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Max Bupa HeartBeat Family Floater Health Insurance Plan- All You Need To Know!

Published On Mar 17, 2019, Updated On Sep 08, 2021

Considering dreams and plans of your family like theirs, Max Bupa has come up with one of a kind Heartbeat Family Floater Plan. Designed especially,  Max Bupa Heartbeat Family Floater Health Insurance protects them through comprehensive blanket coverage for the medical expenses incurred.

The plan comes in two variants, viz, gold and platinum which are explained further in the article. 

Why Choose Max Bupa?

Getting yourself insured with Max Bupa Heartbeat Family Floater Insurance is easy and comprehensive. Let’s get you enlightened with some major benefits that Max Bupa provides its customers.    

1. Direct claim-settlement

Nobody wants to run after claim settlement instead of focusing on the treatment of our loved ones. So, Max Bupa processes all claims directly by their own customer services team. 

2. Cashless facility 

Policyholders can avail the cashless facility at their nearest hospital.

3. 2-year policy tenure option 

As a policyholder, you can opt for 2-year policy tenure and avail discount. 

4. Assured policy renewal for life 

Max Bupa assures the policyholder’s renewability for life with no extra loading based on their claim history. 

5. Tax benefit 

Buying a policy from Max Bupa helps you to save tax under Section 80 D of the Income Tax Act. However, tax benefits are subject to changes, which can be discussed with your tax advisor.     

Also read: Confused Between Individual Health Insurance and Family Floater Plan? Simplify Your Choice

Heartbeat Family Floater Health Insurance Plan 

Salient features of the plan for different variants

The Gold variant prepares the policyholders for future medical expenses with comprehensive cover options of Rs. 5 Lakh, Rs. 7.5 Lakh, Rs. 10 Lakh, Rs. 15 Lakh, Rs. 20 Lakh, Rs. 30 Lakh, and Rs. 50 Lakh. Some features that make it different from the Platinum plan are-

  • In patient-care (hospitalization) (same for all the variants)

The policy covers the cost of medical treatment for the insured family members who are hospitalized for treatment. 

  • Pre and post hospitalization medical expenses (same for all the variants) 

Max Bupa reimburses medical expenses incurred due to the illness of up to 60 days immediately before and 90 days immediately after hospitalization. This happens once the Inpatient Care hospitalization claim has been accepted. 

  • Alternative treatments (for Gold and Platinum variants)

Expenses incurred on alternative treatments such as Ayurveda, Unani, Sidha and Homeopathy (AYUSH) are reimbursed. 

  • All daycare treatment covered (same for all the variants)

Not a selected few, but all the daycare treatments are covered provided such a procedure is not performed as an OPD or in the Diagnostic Centers of a hospital. 

  • Maternity benefits 

In the Silver variant, the benefit is available to female covered in the plan after two years of continuous coverage under the policy. Whereas, for gold and Platinum variants, the plan provides the insured maternity benefits for up to two deliveries. The benefit can be availed if the policyholder has been covered along with the spouse for two continuous years under the policy.

  • Newborn baby (same for all the variants)

If the maternity claim is admissible under the policy, the newborn baby is covered from the date of birth without any additional premium. Vaccination expenses are also covered of the newborn baby for the first year if the baby is added in the policy for the next policy year. 

  • Any age enrollment (same for all the variants)

The insured members are covered across every stage of life.

  • Loyalty additions (same for all the variants)

If the policy is renewed with Max Bupa without any break, the sum insured is increased at a rate of 10% per annum up to a maximum of 100%.  

  • Hospital cash (same for all the variants)

Under Hospital Cash benefit, the insurance company will pay a fixed amount as Hospital Cash for up to a maximum of 30 days of hospitalization, for a continuous period of 24 hours of hospitalization. This is applicable when an insured person has been admitted in a hospital for a minimum period of 48 hours continuously.

  • Health check-up (same for all the variants)

If the policy is renewed with Max Bupa without any break, then the cost of health check-up (Diagnostic Tests) may be availed through empanelled service providers in the Gold variant. In the Silver variant, health check-up is provided once in every 2 years. 

  • Organ transplant (same for all the variants)

Medical expenses for harvesting the organ in organ transplant is also covered. These expenses are paid once your in-patient claim has been accepted. 

  • Domiciliary hospitalization (same for all the variants)

Sometimes, treatment is administered at home on the advice of the attending physician or in case the hospital bed is unavailable. In such cases, the company pays for domiciliary treatment (treatment taken at home), which would otherwise have required hospitalization. The only condition is that the domiciliary hospitalization should continue for at least 3 consecutive days.

