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What Is Health Insurance ?

Health Insurance is a financial safety net that helps cover your medical expenses. Whether it’s a routine doctor visit or a major surgery, your insurance plan helps pay the bills. You pay a regular premium, and in return, the insurance company helps cover your healthcare costs, making medical treatment more affordable.

  • Receive quality medical care
  • Customise your plans with riders

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Feature and Benefits

Cashless Treatment

No need to arrange for large sums of money as your policy takes care of the bill and you don’t have to pay out of your pocket.

No Claim Bonus

Earn a no-claim bonus in the form of extra sum insured for each claim-free year.

Coverage for Pre-existing Conditions

Ensure even with ongoing health issues, you can still access necessary care when needed.

Wellness Programs

Get incentives and rewards for making healthy lifestyle choices such as fitness programs and taking preventive health screenings.

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Top Health Insurance Plans by ABCD

Get Comprehensive Cover

Choose from indemnity-oriented health plans for covering your medical bills.

Protect Your Health and Wealth

Stay fit and benefit from a comprehensive cover with our health and wellness plans

Boost Your Cover

Supplemental health insurance plans which allow high coverage at lower premiums.

Activ Health Platinum Essential

UIN: ADIHLIP24102V052324

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Receive cashless treatment at home
  • Get coverage for 586 day care procedures
  • Earn up to 50% of premium back as HealthReturns™

Premium starts at

₹5,579* /year
Activ Health Platinum Enhanced

UIN: ADIHLIP24102V052324

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Expert health coaches available
  • Earn up to 100%* premium back as HealthReturnsᵀᴹ
  • Double the sum insured with NCB

Premium starts at

₹8,215*/ year
Activ One MAX

UIN: ADIHLIP24097V012324

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Sum insured up to ₹6 crores
  • Modern treatments and procedures are covered
  • Coverage for non-payable items with Claim Protect

Premium starts at

₹4,713* /year
Activ One NXT

UIN: ADIHLIP24097V012324

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Earn up to 100% premium as HealthReturnsTM
  • Range of optional coverage benefits
  • Coverage for mental illnesses

Premium starts at

₹5,630* /year
Activ Fit Plus

UIN: ADIHLIP22008V012223

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Get up to 100% of the sum insured refilled
  • Get covered for mental healthcare
  • Double the sum insured with NCB

Premium starts at

₹6863*/per annum
Super Top-up

UIN: ADIHLIP21061V022021

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Waive off the deductible without health re-evaluation
  • Choose between any room category
  • Get covered for home treatments

Premium starts at

₹1921/per annum

Health and Wellness Plans

Holistic health insurance plans that not only cover your medical expenses but also encourage you to stay healthy by rewarding good habits.

Super Top Up Plans

Reliable and convenient health insurance plans that provide additional coverage on top of your existing health plan while being affordable

Activ One MAX

UIN: ADIHLIP24097V012324

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Sum insured up to ₹6 crores
  • Modern treatments and procedures are covered
  • Coverage for non-payable items with Claim Protect

Premium starts at

₹4,713* /year
Activ One NXT

UIN: ADIHLIP24097V012324

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Earn up to 100% premium as HealthReturnsTM
  • Range of optional coverage benefits
  • Coverage for mental illnesses

Premium starts at

₹5,630* /year
Activ Fit Plus

UIN: ADIHLIP22008V012223

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Get up to 100% of the sum insured refilled
  • Get covered for mental healthcare
  • Double the sum insured with NCB

Premium starts at

₹6863*/per annum
Activ Health Platinum Enhanced

UIN: ADIHLIP24102V052324

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Expert health coaches available
  • Earn up to 100%* premium back as HealthReturnsTM
  • Double the sum insured with cumulative bonus

Premium starts at

₹8,215*/ year
Activ Health Platinum Essential

UIN: ADIHLIP24102V052324

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Receive cashless treatment at home
  • Get coverage for 586 day care procedures
  • Get chronic illness cover from day 1

Premium starts at

₹5,579* /year
Super Top-up Plus Plan B

UIN: ADIHLIP21061V022021

Our Health Insurance Plans KEY FEATURES Our Health Insurance Plans
  • Waive off the deductible without health re-evaluation
  • Choose between any room category
  • Get covered for home treatments

Premium starts at

₹10,768* /annum

Compare Our Health Insurance Plans

A quick glance at how different types of health insurance plans differ from each other**.

PLAN TYPEs Health and Wellness Plans Top-up Plans
Best Suited For Individuals seeking both medical cost coverage and rewards for maintaining a healthy lifestyle Individuals with existing policies who want additional coverage
Entry Age Depends on the plan selected Depends on the plan selected
Ambulance Coverage Included in some plans Included
Health Returnsᵀᴹ Included Included
Cashless Hospitals Included Included
Room Type  Any room category at the time of hospitalisation; varies from plan to plan Restriction in some plans
Wellness Coach Included ---
Tax Benefits Yes Yes
Day Care Treatments  Included Included
KNOW MORE KNOW MORE

Check Your Eligibility

Before you purchase Health and Wellness plan, ensure you qualify and have the necessary documents.

