Activ Health Platinum Enhanced: Best All-in-One Insurance Plan

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Aditya Birla Capital Limited (“ABCL”) is a listed systemically important nondeposit taking Non-Banking Financial Company (NBFC) and the holding company of the financial services businesses. ABCL and its subsidiaries/JVs provides a comprehensive suite of financial solutions across Loans, Investments, Insurance, and Payments to serve the diverse needs of customers across their lifecycles. Powered by over 68,400 employees, the businesses of ABCL have a nationwide reach with over 1,740 branches and more than 200,000 agents/channel partners along with several bank partners.

Nationwide Branches

1,740

No. of Employees

68,400

Agents/Channel Partners

2,00,000+

Aggregate Assets

INR 5.91 Lakh Cr

Consolidated Lending Book

INR 2 Lakh Cr

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Why buy Activ Health Platinum Enhanced Plan?

Activ Health Platinum Enhanced plan gives you insurance coverage with wellness benefits, chronic care expert health coaching and more to make sure you get 360-degree protection. In addition, the plan rewards you for staying fit with HealthReturns™ which can be used towards the next premium or other services.

Covers mental health hospitalisation
Helps manage chronic illnesses
Covers cashless home treatment

How Does Activ Health Platinum Enhanced Plan work?

Kriti ( 42 years)

She’s a professor and a mother who spends most of her time juggling her responsibilities

She bought the Activ Health Platinum Enhanced Policy with a cover of ₹20 lakh.

Three years later when she went in for her free annual health check, she discovered her blood pressure was very high.

Her plan covered her for the diagnostic test as well as the doctor’s consultation and put her on a customised Chronic Management Program.

A year later, Kriti has managed to get her blood pressure under control and hasn’t had any serious issues. Being able to buy medicines with HealthReturns™, she practically didn’t have to pay for anything.

What's Included?

HealthReturns™

Earn up to 100% of your premium back as HealthReturnsTM by embracing a healthy life.

Mental Illness Coverage

Get coverage for pre and post-hospitalisation expenses incurred during treatment.

Dedicated Health Coach

Get access to medical counselling, general wellness and lifestyle, nutrition coach and mental health coaching.

Dental Consultation and Investigation Coverage

Get cashless dental treatments, which include one comprehensive consultation, one cleaning and one x-ray. (Disclaimer – Available for SI 15 lac and above).

Upto 100% Sum Insured Reload

Get up to 100% of the sum insured refilled in case it is exhausted in a policy year.

Chronic Management Program

Get specialised support for managing listed chronic health conditions.

Premium Waiver

Get a premium for one year waived if diagnosed with a listed illness for adults 18 & above.

Health Assessment™

Get a free annual health checkup that includes BP, BMI, blood sugar, total cholesterol etc.

What's Not Included?

No coverage on expenses related to pre-existing diseases before the waiting period.

No claims can be made during the initial waiting period.

No coverage if the death is due to alcohol, drug abuse, or involvement in illegal activities.

No cover if there’s an attempt at suicide or self-inflicted injuries.

No coverage for cosmetic treatments, mental disorders or any congenital abnormality.

No coverage on the cost of hearing aids, lenses, spectacles, crutches, etc.

Need More Information?

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Get started with Activ Health Platinum Enhanced Plan

How to buy?

Assess your needs and check the plan on the ABC website.
Carefully go through coverage and exclusions.
Share your details, select coverage, term etc.
Make the payment and enjoy your newfound peace.

How to renew?

Visit the policy renewal page on the website.
Enter policy number and personal details.
Check the renewal amount displayed.
Make payment via the preferred mode and you are done.
You will receive a confirmation email of the successful policy renewal.

How to claim?

Intimate the insurer before your hospitalisation or as soon after as possible.
Gather all required documents - policy, hospital bills, doctor’s notes etc.
Visit the claims section on the website.
Provide basic details about the policy and the policyholder.
Submit the required documents and we’ll get back to you.

Check Your Eligibility

Check your eligibility and take the first step towards financial security

Eligibility Criteria

Family floater minimum age 91 days for dependent children and 18 years for adults
Dependent Children from age 91 days to 5 years will be covered only if one adult is covered under Family Floater Policy
Individual plan minimum age 5 years
Maximum age of entry Can enter at any age
Medical tests May be required depending on age
Smoking habits Affect your premium

Waiting Period

Initial Waiting Period : 30 Days (not applicable in case of an accident)
Specified Diseases or Procedures : 24 months (or genetic diseases or disorders- 48months)
Pre-Existing Diseases : 36 months

Customer Satisfaction Stories

Shruti Davda

Aditya Birla Health Insurance

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.

Mr. Himanshu Chaturvedi

Aditya Birla Health Insurance Customer

Noida, India

Arun Sharma

Aditya Birla Health Insurance

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

Mr. Rajinder Balhara

Aditya Birla Health Insurance Customer

Delhi, India

Mrs. Mangal Prathamesh Mithari

Aditya Birla Health Insurance Customer

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Understanding Activ Health Platinum Enhanced Plan

Table of Contents

What is Activ Health Platinum Enhanced Plan?Who should buy Activ Health Platinum Enhanced Plan?What are HealthReturns™?How to earn HealthReturns™?What is the cashless claim process?What is the Chronic Care Management Program?

