Who can buy the policy?

Individuals aged 55 years to 80 years can buy the policy on an individual or family floater basis. In case of family floater basis, coverage can only be taken for self and spouse.

Which premium discounts are allowed under the policy?

The policy allows different types of premium discounts. Firstly, if the policy is taken for two years and a single premium is paid, a discount of 7.5% is allowed on the premium. Secondly, if two members are covered, discount of 5% is allowed.

Co-payment is when the policyholder has to bear a part of the claim from his/her own pockets. Co-pay is usually applicable in cases when older individuals are insured. Under the Activ Care plan, co-payment is applicable @ 20% for Standard and Classic Plans and 10% for Premier Plan. This means that the policyholder would have to pay 20% or 10% of the claim himself and the insurance company would then settle the remaining.

What are the variant specific sum insured levels?

Sum insured under Standard and Classic Plans are Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh, Rs. 7.5 Lakh and Rs. 10 Lakh. For Premier Plan the coverage level is Rs. 5 Lakh, Rs. 7.5 Lakh, Rs. 10 Lakh and Rs. 25 Lakh.

Are organ donor expenses covered under the plan?

Yes, organ donor expenses are covered under the Classic and Premier Plans. Under the Classic plan, the expenses are covered for up to 50% of the sum insured while under the Premier Plan coverage is allowed for up to the full sum insured.

What is sum insured reload?

The plan refills the sum insured if it is exhausted in a policy year due to a claim. Under the Standard Plan, sum insured reload is available for up to 50% of the basic sum insured while under the Classic and the Premier plan variants, reload feature is available for up to 100% of the basic sum insured.

Are alternative treatments covered under the policy?

Cover for alternative AYUSH treatments is allowed only under Classic and Premier Plans up to limits of 10% and 25% of the sum insured respectively.

What is the extent of home treatment coverage available under the plan?

Home treatment coverage is when the insured takes treatments at home from the company’s empanelled service providers. The limit of coverage depends on the sum insured. If the sum insured is Rs. 3 Lakh or Rs. 4 Lakh, the coverage limit is Rs. 25,000 and if sum insured is Rs. 5 Lakh and above the coverage limit is Rs. 50,000.

What are the Care Benefits available under the plan?

Care Benefits available under the plan include health assessment, complete health check-up, health coach, personal health coach, health returns, second e-opinion and health and wellness discount

What are health returns?

If the insured maintains a healthy life, he can earn Health Returns. The plan monitors the health of the insured and if the insured is healthy, returns are awarded as a percentage of the premium paid. The accumulated Health Returns can then be utilised on meeting various healthcare expenses.

Aditya Birla Activ Care Health Insurance Wordings

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Highlights

Cashless Approval TAT	Within 2 hours
Claim Settlement Ratio	96%
Network Hospitals	11,000+
Pre-existing Disease Coverage Starting From	Day 1
Special Benefits	Incentivized Wellness
Starting Premium for Rs. 5 lakh Coverage	Rs. 270/month

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Aditya Birla Activ Care Brochure

1.26 MB
PDF Document
Jun 08, 2019

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Aditya Birla Health Insurance Plan List

Family (4)
Individual (4)
Kids (3)
Diabetes (2)
Parents (1)
Senior Citizen (1)
Cancer (2)
Critical Illness (2)

Name of Plan	Sum Insured
Activ Assure DiamondMin: 91 Days; Max: No LimitPopular	2 Lakh	Check Premium
Active Health PlatinumPopular		Check Premium
Activ Fit - Plus and PreferredPopular		Check Premium
Global Health Secure Min: 91 Days; Max: 65 yearsPopular	3 Crore - 6 Crore	Check Premium
Activ OnePopular		Check Premium
Activ Health EssentialMin: 91 Days; Max: No Limit	50 Thousand	Check Premium
Activ CareMin: 55 Years; Max: 80 Years	3 Lakh	Check Premium
Corona Kavach PolicyMin: 1 day; Max: 65 days	50,000 - 5 lakh	Check Premium
Activ SecureMin: 5 Years; Max: 65 Years	1 Lakh	Check Premium
Cancer SecureMin: 18 Years; Max: 65 Years	5 Lakh	Check Premium
Activ Health EnhancedMin: 91 Days; Max: No Limit	2 Lakh	Check Premium
Arogya Sanjeevani PolicyMin: 3 Months; Max: 65 Years	1 Lakh - 5 Lakh	Check Premium