Eligibility Criteria

  • Entry Age Children : 91 days in a floater plan and 5 years in an individual plan.
    ​​​Adults - 18 years to 99 years depending on the plan selected ​​
  • Citizenship Indian citizen residing in India at the time of purchase.
  • Medical tests Depends on the conditions of the plan selected
  • Disclosures Must disclose pre-existing conditions and smoking habit.
  • Family Must be spouse, children, parents, and sibling to be covered under a family floater plan.


Document Needed

  • Proposal form
  • Age proof
  • Identity proof
  • Passport size photograph
  • Address proof
  • Medical reports
  • PAN/ Aadhar card
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Get Insured In 5 Easy Steps

STEP
1

Evaluate your requirements - coverage, lifestyle, etc.

STEP
2

Explore different plans to find the right one for you

STEP
3

Ideally, choose a plan with lifetime renewability

STEP
4

Ensure the provider has network hospitals in your area

STEP
5

Assess available riders for added coverage

STEP
4

Ensure the provider has network hospitals in your area

STEP
5

Assess available riders for added coverage

Customer Satisfaction Stories

Hear from our customers what they have to say about their experience.

Hear What The Experts Have To Say
Hear What The Experts Have To Say
Arun Sharma

Aditya Birla Health Insurance

1 Jan 1
Hear What The Experts Have To Say

Aditya Birla Health Insurance has been my companion in my weight loss journey of losing 17 Kgs and helping me stay disease-free. Health Returnsᵀᴹ keeps my whole family motivated to be active and stay fit and each person can do the exercise of their choice

Hear What The Experts Have To Say
Mr. Rajinder Balhara

Aditya Birla Health Insurance Customer

Delhi, India

Hear What The Experts Have To Say
Hear What The Experts Have To Say
Mrs. Mangal Prathamesh Mithari

Aditya Birla Health Insurance Customer

1 Jan 1
Hear What The Experts Have To Say

Staying healthy has become a way of life. I really enjoy using the Activ Health app that gives all my health solutions at one place.

Hear What The Experts Have To Say
Mr. Himanshu Chaturvedi

Aditya Birla Health Insurance Customer

Noida, India

Hear What The Experts Have To Say
Hear What The Experts Have To Say
Shruti Davda

Aditya Birla Health Insurance

1 Jan 1
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Things To Keep In Mind

    • Depends on the policy chosen

As per the Income Tax Act, 1961, Section 80D provides for self, family, and parents

  • Deduction on premiums up to ₹25,000
  • Deduction on Preventive Health Checkup Claims up to ₹5,000
  • Waiting Period Clause
  • Pre-Existing Diseases
  • Maternity-Related Expenses
  • HIV/AIDS
  • Cosmetic Treatments

#Some plans may cover these. Please check the policy wording

ABCD - One app for
all your insurance needs

With a few clicks on the ABCD app, you can get financial protection against medical emergencies with a health insurance plan.

  • Life Insurance
    Comprehensive coverage against illnesses and injuries
  • Life Insurance
    Digital purchase process
  • Life Insurance
    Low and affordable premiums with one-click payments

Scan the QR code to download our Mobile App

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Understanding Health Insurance

  • What are the benefits of Health Insurance?
  • How does Health Insurance work?
  • What is the right age to buy Health Insurance
  • What is not covered in a Health Insurance plan ?
  • What factors can affect my Health Insurance premium?
  • What are the types of Health Insurance plans?
  • Under what conditions is my policy premium likely to increase at renewal?
  • Some important Health Insurance terms you should know?
  • Top reasons to buy Health Insurance?
  • What’s the difference between Mediclaim and Health Insurance?

What are the benefits of Health Insurance ?

  • Peace of mind

    You can rest easy knowing you will be covered in case of a medical emergency or accident.

  • Access to quality medical care

    You can avail of quality medical care, even if you are unable to afford it otherwise.

  • Protection from rising healthcare costs

    You can get cashless treatment at network hospitals with practically no expenses at all.

  • Preventive care

    It encourages and helps you stay healthy with free annual check-ups and rewards for good health.

  • Tax benefits

    You can save tax on the premiums paid as specified in Section 80D of India's Income Tax Act1.

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How does Health Insurance work ?

  • Plan selection: You select a plan considering your current health, lifestyle, and family’s medical history.

  • Premium: You pay premiums on time to avoid the policy from lapsing, leaving you without cover.

  • Hospitalisation: When the need for hospitalisation arises, you inform the insurer as soon as possible.

  • Claim: You raise a claim along with all the documents such as the claims form, your reports, medical bills, etc.

  • Settlement (cashless): In this case, you don’t have to pay anything and the insurer settles the bill with the hospital.

  • Settlement (reimbursement): You pay the bill first in full and then get reimbursed by the insurer.





What is the right age to buy Health Insurance?

img 20 to 30 years

This is the ideal age to buy it because you are most likely healthy and thus your premiums are lower. Most plans also don’t require you to take a medical test.

img 30 to 40 years

You may have a family now and any medical costs can impact your finances significantly. It’s a good idea to invest in a plan that covers you as well as your family.

img 40 to 60 years

Consider a policy with a higher sum insured as you may start to develop certain health conditions now. Also, look for a plan with a refill benefit that will ensure you have enough coverage.

img 60 years and above

Consider a senior citizen health insurance policy with a critical illness rider. These policies typically have higher premiums, but they also offer more comprehensive coverage.

