Niva Bupa Senior First Health Insurance

Niva Bupa Senior First Health Insurance Plan is specially designed to take care of your health needs during your golden years, which is often a time when you might face various health challenges. This plan from Niva Bupa Health Insurance is here to make things easier for you. It offers a range of unique benefits, including the Reassure benefit, an annual deductible, and direct claim settlement without involving any middlemen.

With the Niva Bupa Senior First Plan, you can enjoy peace of mind, knowing that your health and well-being are taken care of, even in your retirement years. This plan is designed to help you stay fit and healthy while providing financial protection for your medical needs. Let's explore more about what this plan has to offer.

Key Features of Niva Bupa Senior First Health Insurance Plan

The key features of Niva Bupa Senior First Health Insurance Plan are listed below:

• Reassure Benefit: The Reassure Benefit is an important feature of the Senior First Policy. It activates after the first claim is made. With this benefit, policyholders can make multiple claims, and each claim is equal to the base sum insured. This means that the coverage is not limited to a single claim, ensuring financial security for multiple health-related expenses.
• No Mandatory Pre-Issuance Medical Tests: This policy offers the convenience of not requiring mandatory pre-issuance medical tests. This can be a significant advantage, especially for senior individuals who might find such tests cumbersome.
• Day 1 Health Check-up: The Senior First Policy offers policyholders the benefit of an annual health check-up from the very first day of the policy. This feature promotes proactive healthcare management and early detection of potential health issues.
• Safeguard (Add-on): The Safeguard add-on is a valuable inclusion that provides comprehensive cashless coverage. Importantly, it covers non-payable items such as gloves and masks. This means that policyholders are not burdened with out-of-pocket expenses for these essential items.
• No Sub-Limits on Common Health Conditions: With the Senior First Policy, there are no sub-limits imposed on common health conditions. This means that policyholders have the assurance that major health issues like cataracts, joint replacements, cancer, and more, will be covered fully without any restrictive caps on expenses, ensuring comprehensive financial protection.
• Annual Aggregate Deductible: This feature allows policyholders to choose an annual deductible. This flexibility empowers policyholders to have a say in the cost-sharing arrangement, depending on their financial preferences and needs.
• Co-pay Feature: The Niva Bupa copay feature is a provision where the policyholder agrees to share a specified percentage of the medical expenses with the insurance company. This feature helps in reducing the premium cost for the policyholder since they are contributing to the expenses.

Variants of Niva Bupa Senior First Insurance Policy

There are two types of plans, Gold and Platinum, that you can choose from. These plans offer different levels of financial coverage.

Features	Gold	Platinum
Base Sum Insured	5 lakhs/10 lakhs	5 lakhs/10 lakhs/15 lakhs/20 lakhs/25 lakhs
Room Category	Shared Room	Private Room
In-patient Care	Upto Sum Insured	Upto Sum Insured
Pre-Hospitalisation	Upto Sum Insured	Upto Sum Insured
Post-Hospitalisation	Upto Sum Insured	Upto Sum Insured
Day Care Treatment	Upto Sum Insured	Upto Sum Insured
Ambulance	Air Ambulance: Upto Rs. 2,50,000 per Hospitalisation Road Ambulance: Upto Rs. 2,000 per Hospitalisation	Air Ambulance: Upto Rs. 2,50,000 per Hospitalisation Road Ambulance: Upto Rs. 2,000 per Hospitalisation
Modern Treatments	Upto Sum Insured, Maximum to Rs. 1 lakh per claim on a few robotic surgeries	Upto Sum Insured, Maximum to Rs. 1 lakh per claim on few robotic surgeries
AYUSH Treatments	Upto Sum Insured	Upto Sum Insured
Domiciliary Hospitalisation	Upto Sum Insured	Upto Sum Insured
Organ Donor	Upto Sum Insured	Upto Sum Insured

Know about these variants in brief:

• In the Gold plan, you can get insured for Rs. 5 lakhs or Rs. 10 lakhs.
• The Platinum plan, on the other hand, gives you more options, allowing you to get insured for Rs. 5 lakhs, Rs. 10 lakhs, Rs. 15 lakhs, Rs. 20 lakhs, or Rs. 25 lakhs.

