Max Bupa Health Recharge Family Floater- Types, Eligibility & Features

Updated: 28-01-2019 08:56:31 AM

Health is the most sought after need in humanity. To ensure the well being of one’s family and themselves, insurance is needed. Max Bupa insurance provides Max Bupa Health Recharge Family Floater insurance policy for all the policyholders who seek to cover their medical expenses associated with their family.

Types of Health Recharge Family Floater

This policy is provided to the policyholders under two variants namely:

• E-Saver
• Super Top-Up

Eligibility Criteria 

Parameters	Details
Entry Age	Min: 18 years Max: 65 years
Dependent children	Min: 91 days Max: 25 years
Sum Insured	e-Saver– Rs 2 Lakhs, Rs 3 Lakhs, Rs 4 Lakhs and Rs 5 Lakhs Super Top-Up – Rs 2 Lakhs, Rs 3 Lakhs, Rs 4 Lakhs, Rs 5 Lakhs, Rs 7.5 Lakhs, Rs 10 Lakhs, Rs 15 Lakhs and Rs 25 Lakhs.
Policy Tenure	One and Two-year options
Maximum members that can be covered under this policy	Two adults and Four children
Lifetime Renewals	This policy is subject to lifetime renewals as per the policy clause.

Features

Features	Particulars
	e-Saver	Super Top-Up
Claim Type [In house or TPA]	Direct Claim Settlement is provided under this claim.	Direct Claim Settlement is provided under this claim.
In-Patient Care	Covered up to sum insured	Covered up to sum insured
Annual Aggregate Deductible	10,000, 25,000 and 50,000 respectively	1 Lac to 10 Lacs [subject to multiple of 1 lacs only]
Pre-Hospitalization	Covered up to sum insured for a period of 60 days	Covered up to sum insured for a period of 60 days
Network Hospitals Count	4000+	4000+
Post-Hospitalization	Covered up to sum insured for a period of 90 days.	Covered up to sum insured for a period of 90 days.
Room Eligibility	It is covered up to 1% of the sum insured per day A single private room which is covered up to the sum insured	It is covered up to 1% of the sum insured per day A single private room which is covered up to the sum insured
Hospitalization at Home	Covered up to sum insured	Covered up to sum insured
Day-Care Treatment	Covered up to sum insured	Covered up to sum insured
Emergency Ambulance	It is subject to up to Rs 1500/- per hospitalization.	It is subject to up to Rs 1500/- per hospitalization.
Health Check-up	Annually covered up to Rs 1250 – Rs 2500.	Annually covered up to Rs 3750 – Rs 5000.

Points to consider before buying a plan

1. Lifetime renewal

The policyholder should check whether the policy is subject to lifetime renewals. This is a  factor to be considered when long term planning is concerned. This is due to the fact that an individual’s health tends to get affected more as they get older.

2. Free Medical Checkup

The policyholder should check whether the respective policy provides for a medical check-up or a health check-up in their policy clause. This is subject to various eligibility requirements that need to be fulfilled. Thus all the documents associated with the plan such as the prospectus, claim form and brochure needs to be read carefully.

3. Network Hospitals

The network hospitals provided under the respective policy needs to be seen. This lets the policyholder know which hospital to approach in a retrospective case. This enables the policyholder to know which hospital provides cashless facility and which operate under reimbursement claims.

4. Pre and post hospitalization requirements

The policyholder should read carefully through the prospectus, claim form and brochure regarding the pre and post hospitalization conditions under the specific policy. This is a retrospective factor and needs to be considered accordingly. Thus it varies from policy provider to policy provider.

5. Claim process

It is beneficial to check the claim process under the policy to be purchased. The simpler and hassle-free the claim procedure, the more beneficial it will be to the policyholder. This is beneficial to the insurance company providers too.

Filing claims with Max Bupa Health Recharge Family Floater

• In the case of admittance to a network hospital, the policyholder is required to approach the TPA desk. They need to approach the desk before 72 hours of hospitalization as per policy clause.
• Submit the concerned documents at the TPA desk for the initiation of the claim process.
• The network hospital will, in turn, verify the documents and contact the insurer for validation purposes.
• Within four hours of the intimation, the insurance company will let the network hospital know  whether the respective claim is accepted or rejected respectively
• Upon acceptance of the claim, the bills are settled by the insurance company, and the policyholder is authorized to move out of the hospital without incurring any charges from their pockets respectively.

In case of being admitted to a non-network hospital, you need to pay the charges of the treatment and claim for reimbursement by contacting the insurance provider as per the policy clause. You will be required to submit the necessary documents as proof for your claim filling process. Upon verification of the documents, your expenses will be reimbursed within a few working days, once all the formalities are completed.

Documents Required

• Duly filled and signed claim form
• Doctor’s certificate [ the doctor who attended the patient regarding the diagnosis]
• Hospital discharge summary and bills to be provided in the original copy.
• FIR copy [ In certain circumstances]
• Original bills and prescription papers need to be submitted

Exclusions

• Circumcision is excluded under this policy.
• Artificial Life Maintenance.
• Involvement in any hazardous activities or sports is subject to exclusion under this policy.
• All HIV, AIDS and their complications.
• All surgeries which are done for the purpose of Cosmetic and Reconstructive purposes.
• Any hospitalization which is deemed not justified is excluded under this policy.
• All mental and psychiatric conditions are excluded under this policy.
• Dental treatment along with Oral treatment is subject to exclusions under this policy.
• All non-medical expenses will be excluded under this policy.
• All unlawful activities are excluded under this policy.
• Treatments received outside India.
• Any medical treatment received from any unrecognized physician or hospital.
• All expenses for maternity and reproductive purposes
• Obesity and weight control treatments are subject to exclusions under this policy.
• Off-label drugs and treatments.
• Rehabilitation is also excluded under this policy.
• Any diagnostic procedures which may be considered inconsistent, irrelevant or incidental.
• All behavioral, neurodevelopmental and neurodegenerative disorders are to be excluded under this policy.
• All exclusions which have been included in Annexure 2 of the policy clause are subject to exclusions.

How much time does the claim settlement procedure take?

The time for Claim Settlement is subject to the terms and conditions in the policy clause. Generally, 30 days’ time frame is given for submission of the necessary documents to start the claim process respectively.

Renewal Process of Max Bupa Health Recharge Family Floater

For policyholders looking for renewing their policy may follow the below mentioned steps:

Step 1: Type your policy number and date of the policy

Step 2: Click Submit

Step 3: Know your premium amount for the current year

Step 4: Click “Pay” to make the payment

Advantages of Max Bupa Health Recharge Family Floater

• The feature of E-Consultation is provided under this policy for individuals who are planning to undergo a surgery or any surgical procedure.
• The policy provides loyalty addition in the form of an additional 5 % base sum insured which is subject to a maximum of 50% of the base sum insured every year.
• This policy also offers the options of Personal Accident care, Critical illness, Modification of the room rent and annual aggregate deductible under its scheme.
• There exists no age limit for availing of this policy. Thus this policy is available to all persons pertaining to their specific age group.
• This insurance policy is subject to lifetime renewals.

FAQs

Q1. Does this policy provide direct claim settlement or TPA claim settlement feature?

Health Recharge Family Floater provides direct claim settlement to its policyholders.

Q2. Is this policy subject to tax benefits?

Yes, this policy is subject to income tax benefits under section 80D of The Income Tax Act, 1961.

Q3. What is the renewal options under this policy?

The policy is subject to lifetime renewal as per the policy clause.

Q4. What is the free look period with this policy?

The free look period concerning this policy is for a period of 15 days.