Last Updated on May 19, 2023 by Hemant Beniwal
It is important to provide for adequate medical protection for ourselves and our family. There are many health insurance schemes available and we have to choose the one that suits our requirements the best. Max Bupa’s Health Companion plan is an individual and a family floater plan. It has been redesigned now to cover more family relationships. This is to address the needs of joint families.
There are three different sub-plans in it – Individual Plan, Family Floater Plan and Family First Plan. The Individual plan covers just 1 person.
The Family Floater plan covers medical expenses of self, spouse and up to 4 children.
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The Family First Plan covers a maximum of 19 relations. It includes self, spouse, sons, daughters, sons-in-law, daughters-in-law, father, mother, father-in-law, mother-in-law, grandparents, grandchildren, brothers, sisters, brothers-in-law, sisters-in-law, nephews and nieces.
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Features of Max Bupa Health Companion Plan
The insurance cover has 3 variants for each of the sub-plans. The following features are common for all variants of Max Bupa Health Companion Plan –
| Features | Details |
| Pre and Post Hospitalization Expenses | Medical expenses due to illness is covered for 30 days before admission in hospital and up to 60 days after discharge depending on approval on the in-patient care hospitalization claim. |
| AYUSH Coverage | The plan covers all forms of treatment such as Ayurvedic, Unani, Siddha and Homeopathy for the base sum assured. |
| Network – | The plan has a geographical condition. There are two zones in the network
Zone 1 – Includes Ahmedabad, Bengaluru, Chennai, Delhi/NCR, Hyderabad, Kolkata, Mumbai(including Thane and Navi Mumbai), Pune and Surat. Zone 2 – Covers Rest of India. If you stay outside Zone 1, you can choose from the network of cities. You can opt for one of these – 1) Cashless facility in Zone 2 cities 2) Reimbursement facility in Zone 1 cities with 20% co-payment 3) 10% discount for your premium calculation. |
| Tax benefit | You can avail of the tax benefit under Section 80D of the Income Tax Act. |
| Minimum and maximum Age | Medical expenses are covered for all irrespective of age once the person is over 3 months old. |
| Organ Donation | Medical expenses for organ donation are covered under the plan. |
| Emergency Ambulance Services | Emergency Ambulance Services are covered under the plan up to Rs. 3000. |
| Cashless Treatment | Cashless treatment is possible in over 3500 hospitals across the country. |
| Medical Tests | Medical test is required for sum insured up to Rs 4,00,000 and the applicant has to bear 50% of the expenses. |
| No Claim Bonus | If you have a claim-free year, you get 20% additional sum insured, up to a maximum of 100% of Base Sum Insured as long as there is no penalization in case of claim. |
| Discount on Premium | 12.5% discount is available if policy is taken for 2 years. |
| Waiting Period | Treatment during the first 30 days of the policy, unless the treatment needed is for an accident will not be covered. |
| Exclusions | Some conditions like artificial life maintenance, dental treatment, eyesight, heredity conditions, AIDS, Reproductive Medicine, self inflicted injuries, sleep disorders, treatment outside India and claim arising out of unlawful activities are not covered. |
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There are some differences in each of the variants for these features –
| Features | Variant 1 | Variant 2 | Variant 3 |
| Sum Assured, Top Up and Deductible Options |
Rs. 2,00,000, Rs, 3,00,000 and Rs. 4,00,000 Top Up and Deductible Options of Rs. 1,00,000, Rs. 2,00,000, Rs. 3,00,000, Rs.4,00,000, Rs. 5,00,0000 and Rs.10,00,000 are available. |
Rs. 5,00,000, Rs. 7,50,000, Rs. 10,00,000 and Rs. 12,50,000
Top Up and Deductible Options of Rs. 1,00,000, Rs. 2,00,000, Rs. 3,00,000, Rs.4,00,000, Rs. 5,00,0000 and Rs.10,00,000 are available. |
Rs. 15,00,000 Rs. 20,00,000, Rs. 30,00,000, Rs. 50,00,000 and Rs. 1 crore Top Up and Deductible Options of Rs. 1,00,000, Rs. 2,00,000, Rs. 3,00,000, Rs.4,00,000, Rs. 5,00,0000 and Rs.10,00,000 are available. |
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The Family First Plan has a sum assured of Rs. 1,00,000, Rs. 2,00,000, Rs, 3,00,000, Rs. 4,00,000 and Rs. 5,00,000 for individuals and a floater sum assured of Rs. 3,00,000, Rs. 4,00,000, Rs. 5,00,000, 10,00,000, 15,00,000 and Rs. 20,00,000. Deductible Options of Rs. 1,00,000, Rs. 2,00,000, Rs. 3,00,000, Rs.4,00,000, Rs. 5,00,0000 and Rs.10,00,000 are available. |
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| Vaccination in case of Animal Bites | Not Covered | OPD treatment, vaccination and immunization is covered up to Rs. 5000 for reimbursement. |
OPD treatment, vaccination and immunization is covered up to Rs. 7500 for reimbursement. The Family First Plan has a cover of only Rs. 5000 in case of all variants. |
| Renewal Benefits | No Claim Bonus and complementary complete health check up for main person insured and family once in 2 years. | No Claim Bonus and complementary yearly health checkup for main person insured and family | No Claim Bonus and free yearly health checkup for main person insured and family. |
| Pre-existing Diseases |
Pre-existing Diseases are not covered until 48 months of continuous coverage from the first policy start date. |
Pre-existing Diseases are not covered until 36 months of continuous coverage from the first policy start date. | Pre-existing Diseases are not covered until 36 months of continuous coverage from the first policy start date |
| Hospital Cash Expenses | For an additional cover, you can get Rs. 1000 per day for 30 days of hospitalization over and above the sum assured. | For an additional cover, you can get Rs. 2000 per day for 30 days of hospitalization over and above the sum assured. |
For an additional cover, you can get Rs. 4000 per day for 30 days of hospitalization over and above the sum assured. The Family First Plan has a cover of only Rs. 1000/ Rs. 2000 in case of all variants. |
Infographics – Terms Commonly used in Health Insurance Policy
How much premium do I pay?
For a 30 year old individual opting for a Family Floater Plan of Rs. 10,00,000, the premium amounts to Rs. 17,235 (2 adults +2 children)
For a 30 year old individual opting for a Family First Plan of Rs. 1,00,000 individually and Rs. 5,00,000 lakh cover for a family of 4 adults and 2 children, the premium amounts to Rs. 51,975.
Read: Top Up Vs Super Top up health insurance plans
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What does the top-up deductible option mean?
The Top-Up option is an option available to you to buy additional cover. It comes into effect when the total claim in a year is more than the sum assured amount.
Here is an example –
Assume you have a medical policy of Rs. 5,00,000 and a Health Companion policy with a top-up of Rs. 3,00,000.
If you have a claim for Rs. 5,00,000 in a year, your medical policy will cover that amount.
Suppose you have two claims of Rs. 4,00,000 each in one year at two separate occasions, your medical policy will cover the first claim by paying you Rs. 4,00,000. For the second claim, the medical policy will pay Rs. 1,00,000 and the Health Companion plan with top-up will pay Rs. 3,00,000 for the second claim. The top-up option comes into action when the threshold limit (total sum assured) is crossed.
The plan is quite comprehensive as it covers many relationships and most day care procedures. It has some advantages like coverage of different types of treatment, hospital cash, annual health checkups and discount on premium. It is a good plan to consider if you want to provide medical cover for a large family.
It will be great if you can share the name of your health insurance plan & any specific reason for considering it over others.
This review is done by our Para Planner Ravi Viryani