What is not covered in a Health Insurance plan?

All health insurance plans have a defined list of exclusions which are essentially conditions or treatments that are not covered under the policy. Here are some of the most common exclusions^

img Dental surgery/treatment (unless requiring hospitalisation)

Only dental surgery or treatment that requires hospitalisation is covered under health insurance

img Congenital diseases

These are health problems that are present at birth

img Venereal disease

These sexually transmitted diseases which are not covered

img General debility

This is a general weakness or ill health and is not covered under health insurance.

img Self-inflicted injuries

Any injury that is intentionally caused by the insured person is not covered under health insurance

img Infertility treatment

The cost of infertility treatment, such as in vitro fertilisation, is not covered under health insurance.

img Cosmetic surgeries

The cost of cosmetic surgeries, such as rhinoplasty and liposuction etc.

img Pre-existing illnesses

Health insurance plans typically have a waiting period of 12 to 48 months before they cover illnesses that were already present at the time of purchasing the policy.

What factors can affect my Health Insurance premium?

img Age

The older you are, the higher the premiums are typically. It’s because, with age, your chances of falling sick also increase.

img Medical history

If you have any pre-existing health conditions, you may need to pay a higher premium or may not be eligible for coverage at all.

img Lifestyle

Your lifestyle choices, such as smoking, drinking, and being overweight can increase your risk of health problems, which can also affect your premiums.

img Location

The cost of healthcare varies from place to place, and the premiums in expensive areas are typically higher.

img Policy type

The type of policy you choose can also affect your premium. More comprehensive plans typically have higher premiums than basic plans.

img Your deductible

It is the amount of money you have to pay out of pocket before your insurance company starts to pay. Higher deductibles typically lead to lower premiums.

img Gender

In some cases, your gender may affect your premiums. For example, women may pay higher premiums for plans with maternity coverage.

img Sum Insured

The sum insured is the maximum amount your insurance policy will pay for your medical expenses. A higher sum insured will typically result in higher premiums.

img Smoking and drinking alcohol

Smoking and drinking alcohol can increase your risk of health problems and lead to higher premiums.

img Family medical history

Having a family history of certain health conditions can increase your risk of developing those conditions yourself, which may lead to higher premiums.

What are the types of Health Insurance plans ?

img Health & Wellness Plans

This is the most common type of plan that provides coverage for a wide range of preventive and wellness services.

img Cancer Secure Plans

It provides financial assistance if diagnosed with cancer. They typically cover the cost of treatment and even the loss of income in some cases.

img Critical Illness Plans

These are more specialised plans that provide coverage against more than 60 listed critical illnesses.

img Personal Accident Plan

This plan provides coverage for accidental death, accidental permanent disability, and accidental hospitalisation.

img Corporate Plans

These plans are designed for businesses that want to offer group health coverage to their employees.

img International Cover

This plan provides coverage for medical expenses incurred while travelling abroad. It also covers the cost of emergency evacuation and repatriation.

Under what conditions is my policy premium likely to increase at renewal?

  • Medical inflation: As medical costs rise, so too does the cost of health insurance premiums. This includes the cost of drugs, medical devices, hospital care, etc.

  • Your age: As you get older, your risk of developing health problems increases as well. Getting a multi-year policy can lock in your premium for the duration.

  • Previous claims: If you raised a lot of claims in the previous year, your health insurance company may increase your premium for the next year.

  • Alteration in coverage benefits: If you make any changes to your coverage benefits, such as increasing the sum insured or adding new riders, your premium may increase.

  • Diagnosis of a disease: If you are diagnosed with a disease, your health insurance company may increase your premium next year to reflect the increased risk.

  • Policy lapse: If your policy lapses, you may have to pay a higher premium when you renew it as you have not had continuous health insurance coverage.

Some important Health Insurance terms you should know ?

  • Initial waiting period

    The time you have to wait before your health insurance coverage starts. Usually 30 days from the start date of the policy.

  • Cashless claim

    A type of health insurance claim where the insurance company reimburses the network hospital directly, so you don't have to pay out of pocket.

  • Co-pay

    It is the share of the amount to be paid by you, in case of a claim.

  • No claim bonus

    It's a bonus offered in the form of increased sum insured if no claims were made during the previous policy term.

  • Pre-existing condition

    A health condition that you had before you got health insurance.

  • Pre-hospitalisation expenses

    This refers to the medical expenses incurred before getting admitted to a hospital.

  • Post-hospitalisation expenses

    This refers to the cost of follow-up tests and consultation treatment charges incurred after getting discharged from the hospital.

  • Network hospital

    It is a medical facility that has a tie-up with the health insurance provider where you can receive cashless treatment.

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Top reasons to buy Health Insurance

  • Beat Medical Inflation

    Medical costs are rising rapidly, and it can be difficult to keep up with the expense of medical care without health insurance. Health insurance can help protect your finances from the burden of medical inflation.

  • Afford Quality Medical Treatment

    Health insurance can help you afford quality medical treatment, regardless of your income level. Without health insurance, you may be forced to delay or forgo necessary medical care, which could lead to serious health problems.

  • Fight Lifestyle Diseases

    Lifestyle diseases, such as heart disease, stroke, and diabetes, are on the rise. These diseases can be expensive to treat, and health insurance can help you manage the costs.