So, you can pick the plan and coverage amount that suits your needs.

Eligibility Criteria of Niva Bupa Senior First Health Insurance Plan

Listed below are the eligibility criteria for the Niva Bupa Senior First health insurance plan:

Parametres	Eligibility Criteria
Minimum entry age	61 years
Maximum entry age	75 years
Policy duration	1, 2 and 3 years
Sum insured	5, 10, 15, 20, 25 lakhs
Renewal	Lifetime Renewability

Benefits of Niva Bupa Senior First Health Insurance Plan

The Niva Bupa Senior First Policy offers a range of benefits designed to cater to the healthcare needs of senior citizens. These benefits include:

• Reassure Benefit: This feature lets you have extra coverage without any limit, which is useful for paying for more costly medical expenses.
• Direct Claim Settlement: You can settle your insurance claims directly, which means you don't need to deal with middlemen, making it easier to get your money when you need it.
• Alternative (AYUSH) Treatments: It covers treatments like Ayurveda, Yoga, Unani, Siddha, and Homeopathy, in addition to conventional medicine.
• Domiciliary Hospitalisation: If you can't go to the hospital for certain reasons, like no available room or your medical condition, you can receive treatment at home, and the insurance will pay for it.
• Modern Treatments: It covers regular medical treatments, but some advanced procedures might have a limit on how much is covered.
• Emergency Ambulance Cover: This policy pays for both regular and air ambulance services, so you can quickly reach the hospital in case of emergencies.
• No Claim Bonus (NCB): If you don't make any claims in a year with the Platinum plan, your coverage increases by 10% of your existing insured amount, up to a maximum of 100%. If you make a claim, your No Claim Bonus (NCB) doesn't decrease.
• Health Check-Up: The Platinum plan includes a yearly health check-up with specific tests to help you keep track of your health.
• Co-Payment: You'll need to pay 50% of the expenses, and if you choose a higher room category than allowed, this co-payment increases by 10%.
• Other Discounts: If you maintain good health, you can get a discount of up to 20% when renewing your policy, which means you pay less for your insurance.

Inclusions of Niva Bupa Senior First Health Insurance Plan

Below-mentioned are the inclusions of the Niva Bupa Senior First health insurance plan:

• In-Patient Care: This means that if you have to stay in the hospital, the insurance will pay for your medical expenses up to the amount you're insured for.
• Day Care Treatment: It covers treatments that don't require a full hospital stay, like certain surgeries or procedures. The insurance will pay for these treatments up to your insured amount.
• Pre and Post-Hospitalisation Treatment: The insurance covers medical expenses both before and after your hospital stay. It includes costs up to 60 days before going to the hospital and up to 180 days after leaving.
• Alternative (AYUSH) Treatments: This includes treatments like Ayurveda, Yoga, Unani, Siddha, and Homeopathy. The insurance will pay for these treatments up to your insured amount.
• Domiciliary Hospitalisation (Treatment at Home): If you can't go to the hospital and need treatment at home, the insurance will cover these costs up to your insured amount.
• Organ Donor Expenses: If you need an organ transplant, the insurance will pay for the expenses related to the donor. This is also covered up to your insured amount.
• Room Category: For the Gold Plan, you'll get a shared room in the hospital, while the Platinum Plan offers a private room for more comfort.
• Modern Treatments: The insurance covers advanced medical treatments up to the amount you're insured for. However, for certain robotic surgeries, there's a limit of up to Rs. 1 lakh per claim.
• Emergency Road Ambulance Cover: If you need an ambulance to take you to the hospital by road in an emergency, the insurance will cover expenses up to Rs. 2,000 for each hospitalization.
• Emergency Air Ambulance Cover: In extreme cases where you need to be airlifted to the hospital, the insurance will cover these costs up to Rs. 2,50,000 for each hospitalization.
• Reassure Benefit: Reassure Benefit is a valuable provision that goes the extra mile to safeguard policyholders. While this benefit isn't available in the Gold Plan, it offers boundless support, up to the base sum insured, in the Platinum Plan. What's noteworthy is that it's applicable whether you're dealing with the same illness or different health concerns, ensuring comprehensive coverage for all your medical needs.
• Health Check-Up: Gold Plan: Not applicable, Platinum Plan: Annual health check-up starting from day 1. Applicable for pre-listed tests only, with a limit of up to Rs. 500 for every Rs. 1 lakh base sum insured.

