Health Insurance 211 views January 23, 2021

Aditya Birla Activ Health Platinum Enhanced is a health insurance plan for you and your loved ones. It is slightly different from a simple health insurance plan. If you live a healthier life, the policy will provide you HealthReturns™ with which you can get up to 30% of your premium amount. Also, there are benefits like reload of the sum insured, choice of hospital room rent, chronic management program and coverage for COVID treatment as well. Know more about the Aditya Birla Activ Health Platinum Enhanced coverages and exclusions in the page below.

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Aditya Birla Activ Health Platinum Enhanced Sum Insured Options

You can choose your sum insured for the Aditya Birla Activ Health Platinum Enhanced plan from the following –

  1. INR 2 Lakh to INR 10 Lakh
  2. INR 15 Lakh
  3. INR 20 Lakh
  4. INR 25 Lakh
  5. INR 30 Lakh
  6. INR 40 Lakh
  7. INR 50 Lakh
  8. INR 100 Lakh
  9. INR 150 Lakh
  10. INR 200 Lakh

Basic Covers of Aditya Birla Activ Health Platinum Enhanced Plan

The insurer will pay for the following if any of the covered health risks arise during the policy term.

  1. In-patient hospitalization
  2. Pre-hospitalization medical expenses up to 60 days before the date of admission
  3. Post-hospitalization medical expenses up to 180 days after the date of discharge from the hospital
  4. 527 daycare procedures
  5. Domiciliary hospitalization
  6. Road ambulances cover up to actual expenses if admitted to a network hospital. Otherwise, up to INR 5,000, if admitted to a non-network hospital
  7. Organ donor expenses
  8. Reload of the sum insured

Copayment Clause of Aditya Birla Activ Health Platinum Enhanced Plan

A copayment will apply to your Aditya Birla Activ Health Platinum Enhanced Plan where you need to pay a part of your hospitalization expenses while the rest will be paid by the insurer. Let’s have a look at the co-payment charges below.

Room CategoryNormal CopaymentZone 1 Cities CopaymentZone 2 and 3 Cities Copayment
Single Private Room to Shared Room15%10%5%
Any room to Shared Room40%30%25%
Any room to Single Private Room25%20%15%

Note – Check out your zone cities on Aditya Birla General Insurance’s official website.

Aditya Birla Activ Health Platinum Enhanced Plan Additional Benefits

  1. Cumulative Bonus – Receive a cumulative bonus of 20% on every claim-free year, and this can go up to 100%. And your accumulated bonuses will not reduce if you claim in the subsequent years.
  2. Health Check-up Program – You can get a free health check-up once in a policy year at Aditya Birla network centers.
  3. Recovery Benefit – 1% of the sum insured will be recovered if it is exhausted in a policy year, subject to a maximum of INR 10,000 (10 days of hospitalization)
  4. Second E-Opinion on Critical Illness – To seek a second opinion on your critical illness, just send a request for the same. And choose from the insurer empanelled list of medical practitioners. The medical practitioner will send you the e-opinion directly.
  5. Worldwide Emergency Assistance Services -Your health cover will always be active with the worldwide emergency assistance service for 24/7 emergencies when travelling abroad.

Value-added Benefits of Aditya Birla Activ Health Platinum Enhanced Plan

The following benefits make this plan more attractive for the customers –

Chronic Management Program

Activ Health’s Chronic Management Program (CMP) is specially designed for those who are suffering from Diabetes, Asthma, High Cholesterol, High Blood Pressure and other such conditions. On day one, the company offers coverage for chronic conditions. And if unfortunately, you develop a chronic condition after buying the policy, you will be upgraded to the program without any additional premium. This program covers the expenses of tests, consultation, medicines and hospitalization cover after 30/90 days.

HealthReturns™

If you want to earn HealthReturns™ under the Aditya Birla Activ Health Platinum Enhanced Plan, follow the steps below –

  1. Download the Activ Health App on your Android or IOS smartphone
  2. Check out your Healthy Heart Score
  3. And if it is at low risk or high risk currently, improve your health
  4. The app will give you a fitness assessment test every six months

If you are successful in being healthy, you could earn up to 30% of your premium as HealthReturns™ on completing 13 Active Dayz™ every month. Or up to 6% of your premium as HealthReturns™ on completing 4 Active Dayz™ every month.

You can use your HealthReturns™ to buy medicines, payment for diagnostic tests, next policy premium payment. Or you can save it like a fund for any health contingency.

Wellness Coach

A wellness coach will guide you to make healthy choices.

Eligibility for Aditya Birla Activ Health Platinum Enhanced

You can purchase this policy if you meet the below criteria –

  1. Minimum entry age 91 days
  2. No maximum entry age
  3. Children up to 25 years of age can be covered under a family floater plan
  4. Under family floater, up to 9 members can be covered consisting of self, spouse, dependent parents, parents-in-law and children.
  5. Policy term 1, 2 or 3 years

Avail discount of 7.5% and 10.00% on premium payment upon choosing a policy term of 2 and 3 years respectively.

Claim Procedure

To claim the Aditya Birla Activ Health Platinum Enhanced sum insured in a network hospital, follow the instructions below –

  1. Call the 24/7 claim assistance
  2. You can make cashless claims across network hospitals provided in your policy document.
  3. For pre-authorization intimation, you can use the Activ Health app or call the toll free number
  4. Pre-authorization feedback will be provided to you within 2 hours of its request

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