  • Protect Your Savings

    A major medical expense can wipe out your savings, leaving you in financial hardship. Health insurance can help protect your savings by paying for covered medical expenses.

  • Avail Cashless Hospitalisation Facility

    Many health insurance plans offer cashless hospitalisation, which means you don't have to pay upfront for your hospital stay. This can be a huge relief, especially if you're not prepared for a large medical expense.

  • Get Tax Benefits

    The premiums you pay for health insurance are tax-deductible, which can reduce your taxable income and save you money on taxes.

  • Ensure Peace of Mind

    Health insurance can provide you with peace of mind, knowing that you are protected from the financial burden of unexpected medical expenses.

What’s the difference between Mediclaim and Health Insurance ?

  • Cover:
  • Mediclaim: Primarily covers hospitalisation expenses due to illness or accidents.
    Health Insurance: Offers comprehensive coverage for hospitalisation, pre- and post-hospitalisation expenses, day-care procedures, ambulance charges, and a wider range of medical expenses.

  • Add-on covers:
  • Mediclaim: Limited add-on covers for critical illnesses or specific diseases.
    Health Insurance: Offers various add-on covers for critical illnesses, maternity care, dental care, and other specialised treatments.

  • Sum insured:
  • Mediclaim: Generally lower sum insured options.
    Health Insurance: Provides higher sum insured options to cover a broader range of medical expenses.

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FAQs on Health Insurance

Health insurance is a type of insurance coverage that provides financial protection against medical expenses incurred due to illness, injury, or hospitalisation. It helps individuals and families pay for medical treatments, hospital stays, prescription medications, and other healthcare services.

Aditya Birla's health insurance plans give you good coverage for quality healthcare. They have different options, so pick the one that fits your needs the best.


• Health & Wellness Plans: These plans provide coverage for a wide range of preventive and wellness services, such as doctor's consultations, annual health check-ups, diagnostic tests, and vaccinations. They also offer discounts on gym memberships and other health-related expenses.


• Cancer Secure Plans: These plans provide financial assistance if you are diagnosed with cancer. They typically cover the cost of treatment, including surgery, chemotherapy, and radiation therapy.


• Critical Illness Plans: These plans provide financial assistance if you are diagnosed with any of the 60+ critical illnesses covered in the plan, including heart attack, stroke, or kidney failure. They can help cover the cost of treatment as well as lost income and other expenses.


• Personal Accident Plan: This plan provides coverage for accidental death, accidental permanent disability, and accidental hospitalisation. It also covers the cost of ambulance charges, surgery, and ICU stays.


• Corporate Plans: These plans are designed for businesses and organisations, to protect their employees' health and well-being. They typically offer group discounts and other benefits, such as access to a wider network of hospitals and doctors.


• International Cover: This plan provides coverage for medical expenses incurred while travelling abroad. It also covers the cost of emergency evacuation and repatriation.

There are many benefits to having health insurance, including:

• Peace of mind knowing that you will be covered in case of a medical emergency.

• Access to quality medical care.

• Financial protection from high medical costs.


Most health insurance plans provide optional add-ons or riders or optional benefits to enhance your coverage. These may include maternity cover, critical illness cover, personal accident cover, and more. It is advisable to check with the insurance provider about the availability of customisation options.


Health insurance is vital for a variety of reasons, the most important ones are mentioned below:


• Peace of mind: Medical insurance gives you peace of mind knowing that you will be covered in case of a medical emergency. This can be especially important if you have a chronic illness or a family history of medical problems.

Access to quality medical care: A good health insurance plan can give you access to quality medical care, even if you are unable to afford it otherwise. This includes access to hospitals, doctors, and other healthcare providers.

Financial protection from high medical costs: Medical expenses can be very expensive, even for a minor illness or injury. Medical insurance can help to protect you from these costs, so you don't have to worry about going into debt to pay for your medical care.

Access to a network of healthcare providers: A good medical insurance plan will give you access to a wide network of healthcare providers, which means you can go to any doctor or hospital in the network without having to worry about whether your insurance will cover it.

Tax benefits: You can avail of tax benefits*, as specified in Section 80D* of India's Income Tax Act, subject to the fulfilment of the criteria mentioned in it.

Here are some tips on how to choose the right health insurance plan in India:


• Consider your needs and budget: What types of medical expenses do you need coverage for? How much can you afford to pay in premiums?

• Compare different plans: There are many different health insurance plans available in India, so it's important to compare them before you choose one. Look at the coverage, premiums, and deductibles of each plan.

• Choose a plan with a wide network: A wide network means that you will have access to a wider range of hospitals and doctors.

• Read the fine print: Make sure you understand all of the terms and conditions of the plan before you sign up.

There are two ways to purchase health insurance in India:


Offline: You can purchase health insurance from a traditional insurance agent.

• Online: You can purchase health insurance online from the website of an insurance company.


To purchase health insurance online, you will need to provide some basic information, such as your name, age, and address. You will also need to choose a plan and pay the premium.


