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Aditya Birla Activ Heath Enhanced Plan

What is the Plan all About?

Activ Heath Enhanced from Aditya Birla Health Insurance provides a comprehensive coverage against ever-rising medical bills. This health plan offers comprehensive benefits and cover amount, so you can avail quality medical care without any worries.

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Key Features

  • Comprehensive cover up to Rs 2 crores
  • Rewards to stay fit & healthy
  • Day 1 cover for chronic diseases
  • Reload of sum insured
  • Choice of hospital room category
  • Avail cumulative bonus
  • Choice of riders to broaden policy benefits
  • Avail second E-opinion
  • Worldwide emergency assistance services

Policy Benefits

  • In-patient treatment expenses like room rent, doctor’s fee, ICU charges, operation theater charges, medicines, consumables, etc. are covered for having a hospitalization for more than 24 hours.
  • Pre hospitalization expenses when incurred before hospitalization are covered up to 60 days.
  • Post hospitalization expenses when incurred after discharge from hospital are covered up to 180 days.
  • 527 listed day care procedures that require the insured person to get hospitalized for less than 24 hours are covered.
  • Domiciliary hospitalization is covered up to the limits as specified under the policy.
  • Organ donor expenses to cover the medical expenses of the organ donor for harvesting the organ.
  • Recovery Benefit is applicable on hospitalization of at least 10 consecutive days.
  • Benefit for choosing a lower hospital room category is payable on claims.

Value Added Benefits

  • 100% Reload of Sum Insured for an illness unrelated to previous claims in the same policy year. In case of accidental hospitalization, this benefit can be availed in the first claim as well.
  • Road Ambulance Cover towards cost incurred for transportation to a hospital.
  • Get cumulative bonus of 20% for every claim-free policy year.
  • A free annual health check-up is provided to each insured person (above 18 years).
  • Second E-opinion on critical illness can be availed through well-qualified international specialists.
  • Riders can be opted to enhance policy coverage.
  • Worldwide emergency assistance services to avail medical care.
  • Chronic Management Program to control chronic illnesses and keep you healthy.
  • This policy rewards you for staying fit and you can get these rewards as Health Returns.
  • Wellness Coach to guide you through your wellness journey such as weight management, nutrition, activity & fitness and tobacco cessation.
  • Avail tax benefits u/s 80D of the IT Act, 1961 for the premiums paid.

Sub Limits

  • No co-payment is applicable under this plan.
  • Co-payment for treatment in the higher zone or higher room category is applicable.
  • Option to select a deductible amount to get discounts on premium.

Waiting Period Clause

  • Initial Waiting Period: A waiting period of 30 days from the inception date for all hospitalization claims except in case of accidents.
  • Specific Waiting Period: Specific illnesses such as Cataract, Sinusitis, Osteoarthritis, Hernia, Hydrocele, etc. are covered after 24 months of continuous policy coverage.
  • Pre existing Disease Waiting Period: Any pre-existing ailment/injury is covered after a waiting period of 3 continuous years.
  • Maternity Waiting Period: Any maternity or pregnancy-related expenses are covered after 24 months of continuous policy coverage.
  • Chronic Management Program Waiting Period: Waiting period for availing benefits of Chronic Management Program is 24 months. There is no waiting period for Chronic Management Program, if the insured person has undergone pre-policy medical examination. Hospitalization related to chronic condition is having a waiting period of 90 days.

Who can Buy the Plan?

Factor Minimum Maximum
Age (as on last birthday) Child: 91 Days Adult: 18 Years Child: 25 Years Adult: No Limit
Sum Assured 2 Lac 2 Crore
Cover Type Individual/Family Floater -
Policy Tenure 1 Year 3 Years
Grace Period 30 Days -
Free Look Period 15 Days/30 Days (for Distance Marketing Channel) From The Receipt Of The Policy -
Riders OPD Expenses, Deductible, Maternity Expenses, Hospital Cash Benefit -

Exclusions

  • War, invasion, act of foreign enemy
  • Intentional self injury
  • Attempted suicide
  • Breach of law with criminal intent
  • Abuse of intoxicants
  • Cosmetic treatment & surgeries
  • Cost of spectacles, contact lenses or hearing aids
  • Non allopathic treatment, etc.