Niva Bupa Senior first

All You Need To Know

Variant	Gold	Platinum
Base Sum Insured	5L / 10L	5L / 10L / 15L / 20L / 25L
Benefits
In-patient Care	Covered up to Sum Insured
Room Category	Shared Room	Single Private Room
Pre-Hospitalization (60 days)	Covered up to Sum Insured
Post-Hospitalization (180 days)	Covered up to Sum Insured
Day Care Treatment	Covered up to Sum Insured
Modern treatments	Covered up to Sum Insured with sub-limit of INR 1 Lakh per claim on few robotic surgeries
Ambulance	Road ambulance: up to INR 2,000 per hospitalization
	Air ambulance: up to INR 2,50,000 per hospitalization
AYUSH Treatments	Covered up to Sum Insured
Treatment at home (Domiciliary Hospitalization)	Covered up to Sum Insured
Organ Donor	Covered up to Sum Insured
No Claim Bonus	Not applicable	In case of claim free year, increase of 10% of expiring Base Sum Insured in a Policy Year; maximum up to 100% of Base Sum Insured (In case of claim, no reduction in No Claim Bonus)
ReAssure	Not applicable	Unlimited reinstatement up to base Sum Insured (Applicable for both same & different illness)
Health Check-up	Not applicable	Annual (From Day 1); For defined list of tests; up to INR 500 for every INR 1 Lakh Base Sum Insured (Individual policy: maximum INR 5,000 per Insured; Family Floater policy: maximum INR 10,000 per policy)
Co-payment	50%
Optional Benefits
Annual Aggregate Deductible	1L / 2L / 3L / 4L / 5L
Modification in co-payment	40% / 30% / 20% 0% (Addon)
Safeguard	a. Claim Safeguard: Non-payable items paid up to Sum Insured (List I) b. Booster Benefit Safeguard: No impact on Booster benefit if claim in a policy year is less than Rs. 50,000 c. Sum Insured Safeguard: CPI linked increase in Base Sum Insured

For detailed coverage information, please refer to the policy terms and conditions document.

FAQs

1. Who is eligible to buy Senior First policy?
Entry age: 61 years to 75 years
1 Adult (Self) or 2 Adults (Self and Spouse)
Policy can be taken on Individual SI basis or Family Floater basis

2. Is Co-payment or Deductible mandatory under this product?
Yes, either co-payment of Deductible is mandatory to be chosen under this plan.
If you choose co-payment – the options are 0%, 20%, 30%, 40%, 50%
If you chose deductible – the deductible amount will be 20% (i.e. 1/5) of base sum insured opted

3. Can I change co-payment percentage at renewal?
No. The co-payment can ONLY be chosen at inception of the policy and cannot be changed later.

4. Are there any room rent / category capping applicable in this plan?
There is no amount capping, however the room category is capped at ‘Single Private Room’ for Platinum plan and ‘Shared Room’ for Gold plan.

5. What if customer goes into a higher room category at the time of claim?
If you opt for higher room category than the eligible room category, then an additional co—payment of 10% shall be applicable.

6. Suppose if I choose deductible option, do I need to bear that amount on each & every claim?
No, once you’ve exhausted your deductible limit in a single bill or multiple bills, all further claim amounts in that policy year would be admissible.

7. Do I need to undergo any pre-medical test to buy this policy?
No medical tests are required. Only telephonic underwriting will be done on the basis of which the policy will be accepted or declined. Medical tests may be asked by the underwriter in case of any adverse deceleration.

8. What is the waiting period for Specific & Pre-existing diseases?
24 months waiting period is applicable for both Specific & Pre-existing diseases.

9. Can I purchase this policy for my parents?
Yes, you can propose the policy for your parents, i.e. you can be the proposer and your parents can be the insured.

10. Can we give 2 Senior first polices to the same customer?
Yes, but it would be subject to U/W and maximum SI limits.

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Senior First

All You Need To Know

Coverage and Limits

Eligibility

Discounts Offered

FAQs

Tools & Calculators

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