Aditya Birla Activ Health Essential Plan

What is the Plan all About?

Activ Heath Essential helps you get a customized health cover to cater to your health care needs. It also provides cover for chronic diseases such as diabetes, hypertension and asthma.

Key Features

Complete health cover
Health Returns Rewards to stay fit
Day 1 cover for chronic illnesses
Choice of hospital room category
Optional covers to enhance benefits
Avail cumulative bonus
Range of optional covers to enhance coverage
Second E-opinion for critical illness

Policy Benefits

In-patient treatment expenses like room rent, doctor’s fee, operation theater charges, ICU charges, medicines, consumables, etc are covered, when hospitalized for more than 24 hours.
Pre hospitalization expenses when incurred before hospitalization are covered up to 30 days.
Post hospitalization expenses when incurred after discharge from hospital are covered up to 60 days.
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.
Benefit of choosing a lower hospital room category is payable on claims.

Value Added Benefits

Road Ambulance Cover towards cost incurred for transportation to a hospital.
Get cumulative bonus of 10% 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 from international specialists is available.
Chronic Management Program to control chronic illnesses and keep you healthy.
This policy rewards you for staying fit and you can get these rewards in form of Health Returns that can be used for getting medicines for fever or a surgery.
Get access to Wellness Coaching in areas such as weight management, nutrition, activity & fitness and tobacco cessation.
Riders can be opted to enhance policy coverage.
Avail tax benefits u/s 80D of the IT Act, 1961 for the premiums paid.

Sub Limits

Treatment wise sub-limits will apply which are applicable per Policy Year based on disease category and zone type.
Mandatory co-payment applies to all payable claims.
Co-payment for treatment in a higher zone. Co-pay of 10%/15%/25% applies, when treatment taken in a zone higher than the eligible zone.
Co-payment for treatment in a Higher room category. Co-pay of 15%/25%/40% applies, when you take a higher room category than the eligible room.
For an annual health check-up, you claim a reimbursement of up to Rs 1,000, depending on the age band.

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 4 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 Lacs	10 Lacs
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, Waiver Of Mandatory Co-payment	-