Niva Bupa Aspire Platinum+
Overview
Niva Bupa’s (formerly known as Max Bupa) latest offering, Aspire, is a feature-rich plan available in multiple variants. Niva Bupa Aspire Platinum+ is a premium variant in the Aspire lineup. It is similar to Diamond+ variant that offers features like age lock, unlimited restorations, bonus up to 10 times of base cover, among others. The difference lies in maternity benefit which is covered after a short waiting period of 9 months in this variant. You also have multiple add-ons to customise your cover. The plan is fairly priced.
The rich and innovative features in the plan may pose challenges for the insurer to service effectively in the future. Also, aggressive pricing can push the insurer to keep the cost of claims tightly under control. 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.
Pros and Cons
- Lock the Clock – The premiums you pay at renewals are locked as per your entry age.
- 2+ hour hospitalisation – Covers all hospitalisation expenses if you are hospitalised for 2 hours or more. Includes all day care treatment too.
- Modern treatments – Listed modern treatments are covered up to the sum insured.
- Booster+ accumulates unutilised sum insured up to 10X.
- Maternity coverage with a waiting period of 9 months.
- Disease Management Rider – Get day 1 coverage on diabetes and hypertension with this add-on.
- Get treatment anywhere in the world with Borderless add-on.
- OPD are benefits available with an add-on.
- Room rent limit – Room category coverage is limited to standard single room. If you pick a higher category room, a 15% copay on the claim applies.
- Higher waiting period on PEDs of 36 months.
- Benefits like Safeguard+ (covers non-medical items) come at extra cost.
- High Complaint Volumes – Niva Bupa faces a high volume of claim-related complaints indicating operational challenges faced by the company.
Plan Benefits
Pay premiums as per entry age till 1st claim
The plan offers Lock the Clock feature, which locks your age at entry until you make your first claim under the policy. Until then, there is no age-related increase in the premium at each renewal.
2+ hour hospitalisation covered
The plan covers in-patient hospitalisation expenses if you are hospitalised for 2 hours or more. A minimum 24-hour hospitalisation is not mandatory. It 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 on the claim 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 the 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 Platinum+ variant allows up to 10X 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 hospitalisation is medically necessary? Your insurer covers the treatment cost if hospitalisation happens under the supervision of a medical practitioner.
Organ donor cover is 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 forever. There is no requirement for 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. 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 9 month wait period
The plan covers maternity and related expenses after a waiting period of 9 months. This is an inbuilt benefit available at no extra cost. Also, this benefit has a separate limit over and above the base coverage.
Ambulance charges covered
The plan covers road and air ambulance charges up to the 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 such as diabetes or hypertension? Opt for the disease management rider and get day 1 cover on these conditions. An extra premium applies.
Combine multi-tenure sum insured with Fast Forward
With Fast Forward add-on, combine the multi-tenure sum insured if you opt for a 2 or 3 year tenure. Use this combined coverage anytime during the policy tenure.
Get your future spouse covered with Future Ready
With this add-on, you get guaranteed coverage for your future spouse. Spouse coverage starts when you marry and add your spouse to your existing policy. Your spouse also gets continuity benefits on waiting periods served by you.
Worldwide coverage with Borderless add-on
With Borderless add-on, you can get emergency or planned treatment anywhere in the world. Your insurer covers the cost of hospitalisation.
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 diagnostic tests, 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. Use this to manage other expenses incidental to hospitalisation.
Rewards for every claim-free year with CashBag add-on
This add-on gets you some rewards for each claim-free year in the policy. Use these reward points 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 a discount on premium
If you opt for the tiered network at purchase, you get a straight 15% discount 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.
e-Consultations
Unlimited online doctor consultations are available within network centres.
Policy Conditions
| Sum Insured Range | Rs. 3 Lakh – Rs. 1 Crore |
| Entry Age | 91 Days – 30 Years for dependent children; 18 Years onwards for adults |
| Policy Tenure Options | 1, 2 or 3 Years |
| Coverage Types | Individual, Multi-individual and Family Floater |
| Family Coverage | Up to 2 adults and 4 children under the family floater option, up to 4 adults and 5 children under multi-individual option |
| Premium Payment | Annual. EMI options are available. |
Exclusions
Waiting Periods
- Initial Waiting Period: 30 days (except accidents)
- Specific Illness Waiting Period: 24 months
- Waiting Period on Pre-Existing Diseases: 36 months
- Maternity Benefit Waiting Period: 24 months
Medical Exclusions
- Cosmetic surgeries (unless due to accident, cancer, etc.)