To buy an online health insurance plan in India, you can follow these steps:


1. Visit the website of an insurance company.

2. Choose a suitable Health Insurance plan..

3. Enter your personal information.

4. Pay the premium.

5. Receive your policy document via email or post.


Everyone should buy a health insurance plan. Healthcare costs are rising rapidly in India, and a health insurance plan can help you protect yourself from financial hardship in the event of a medical emergency.


Buying a health insurance plan at an early age is important for several reasons:


• Premiums are typically lower for younger people.

• You are more likely to be in good health. Younger people are typically healthier than older people, which means that you are less likely to have pre-existing conditions that could affect your coverage.

• You can build up a lifelong coverage history. If you buy a health insurance plan when you are young, you can build up a lifelong coverage history. This can be helpful if you develop a chronic health condition later in life.


Health insurance premiums in India are determined based on various factors, such as the age of the insured individuals, the sum insured, the coverage type, pre-existing conditions, and the geographical location. Premiums may also vary depending on the insurer and the specific benefits offered by the policy.


The cost and coverage of health insurance in India varies depending on the plan that you choose. However, most plans will cover the cost of hospitalisation, surgery, and other major medical expenses. The sum insured under an employer’s health insurance is usually between ₹ 2 lakh and ₹ 5 lakh, which might not be sufficient under the current medical inflation. To cover the various expensive treatment costs, it is important to have a separate health insurance plan of a minimum of ₹ 10 lakh.


The eligibility criteria for health insurance in India vary depending on the insurance company. However, most insurance companies will require you to be a resident of India and to be between the ages of 18 and 65 years old.


There are no documents required as such for purchasing a health insurance plan in India. You may only have to undergo a pre-policy medical check-up if you are a senior citizen. However, you must have a valid proof of your identity, address, age, etc. when you need to file a claim with your insurer.


The premium for your health insurance plan is calculated based on several factors, including your age, gender, health status, and the type of plan you choose. You can use an online health insurance calculator to get an estimate of your premium.


Comparing health insurance plans online is the most comprehensive way to find the best plan for your needs and budget. You can compare the coverage, premiums, and deductibles of different plans side-by-side.


To renew your health insurance plan online, you can visit the website of your insurance company. You will need to enter your policy number and pay the premium.


Any claims arising out of congenital disorders, venereal diseases, general debility, sexually transmitted disease, or dental treatment/surgery (unless required as a part of treatment) are excluded from Health Insurance coverage. But do check your policy wording to know more about the detailed list of exclusions in a Health Insurance plan.

Yes, premiums paid for health insurance plans are eligible for tax benefits under Section 80D of the Income Tax Act in India. Individuals can claim tax deductions for the premiums paid for themselves, their spouses, children, and parents, subject to specified limits.


For yourself and your family (All members below 60 years), the maximum amount that can be saved under Section 80D is ₹25,000.

For self, family, and family + parents (All members below 60 years), the maximum amount that can be saved under Section 80D is ₹50,000 (₹25,000+₹25,000).

For yourself and your family (all members below 60 years) with senior citizen parents, the maximum amount that can be saved under Section 80D is ₹75,000 (₹25,000 + ₹50,000).

For self and family (with the eldest member above 60 years) with senior citizen parents, the maximum amount that can be saved under Section 80D is ₹1,00,000 (₹50,000 + ₹50,000).


Aditya Birla's digital services make it easy to file and track health insurance claims. You can do this through the Active Health App, online, or by calling the toll-free number 1800 270 7000.


There are two types of health insurance claims:


• Cashless claims: If you are admitted to a network hospital, Aditya Birla will pay your medical bills directly to the hospital. To file a cashless claim:

1. Go to a network hospital.

2. Verify your identity with your health card or other valid ID.

3. Fill out and submit a pre-authorization claim form.

4. Get your claim processed and settled.

 

• Reimbursement claims: If you are admitted to a non-network hospital or cannot file a cashless claim, you will need to file a reimbursement claim. This means that you will pay your own medical bills, and then Aditya Birla will reimburse you for your expenses. To file a reimbursement claim:

1. Notify the company within 48 hours of an emergency hospitalisation or 3 days before a planned hospitalisation.

2. Submit all relevant documents.

3. Get your health insurance claim processed and reimbursed.


The reimbursement claim process is simple and hassle-free. Aditya Birla will provide you with all the information and assistance you need to file and track your claim.


Health insurance, cancer insurance, and critical illness insurance serve unique purposes, each with a specific focus; its basic differences have been highlighted below:


• Health insurance plan: A health insurance plan covers the cost of hospitalisation, surgery, and other major medical expenses.

• Cancer insurance: A cancer insurance plan covers the cost of treatment for cancer, including chemotherapy, surgery, and radiation.

• Critical illness insurance: A critical illness insurance plan covers the cost of treatment for a number of critical illnesses, such as cancer, heart disease, and stroke.


Here are some of the most common myths about health insurance:


• Myth: Health insurance is expensive.

• Fact: The cost of health insurance varies depending on the plan you choose and your individual circumstances. However, there are many affordable health insurance plans available.


• Myth: I don't need health insurance because I'm young and healthy.

• Fact: Anyone can get sick or injured, regardless of their age or health status. Having health insurance can protect you from financial hardship in the event of a medical emergency.

 

• Myth: Health insurance is only for people with pre-existing conditions.

• Fact: Health insurance is for everyone, regardless of their health status. However, you may have to pay a higher premium or have a waiting period before certain services are covered if you have pre-existing conditions.