  • Emergency evacuation and ambulance

In the Gold and Silver variants, the ambulance expenses are covered in the policy. These expenses are paid only if the claim is accepted as an in-patient claim. 

Whereas in the Platinum variant, assistance in the medical evacuation of the insured person is provided in case of a medical emergency outside India. The cover and the customary costs of the transportation of the insured person (and an attending doctor if medically necessary). There is also an option for Emergency Medical Evacuation within India wherein the insured's condition is such that he requires air ambulance or commercial flight for evacuation. 

  • Free look period (same for all the variants)

The health insurance policies of Max Bupa are transparent and easy to understand. A 15-day free look period is provided during which you can even cancel your plan stating the reason. 

  • Policy terms (For all the variants) 

Policy terms for both the variants remain the same. The policy term is of 1 year. However, you can choose it to be for 2 years too. The treatment is not covered during the initial 30 days of the policy unless the treatment needed is the result of an accident.

However, this waiting period does not apply for the renewal of the policy. Benefits of continuous coverage from the first policy start date are not provided for pre-existing diseases until 24 months for both the health insurance plans (gold and platinum) and 48 months for silver plans. It is applicable when these pre-existing diseases are stated in the proposal and are specifically adopted by Max Bupa to be endorsed from thereon.

Lastly, all the insured individuals aged more than 45 years of age as on the date of inception of the first policy, will have to complete a waiting period of 24 months in some conditions. These conditions will be covered only in the third policy year.

Permanent exclusions (For all the variants)

  • Ancillary Hospital Charges
  • Hazardous Activities
  • Artificial life maintenance
  • Autoimmune Disorders
  • Behavioral, Neurodevelopmental and Neurodegenerative Disorders
  • Circumcision
  • Complementary and Alternative Medicine
  • Conflict and Disaster
  • Congenital Anomaly, Hereditary or Genetic Disorders
  • Convalescence & Rehabilitation
  • Cosmetic and Reconstructive Surgery
  • Dental/oral treatment
  • Eyesight & Optical Services
  • Experimental/Investigational or Unproven Treatment
  • HIV, AIDS, and related complex
  • Hospitalization not justified
  • Inconsistent, Irrelevant or Incidental Diagnostic procedures
  • Mental and Psychiatric Conditions
  • Non-Medical Expenses
  • Obesity and Weight Control Programs
  • Off- label drug or treatment
  • Puberty and Menopause related Disorders
  • Reproductive medicine & other Maternity Expenses
  • Robotic Assisted Surgery, LASER & Light-based Treatment
  • Sexually Transmitted Infections & diseases
  • Sleep disorders
  • Substance-related and Addictive Disorders
  • Traffic Offences & Unlawful Activity
  • Treatment received out of India
  • Unrecognized Physician or Hospital
  • Any costs or expenses specifically excluded in Annexure IV of the policy wording

 Claim Process (For all the variants) 

1. Choose a hospital from the list of the company’s network hospitals. It is better if the selection is made at least 72 hours prior to hospitalization.

2. You are required to submit any of the following documents along with your Max Bupa Health Card or Policy Number for identification- 

  • Passport 
  • Voter’s Card
  • PAN Card
  • Driver’s License 

3. The network hospital will check your identity for validation and submit a pre-authorization form to the insurer.  

4. The insurer will intimate the hospital within 30 minutes if no further documentation required.  

5. Get admitted to the hospital and sign the required documents at the time of discharge. Even a relationship manager is assigned to simplify the process for your help. 
6. Payments are made to the hospital as per the terms and conditions of the policy. 

Claim process for International Treatment (For Platinum variant) 

  1. Select your preferred hospital and call Max Bupa's International treatment number (mentioned in your policy kit)
  2. Provide the following documents for identification and admissibility purposes-
  • Policy number/Customer I.D
  • Name of the customer
  • Age/Photo I.D proof
  • Contact-Phone/Mail id
  • Diagnosis with supportive investigation reports
  • All previous medical records
  • Treatment/surgery advised by treatment doctor
  • Preferred date options for undergoing treatment
  • Preferred provider for undertaking treatment
  • Preferred country for undertaking treatment   

3. The International claims team of Max Bupa will provide you with a reference number.

4. Once your documents are processed and approved, the team will guide you with international cashless authorization. They shall also monitor your health while you get treated in the best of international medical facilities. 

To know more about the common exclusions about the policy, you can either visit the official website of the health insurance company or simply connect to us at Stay healthy, stay insured with the best health insurance

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