- Unproven therapies
- Obesity treatments (unless certain conditions met)
- OPD expenses
- Dental treatments
Non-Medical Exclusions
- Investigation and evaluation
- Self-injury or attempt to suicide
- Alcoholism, drug or substance abuse
- Expenses for treatment necessitated by committing breach of law with criminal intent
- Expenses for treatment taken by a medical practitioner outside his discipline.
- War, terrorism, nuclear events
About the Insurer
Niva Bupa Health Insurance (formerly known as Max Bupa) is a leading stand-alone health insurance company in India known for its innovative health insurance solutions. It was founded in 2008. It is a joint venture between Bupa Singapore Holdings Pte Limited, a UK based healthcare services provider and Fettle Tone LLP, an affiliate of private equity firm True North.
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+
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Frequently Asked Questions
What is the Niva Bupa Aspire Platinum+ Plan?
Niva Bupa Aspire Platinum+ is a comprehensive health insurance policy from Niva Bupa Health Insurance offering extensive coverage, including in-patient hospitalisation cover, day care treatment cover, maternity benefits, global cover and much more.
Who is eligible to purchase this plan?
Individuals aged 18 years or above can purchase the plan. Dependent children aged between 91 days and 30 years can be included in the family floater option.
What is the sum insured range available under Niva Bupa Aspire Platinum+?
The plan offers sum insured options ranging from Rs. 3 Lakh to Rs. 1 Crore.
Does the plan cover pre and post-hospitalisation expenses?
Yes, it covers 60 days pre-hospitalisation and 180 days post-hospitalisation related medical expenses.
Are daycare procedures covered under Niva Bupa Aspire Platinum+?
Yes, the plan covers all daycare treatments without any treatment-specific limit.
Is AYUSH treatment covered under the plan?
Yes, the plan provides coverage for AYUSH hospitalisation expenses up to the sum insured.
Does the plan offer coverage for organ donor expenses?
Yes, the plan covers the expenses related to organ harvesting in case you are the organ recipient or organ donor.
Are modern treatments like robotic surgeries covered under Niva Bupa Aspire Platinum+?
Yes, the plan covers listed advanced treatments, such as robotic surgeries and stem cell therapy, up to the sum insured.
Does the plan cover home care or domiciliary treatments?
Yes, it covers home-based treatments up to the sum insured, subject to specific conditions.
Is maternity covered under Niva Bupa Aspire Platinum+?
Yes, M-iracle feature covers expenses related to maternity, IVF, adoption, and surrogacy after a waiting period of 9 months.
What are the room rent limits under Niva Bupa Aspire Platinum+?
The plan includes room rent coverage up to a single private room for normal hospitalisation with no cap on ICU charges. If you pick a higher category room during hospitalisation, a 15% copay on the claim applies.
Is there any copayment under Niva Bupa Aspire Platinum+?
The plan does not include a mandatory copay. However, flexible copay options are available with an add-on. Additionally, if you select non-tiered network hospital at purchase, treatment outside the tiered network incurs a mandatory 20% copayment.
Does Niva Bupa Aspire Platinum+ offer any no-claim bonus?
No-claim bonus works a bit differently here. Booster+ feature allows you to accumulate your unused sum insured up to 10X of base sum insured, depending on the entry age.
What is the 'Lock the Clock' feature and how does it work?
‘Lock the Clock’ feature locks your age at policy purchase until your first claim, ensuring renewal premiums remain based on your entry age during this period.
What is ReAssure+ benefit in Niva Bupa Aspire Platinum+ plan?
ReAssure+ feature allows unlimited restorations of the base sum insured under the policy after the 1st claim. There is no requirement for the first claim to re-trigger the restoration benefit after each renewal.
Does the plan offer international coverage?
Yes, with Borderless add-on, you can take treatment anywhere in the world. The add-on covers planned as well as emergency global treatments.
Are there any wellness benefits included in the plan?
Yes, the insurer promotes healthy living by providing free annual health check-up to all insured lives from the first policy year. Additionally, with the Live Healthy feature, 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.
Can I migrate my existing health insurance policy to Niva Bupa Aspire Platinum+?
Yes, you can migrate your existing health insurance policy to Niva Bupa Aspire Platinum+ plan, subject to fresh underwriting and terms & conditions of the plan.
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