 

• Myth: Health insurance is too complicated to understand.

• Fact: Health insurance policies can be complex, but there are many resources available to help you understand your coverage. You can talk to your insurance agent, read your policy documents, or visit the website of your insurance company for more information.

 

• Myth: I can wait until I'm older to buy health insurance.

• Fact: It's best to buy health insurance when you're young and healthy. Premiums are typically lower for younger people, and you'll have less chance of being denied coverage due to a pre-existing condition.


In all our Health Insurance Policies, we cover the treatment for Corona Virus-COVID-19, when the treatment is taken as an inpatient.


Whether or not a medical test is mandatory to buy a health insurance policy depends on the insurance company and the specific policy you are applying for. In general, medical tests are not mandatory for young, healthy individuals who are applying for basic health insurance plans. However, medical tests may be required for older individuals, individuals with pre-existing medical conditions, or individuals who are applying for more comprehensive health insurance plans. If a medical test is required, it will typically be a blood test or a physical examination. In some cases, additional tests, such as an electrocardiogram (ECG) or X-ray, may be required. Even if a medical test is not mandatory, it is generally recommended to get one before purchasing a health insurance policy. This is because a medical test can help to identify any pre-existing health conditions that may not be covered by the policy. It can also help to determine the appropriate sum insured for the policy.


Parents can add their newborn children to their family floater health insurance policies by notifying the insurance company and paying an additional premium.


Yes, a person can have more than one health insurance policy. This is known as dual coverage or excess coverage. Dual coverage can be beneficial in some cases, but it can also lead to higher out-of-pocket costs and potential coordination issues between the two insurers. 

Here are some specific situations where dual coverage may be beneficial:

  • You have a high-deductible plan: If you have a high-deductible plan, you may want to consider adding a secondary policy with lower deductibles to help cover your out-of-pocket costs.

  • You have pre-existing conditions: If you have pre-existing conditions, you may want to consider dual coverage to ensure that you have adequate coverage for those conditions.

You are travelling internationally: If you are travelling internationally, you may want to consider purchasing a travel insurance policy in addition to your domestic health insurance policy.

Yes, health insurance plans typically cover diagnostic charges like X-rays, ultrasound, and MRI. However, the specific coverage for diagnostic charges varies depending on the plan and the insurance company. Some plans may have limitations on the number of diagnostic tests you can receive per year, or they may have sub-limits for specific types of tests.

In general, health insurance plans will cover diagnostic charges if they are ordered by a doctor and are considered medically necessary. This means that the test must be necessary to diagnose a medical condition or to monitor a patient's treatment.


The maximum number of health insurance claims allowed in a year depends on the specific policy and insurance company. In some cases, there is no limit on the number of claims that can be made, as long as the claims do not exceed the sum insured by the policy. However, some plans may have limits on the number of claims that can be made for certain types of medical expenses. For example, a plan may only allow a certain number of claims for hospitalisation or for specific types of treatments. If you are unsure about the maximum number of claims allowed under your health insurance policy, you should contact support or check the policy documents.


If you miss the health insurance policy premium renewal date, your policy will lapse, meaning it will no longer be in effect. This means you will not have coverage for any medical expenses you incur until you renew your policy.

Here are the consequences of missing your health insurance policy premium renewal date:

  • Loss of coverage: You will no longer be covered for any medical expenses you incur, including hospitalisation, doctor visits, prescription drugs, and other medical services.

  • Late payment fees: You will be charged late payment fees for each day your premium is past due.

  • Potential denial of coverage for pre-existing conditions: If you have any pre-existing conditions, your insurance company may deny you coverage for those conditions if you renew your policy after it has lapsed.

  • Higher premiums: You may be charged higher premiums if you renew your policy after it has lapsed.

To avoid these consequences, it is important to renew your health insurance policy on time. Most insurance companies will send you a reminder to renew your policy before it expires. You can also set up a reminder on your calendar or pay your premium online or through your insurance company's app.

If you do miss your premium renewal date, you should contact your insurance company immediately to renew your policy. They may be able to reinstate your coverage without any penalties if you pay your premium within a certain grace period.


Yes, most health insurance companies offer a grace period for health insurance renewal. This is a period of time after the premium due date during which you can still pay your premium and have your coverage reinstated without any penalties.

The length of the grace period varies depending on the insurance company and the type of policy. However, it is typically 30 days. This means that you have 30 days after your premium due date to pay your premium and avoid having your coverage lapse.

If you pay your premium during the grace period, your coverage will be reinstated as if you had never missed a payment. However, you will still be responsible for paying any late payment fees that may have been incurred.

If you do not pay your premium during the grace period, your coverage will lapse. This means that you will no longer be covered for any medical expenses you incur. You will also have to apply for reinstatement, which may result in higher premiums or denial of coverage for pre-existing conditions.


Health insurance plans usually cover all kinds of medical expenses, including hospitalisation, health-checkups and day-care procedures among others; the most common ones are listed below. 