Exclusions of Niva Bupa Senior First Health Insurance Plan

Before buying the Niva Bupa Senior First Policy, it's crucial to understand what it doesn't cover. Here are the things the policy doesn't compensate for:

• Non-Relevant Medical Tests: Coverage does not extend to medical tests unrelated to your current medical condition.
• Bed Rest Expenses: Expenses for bed rest without concurrent medical treatment are not reimbursed.
• Dietary Supplements and Non-Prescription Substances: Costs associated with dietary supplements, vitamins, and minerals that are not prescribed are not covered.
• Unauthorised or Illegal Treatment: Any medical treatment that is unauthorised or illegal is not eligible for compensation.
• Unlicensed or Unregistered Medical Professionals: Services provided by medical professionals lacking the necessary licenses or registration are excluded.
• Injuries or Treatments from Substance Use: Injuries or treatments resulting from the use of drugs, alcohol, or other substances are not covered.
• Sterility, Infertility, and Maternity Expenses: Expenses related to sterility, infertility, and maternity are not included in the policy coverage.
• Injuries from Hazardous Activities: Injuries sustained while participating in hazardous activities or adventure sports are not covered.
• Plastic Surgery & Gender-Related Procedures: The policy does not extend coverage to plastic surgery, gender-related procedures, or cosmetic surgery.
• Self-Inflicted Injuries: Injuries that are self-inflicted, suicide, or suicide attempts are not eligible for coverage.

Riders Available with Niva Bupa Senior First Plan

With Niva Bupa Senior First plan, you get the Safeguard rider. This add-on covers things that are not normally paid for, like gloves and masks, so you don't have to worry about those expenses. It also helps you keep up with rising prices. Your insurance amount increases a bit each year to keep up with inflation. Moreover, if you make a claim of up to Rs. 50,000 in a year, it won't affect the special discount you get for not making claims, called the "No Claim Bonus."

Documents Required to Buy Niva Bupa Senior First Health Insurance Plan

The documents required to buy the Niva Bupa Senior First health insurance plan are as follows:

• A filled-out application form.
• Proof of identity, like your Aadhar card, passport, voter ID, or driver's license.
• Proof of age, which can be a birth certificate, school leaving certificate, or passport.
• Proof of address, like utility bills, a rental agreement, or your Aadhar card.
• Passport-sized photos.
• If needed, medical reports or pre-policy health check-up reports.
• Any other documents required by the insurance company during the application.

How to Buy Niva Bupa Senior First Health Insurance Plan?

Here are the steps to acquire the Niva Bupa Senior First health insurance plan through InsuranceDekho:

Step 1: Visit the Health Insurance section on the official InsuranceDekho website.

Step 2: Choose the "Niva Bupa " option from the list of Health Insurance Companies.

Step 3: Choose "Niva Bupa Senior First" from the available health insurance plans.

Step 4: Carefully read the terms and conditions in the Niva Bupa Senior First policy document.

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

Step 6: KYC, make the premium payment online.

Step 7: You will receive the policy document at your registered email address.

Claim Process of Niva Bupa Senior First Insurance Plan

When it comes to making claims with the Niva Bupa Senior First health insurance plan, you have two options: Cashless Claim and Reimbursement Claim.

For a Cashless Claim

• Visit a nearby hospital that's in the Niva Bupa insurance network.
• Provide your Niva Bupa Senior First plan details and any required information.
• Submit the necessary documents and a pre-authorisation form will be sent to the insurance company.
• Once the insurance company verifies the documents, your medical expenses will be directly settled at the network hospital.

For a Reimbursement Claim

• Choose any nearby hospital and pay for your medical expenses.
• Submit the reimbursement claim request on the insurance company's website.
• Provide the Niva Bupa Senior First claim form and all relevant plan details.
• Upon approval by the insurance company, the reimbursement will be processed for the policyholder.