Niva Bupa Aspire Gold+

Overview

Niva Bupa’s (formerly known as Max Bupa) latest offering, Aspire, is a feature-rich plan that includes 4 variants. Niva Bupa Aspire Gold+ is the base variant in Aspire lineup. It offers unlimited restoration, bonus up to 3X of base cover, maternity expense coverage after a waiting period of 48 months and much more. Apart from this, there is an array of add-ons to customise your cover. The plan is also reasonably priced. 

The rich and innovative features in the plan may pose challenges for the insurer to service effectively in the future. Niva Bupa already faces a lot of service and claim-related issues that reflect in its high volume of claim complaints. Will the insurer be able to resolve service issues and be a customer champion? Only time will tell.

2+ hour hospitalisation covered

The plan covers your in-patient hospitalisation expenses if you are hospitalised for 2 hours or more. Does not impose a minimum 24 hour condition. Includes coverage for all day care treatments too.

Room rent limit

You can choose either a single standard room or a shared room at policy purchase. Your room coverage is restricted to the room type you choose. In case you pick a higher category room during hospitalisation, a copay applies as per the terms of the policy. ICU charges are covered at actuals.

Alternative treatments covered

Want to consider an alternative line of treatment like Ayurveda or Homeopathy? Your insurer covers the cost of treatment provided you are hospitalised for more than 24 hours.

Modern treatments covered at actuals

Expenses related to modern treatments are covered at actuals up to sum insured. A list of modern treatments covered is provided in the policy document.

Cover available for pre and post-hospitalisation expenses

You get cover for treatment-related expenses up to 60 days before hospitalisation and 180 days after hospitalisation. These include diagnostic tests, follow-up consultations, medications and other related expenses.

Carry forward your unutilised sum insured with Booster+

Carry forward your unutilised base sum insured into the future with Booster+ feature. Aspire Gold+ variant allows up to 3X carry forward, depending on your entry age.

Cover available even if you are forced to be hospitalised at home

Are you forced to be hospitalised at home when you actually require hospitalisation? Don’t worry. Your insurer covers the treatment cost if hospitalisation happens under the supervision of a medical practitioner.

Organ donor cover available

Your insurer pays for the medical expenses related to organ harvesting when you are the organ recipient. Your insurer also covers the cost of organ harvesting when you are the donor.

ReAssure+ provides unlimited restorations after 1st claim

After you make the first claim in your policy, you unlock unlimited restorations for life. There is no requirement of the first claim to re-trigger unlimited restorations after each renewal.

Get free health check-up every year

Annual health check-ups are available for all insured lives once every policy year. Only listed tests are included which can be taken on a cashless basis with pre-booking via the insurer’s mobile app.

Get maternity expenses covered after a 4 year wait period

The plan covers maternity and related expenses after a waiting period of 4 years. This is an inbuilt benefit available at no extra cost.

Ambulance charges covered

The plan covers road and air ambulance charges up to sum insured. Air ambulance charges are covered only in case of emergencies.

Opt for Safeguard+ to get cover on non-medical items

The base plan does not cover non-medical items such as syringes, gloves, masks etc. These usually form 10% to 20% of every hospital bill. Opt for Safeguard+ add-on to ensure that your insurer covers this cost.

Disease management rider provides day 1 coverage for diabetes and hypertension

Want immediate coverage for pre-existing illnesses like diabetes or hypertension? Opt for the disease management rider and get day 1 cover on these conditions. Extra premium applies.

Get your future spouse covered with Future Ready

With this add-on, you get guaranteed coverage for your future spouse when you marry and add your spouse to your policy. Moreover, your spouse also gets continuity benefits on waiting periods served by you.

Combine multi-tenure sum insured with Fast Forward

With Fast Forward add-on, combine muti-tenure sum insured if you opt for a 2 or 3 year tenure. Use this combined coverage anytime during the policy tenure.

Get OPD and wellness benefits with WellConsult add-on

With this add-on, you get tele and physical OPD consultations with specialists and general practitioners within the insurer’s network. Prescribed diagnostics, medicines and other wellness benefits are also included.

Get daily hospital cash benefit with an add-on

With this add-on, the insurer pays you a daily fixed cash benefit for each day of hospitalisation. You can utilise the amount received any way you want.

Rewards for every claim-free year with CashBag add-on

If you opt for this add-on, you get some rewards for each claim-free year in the policy. Utilise these rewards to get discounts on renewal premiums, avail of OPD benefits, and pay for copayments or non-payable items.

Opt for a deductible

If you find the plan expensive, choose a small deductible to lower the premium. But choose your deductible carefully. In case of a claim, you have to pay upfront an amount equal to your deductible for policy benefits to get triggered.

Opt for tiered network to get discount on premium

If you opt for the tiered network, you get a straight discount of 15% on your premium. If you take treatment in a non-tiered network hospital, a 20% copay on the claim applies.

Live healthy discounts

Walk daily and stay healthy to get up to a 30% discount on your renewal premium. Step tracking is through the insurer’s official health app.

Policy Conditions

About the Insurer

Niva Bupa Health Insurance (formerly Max Bupa) is a leading stand-alone health insurance company in India known for innovative plans. It was founded in 2008 as a joint venture between Max India and Bupa Singapore Holdings Pte Limited, a UK based healthcare services provider. In 2019, the entire 51% stake of Max India was acquired by Fettle Tone LLP, an affiliate of private equity firm True North and, hence,a the name Niva Bupa.

Niva Bupa offers a wide range of feature-rich health insurance plans for young adults, families and senior citizens.

Performance Highlights (FY24)

Turnover – Rs. 5,608 Crore

Claim Settlement Ratio – 91.93%

Incurred Claim Ratio – 59%

Volume of Claim Complaints – 38.76 / 10,000 claims

Network Hospitals – 10,000+