year, in case opted for. Also, the cumulative bonus will not be reduced in event of any claim.

  • What is the initial waiting period for Activ Health Enhanced plan?

    The initial waiting period for Activ Health Enhanced plan is 30 days.

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