In-patient Hospitalisation Expenses: This includes the cost of room rent, doctor's fees, nursing charges, diagnostic tests, and other expenses incurred during an in-patient hospital stay.
• Pre-existing Illnesses or Diseases: Some health insurance plans cover pre-existing illnesses or diseases after a specified waiting period. However, there may be exclusions or limitations on the coverage for pre-existing conditions.
• Pre and Post Hospitalisation Expenses: These expenses cover the cost of medical treatment received before and after hospitalisation. The coverage may include doctor's consultations, diagnostic tests, and medications.
• Ambulance Charges: Many health insurance plans cover ambulance charges incurred for transportation to and from the hospital. The coverage may have limitations on the distance or amount covered.
• Maternity Cover: Maternity cover provides coverage for the expenses related to pregnancy, childbirth, and newborn care. The coverage may include prenatal care, labour and delivery charges, and postnatal care.
• Preventive Health Check-ups: Preventive health check-ups, such as annual physicals and screenings, are often covered by health insurance plans. This can help detect potential health problems early on and prevent serious illnesses.
• Day-care Procedures: Day-care procedures, such as minor surgeries and treatments that do not require an overnight stay, are often covered by health insurance plans.
• Home Treatment Cover: Some health insurance plans cover home treatment expenses for certain conditions, such as post-operative care or chronic illnesses.
• AYUSH Benefit: AYUSH treatments, which are traditional Indian therapies, are becoming increasingly covered by health insurance plans.
• Mental Healthcare Cover: Mental healthcare cover provides coverage for the diagnosis and treatment of mental illnesses, such as depression, anxiety, and substance abuse.

It’s best to do all your research before making your final Health Insurance purchase. Make sure to check the following things:


Waiting Period: The waiting period is the period during which you are not eligible for coverage for certain pre-existing conditions. This period typically ranges from 30 to 90 days. It's important to check the waiting period for any pre-existing conditions you or your family members may have before purchasing a health insurance plan. 
Co-payment: A co-payment is a fixed amount you pay for covered medical expenses. For example, you might have a 15% co-payment for doctor visits. Co-payments are typically lower than deductibles but can still add up over time.
Preventive Health Check-up: Many health insurance plans offer coverage for preventive health check-ups, such as annual physicals and screenings. This can help you identify potential health problems early on and receive treatment before they become more serious.
Grace Period: The grace period is a short period of time after your premium is due during which you can still make your payment without losing coverage. This is typically 15 or 30 days. It's important to be aware of the grace period in case you experience any financial hardship.
Restore Benefits: Restore benefits are a feature that some health insurance plans offer. This allows you to reset your annual coverage limits if you have a claim that exceeds a certain amount. This can be helpful if you have a major medical expense.
No Claim Bonus: Some Health Insurance plans offer a no-claim bonus, which is a discount on your premium. This can encourage you to use your Health Insurance for preventive care and avoid unnecessary claims.
Sub-limits: Sub-limits are restrictions on the amount of coverage you have for certain medical expenses. For example, you might have a sub-limit on the amount your insurance will pay for hospital stays or surgery.
Network Hospitals: Network hospitals are hospitals and doctors that have contracted with your insurance company. You will typically pay less for covered services if you go to a network provider. It's important to check the network of hospitals and doctors in your area before purchasing a health insurance plan.

Choosing the right health insurance is important and needs careful thought. Some of the important things to think about when picking a health insurance plan are listed below:



• Check the Scope of Coverage: It's crucial to thoroughly review the scope of coverage offered by the health insurance plan. This includes understanding the types of medical expenses covered, exclusions, and any limitations or sub-limits. Ensure the plan covers your primary healthcare needs and any pre-existing conditions you may have.
• Adequate Sum Insured: The sum insured is the maximum amount the insurance company will pay for covered medical expenses. Choose a sum insured that adequately covers your potential medical needs, considering factors like age, lifestyle, and family medical history.
• Policy Type: Health insurance plans come in various types, each with different benefits and structures. Compare individual, family floater, and senior citizen plans to find the one that best suits your needs and budget.

• Waiting Period Clause: Most health insurance plans have waiting periods for certain pre-existing conditions. This means you won't be eligible for coverage for these conditions during the waiting period. Understand the waiting periods for any pre-existing conditions you or your family members may have.
• Co-payment Clause: A co-payment is a fixed amount you pay for covered medical expenses. Understand the co-payment structure of the plan and how it affects your out-of-pocket expenses.
• Room Rent Sub-limits: Room rent sub-limits restrict the amount the insurance company will pay for your hospital room charges. Choose a plan with room rent sub-limits that match your preferences and budget. 
• Network of Cashless Hospitals: Cashless hospitalisation allows you to settle hospital bills directly with the insurance company without paying upfront. Check the network of cashless hospitals associated with the plan and ensure it includes hospitals in your area.
• Lifelong Renewability Option: It is advisable to choose a plan with a lifelong renewability option, which guarantees renewal of your Health Insurance coverage regardless of your age or health status.
• Premium Loading Factor: Insurance companies may apply a premium loading factor if you have certain pre-existing conditions or engage in risky activities like smoking. Understand how these factors affect your premium rates.
• Check the Claim Settlement Ratio: The claim settlement ratio (CSR) indicates the percentage of claims settled by the insurance company. Choose a plan with a high CSR for better chances of a smooth claim settlement process.

Individual health insurance covers only one person with a fixed sum insured, while a family floater plan covers the entire family under a shared sum insured, offering cost savings and flexibility.