Aditya Birla Health Insurance Top Up List

Name of Plan	Sum Insured
Super Health Plus Top-up PolicyMin: 91 Days; Max: 65 years	3 Lakh - 95 Lakh	Check Premium

10849 Aditya Birla Cashless Network Hospitals in India

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FAQs on Activ Care Health Insurance Plan

Who can buy the policy?
Individuals aged 55 years to 80 years can buy the policy on an individual or family floater basis. In case of family floater basis, coverage can only be taken for self and spouse.
Which premium discounts are allowed under the policy?
The policy allows different types of premium discounts. Firstly, if the policy is taken for two years and a single premium is paid, a discount of 7.5% is allowed on the premium. Secondly, if two members are covered, discount of 5% is allowed.
What is co-payment?
Co-payment is when the policyholder has to bear a part of the claim from his/her own pockets. Co-pay is usually applicable in cases when older individuals are insured. Under the Activ Care plan, co-payment is applicable @ 20% for Standard and Classic Plans and 10% for Premier Plan. This means that the policyholder would have to pay 20% or 10% of the claim himself and the insurance company would then settle the remaining.
What are the variant specific sum insured levels?
Sum insured under Standard and Classic Plans are Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh, Rs. 7.5 Lakh and Rs. 10 Lakh. For Premier Plan the coverage level is Rs. 5 Lakh, Rs. 7.5 Lakh, Rs. 10 Lakh and Rs. 25 Lakh.
Are organ donor expenses covered under the plan?
Yes, organ donor expenses are covered under the Classic and Premier Plans. Under the Classic plan, the expenses are covered for up to 50% of the sum insured while under the Premier Plan coverage is allowed for up to the full sum insured.
What is sum insured reload?
The plan refills the sum insured if it is exhausted in a policy year due to a claim. Under the Standard Plan, sum insured reload is available for up to 50% of the basic sum insured while under the Classic and the Premier plan variants, reload feature is available for up to 100% of the basic sum insured.
Are alternative treatments covered under the policy?
Cover for alternative AYUSH treatments is allowed only under Classic and Premier Plans up to limits of 10% and 25% of the sum insured respectively.
What is the extent of home treatment coverage available under the plan?
Home treatment coverage is when the insured takes treatments at home from the company’s empanelled service providers. The limit of coverage depends on the sum insured. If the sum insured is Rs. 3 Lakh or Rs. 4 Lakh, the coverage limit is Rs. 25,000 and if sum insured is Rs. 5 Lakh and above the coverage limit is Rs. 50,000.
What are the Care Benefits available under the plan?
Care Benefits available under the plan include health assessment, complete health check-up, health coach, personal health coach, health returns, second e-opinion and health and wellness discount
What are health returns?
If the insured maintains a healthy life, he can earn Health Returns. The plan monitors the health of the insured and if the insured is healthy, returns are awarded as a percentage of the premium paid. The accumulated Health Returns can then be utilised on meeting various healthcare expenses.

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Claim Process at Aditya Birla Health Insurance

Network Hospital
Non-Network Hospital

1
Claim Assistance
For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
2
Claim Intimation
Emergency hospitalisation needs intimation within 48 hours and for planned hospitalisation intimate within 3 days prior to admission.
3
Claim Processing
Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
4
Claim Settlement
Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.

1
Claim Assistance
For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
2
Claim Intimation
Emergency hospitalisation needs intimation within 48 hours and for planned hospitalisation intimate within 3 days prior to admission.
3
Claim Processing
Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
4
Claim Settlement
Once your request for reimbursement of expenses is approved, the claim will be settled.

Aditya Birla Health Insurance Contact Details

Reach us for help anytime

Insurance Dekho
755 1196 989Mon to Sun 10:00 AM to 7:00 PM
support@insurancedekho.com
Aditya Birla Health Insurance
1800-270-7000Mon to Fri 10:00 AM to 7:00 PM
care.healthinsurance@adityabirlacapital.com