Assess factors like sum insured, coverage for critical illnesses, network hospitals, claim settlement ratio, waiting periods, and exclusions before making a decision.

Consider factors like medical inflation, hospitalisation costs in your city, family medical history, and existing health conditions to select an adequate sum insured.

A top-up plan covers medical expenses beyond a deductible per claim, while a super top-up plan considers cumulative medical expenses in a policy year, making it a better choice for frequent hospitalisations.


A health insurance wellness programme is a type of health insurance plan that rewards members for taking steps to improve their health. These programmes typically offer incentives such as premium discounts, cash back, or gift cards for completing certain health activities, such as exercising regularly, eating healthy foods, and getting preventive care screenings.


To participate in a health insurance wellness programme, you must typically enrol in the programme through your health insurance provider. Once you are enrolled, you will need to complete certain health activities to earn rewards. The specific activities that are covered by the programme will vary depending on the provider, but they may include things like:


• Tracking your daily steps or exercise minutes

• Eating healthy foods and logging your meals in a food diary

• Getting preventive care screenings, such as annual checkups and flu shots.

• Completing health assessments


There are many benefits to opting for health insurance wellness programs. Some of the key benefits include:


• Improved health: Wellness programmes can help you to improve your overall health and well-being by motivating you to make healthy choices.

• Reduced healthcare costs: By helping you to stay healthy, wellness programmes can help reduce your healthcare costs in the long run.

• Lower premiums: Many health insurance providers offer premium discounts to members who participate in wellness programmes.

• Other rewards: In addition to premium discounts, some wellness programmes also offer other rewards, such as cash back, gift cards, or access to exclusive discounts and promotions.


The specific services and activities that are covered by health insurance wellness programmes will vary depending on the plan and the provider. However, some common examples include:


• Fitness classes and gym memberships

• Weight loss programmes

• Expert health coach

• Stress management programmes

• Mental health programmes

• Annual health assessments


The Insurance Regulatory and Development Authority of India (IRDAI) has issued guidelines for health insurance wellness programs. These guidelines are aimed at ensuring that wellness programmes are fair and transparent and that they do not discriminate against members with pre-existing health conditions.


The IRDAI guidelines require health insurance providers to:


• Disclose all of the terms and conditions of the wellness programme to members before they enrol.

• Make it easy for members to participate in the programme and earn rewards.

• Offer a variety of health activities that are accessible to all members.

• Not to discriminate against members with pre-existing health conditions.


There are many reasons why one should opt for a medical insurance wellness program. Some of the key reasons include:


• To improve overall health and well-being.

• To reduce healthcare costs in the long run.

• To save money on health insurance premiums.

• To earn rewards for making healthy choices.

• To have access to exclusive discounts and promotions.


Aditya Birla Capital currently offers 12 health and wellness plans:


Activ Fit: Health Insurance + Health Benefits + Rewards


Activ Health Platinum Enhanced: Health Insurance + Wellness Benefits + Chronic Care


Activ Assure Diamond + Super Health Topup: Health Insurance + Affordable Comprehensive Health Cover


Activ Assure Diamond: Budget-friendly health insurance with 360˚ protection


Activ Care Classic: A comprehensive health insurance plan that provides 360˚ care for your parents


Activ Health Platinum Essential: Health Insurance, Wellness Benefits + Chronic Care


Activ Health Platinum Premiere: Health Insurance + Wellness Benefits + Chronic Care


Activ Care Standard: A comprehensive health insurance plan that provides 360˚ care for your parents


Activ Care Premier: A comprehensive health insurance plan that provides 360˚ care for your parents


Aarogya Sanjeevani: Health insurance + All day care procedures covered + AYUSH in-patient treatment cover


Corona Kavach: A comprehensive health insurance plan that provides 360˚ Covid-19 coverage


Ekam Suraksha: Health insurance + AYUSH coverage + Cataract treatment cover up to ₹ 40,000 per eye

*The starting plan prices listed on the website apply to individual customers aged 30 with a sum insured of ₹5 lakh.

**Tax benefits are subject to changes in tax laws. Please consult your financial advisor for details.

^The list of exclusions may vary. For the applicable exclusions, please refer to the policy wording of your selected plan.

**Benefits may vary as per the plan selected

UIN: ADIHLIP24102V052324 - Activ Health Platinum Essential is a Health Insurance Plan

UIN: ADIHLIP24102V052324 - Activ Health Platinum Enhanced is a Health Insurance Plan

UIN: ADIHLIP22008V012223 - Activ Fit Plus is a Health Insurance Plan

UIN: ADIHLIP22008V012223 - Activ Fit Preferred is a Health Insurance Plan

UIN: ADIHLIP23130V042223 - Activ Assure Diamond is a Health Insurance Plan

UIN: ADIHLIP21061V022021 - Activ Assure Diamond + Super Health Top-up is a Health Insurance Plan

UIN: ADIHLIP21062V022021 - Activ Care Classic is a Health Insurance Plan

UIN: ADIHLIP21061V022021 - Super Top-up Plus Plan A is a Super Top Up Health Insurance Plan

UIN: ADIHLIP21061V022021 - Super Top-up Plus Plan B is a Super Top Up Health Insurance Plan