What is Activ Health Platinum Enhanced Plan?

Aditya Birla Activ Health Platinum Enhanced plan prioritises both health and financial well-being.
Get comprehensive coverage for medical expenses with unique features like HealthReturns™ and sum insured reload.
Get health support with the Chronic Management Program.
The policy offers both individual and family floater policies, a choice of hospital rooms, and an annual health check-up facility to the insured, among other features.

Who should buy Activ Health Platinum Enhanced Plan?

Young adults

Premiums are low at a younger age and it can help you inculcate healthy habits. You can also earn back up to 100% of your premium as HealthReturns™.

People with chronic illnesses

Many features of the plan such as health screening, coverage from day one, Chronic Management Program, and Health Coach can be especially helpful in mitigating risks.

Families

With the family floater option, you can cover the whole family under one plan. This would allow you to go for a much higher sum insured while being quite cost-effective.

Elderly individuals

The plan offers coverage for various age-related issues such as hypertension, heart issues, high cholesterol etc. which can be quite useful for someone in their advanced age.

What are HealthReturns™ ?

HealthReturns™ is designed to encourage and reward you for adopting a healthy lifestyle and staying active. Here are some of its key features and benefits:

Earn points

You can earn HealthReturns™ points for maintaining an active lifestyle, which includes activities like walking, running, or cycling. These points are tracked through wearable fitness devices or mobile apps.

Annual payout

Accumulated HealthReturns™ points get you an annual payout, typically in the form of a premium discount or wellness benefits. You can also use these points to pay for things your plan doesn’t cover.

Requirement

The more active you are, the higher your potential reward. For example, you can earn up to 100% of your premium by staying active for 275 days in a year.

Health coaching

Some policies also offer access to health coaching services and personalised wellness programs to help you make healthier choices.

How to earn HealthReturns™?

Step 1: Download the Activ Health App
Step 2: Schedule your Health Assessment
Step 3: Stay activ and track your steps to get Activ Dayz™
1 Active Dayz™ = 10,000 steps or 300 calories burned
Step 4: Complete 325 Activ Dayz™ in a year to get 100% HealthReturns™
Step 5: Redeem your HealthReturns™and use it to pay your next policy premium

What is the cashless claim process?

Step 1: Inform the insurer and visit the nearest network hospital.
Step 2: Present your health card and an ID proof at the hospital helpdesk.
Step 3: Fill out the cashless hospitalisation request form and submit the pre-authorization letter.
Step 4: Once your request is approved, you can avail cashless services at the network hospital.
Step 5: The incurred expenses will be settled directly by the insurer according to the policy terms.

What is the Chronic Care Management Program?

What?

Designed to provide specialised support to policyholders dealing with chronic health conditions.
Covers asthma, high blood pressure, high cholesterol and diabetes.

How?

Coverage for listed ailments from day 1.
Dedicated support and guidance from healthcare professionals.

Who?

Anyone over the age of 91 days.
Spouses and children (under 25) can be added as dependents.

FAQs on Activ Health Platinum Enhanced Plan

A dependent child from the age of 91 days to 5 years will be covered but only if one adult is covered under the Family Floater Plan.

HealthReturns™: Earn up to 100% of your premium back by embracing a healthy life.
Mental Illness Coverage: Get coverage for pre and post-hospitalisation expenses incurred during treatment.
Dedicated Health Coach: Get access to medical counselling, general wellness and lifestyle, nutrition coach and mental health coaching
Dental Consultation and Investigation Coverage: Get cashless dental treatments, which include one comprehensive consultation, one cleaning and one x-ray.
Up to 100% Sum Insured Reload: Get up to 100% of the sum insured refilled in case it is exhausted in a policy year.
Chronic Management Program: Get specialised support for managing listed chronic health conditions.
Premium Waiver: Get a premium for one year waived if diagnosed with a listed illness.
Health Assessment™: Get a free annual health checkup that includes BP, BMI, blood sugar, total cholesterol etc.
Cumulative Bonus: Earn a cumulative bonus of 50% per annum, up to a maximum of 100% of Base Sum Insured (max up to ₹1 crore) for each claim-free year.
Modern Treatment Methods and Advancements in Technologies: Get coverage for listed treatments like robotic surgeries, oral chemotherapy, stem-cell therapy and more.
In-Patient Hospitalisation: Get coverage on expenses that include room rent, nursing expenses, doctor’s fees, OT charges, medicine costs, consultation fees etc.
Daycare Treatment: Get easy coverage on daycare procedures that do not require 24-hour hospitalisation.
Domiciliary Hospitalisation: Get coverage on the cost of the treatment availed at home in case hospitalisation is not possible.
Road Ambulance Cover: Get coverage for road ambulance expenses up to actual costs at network hospitals and up to ₹5000 per hospitalisation at non-network hospitals.
Organ Donor Expenses: Get coverage for expenses related to organ harvesting for transplants incurred by organ donors.
AYUSH Cover: Get coverage on in-patient hospitalisation under AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy).
Obesity Treatment: Get coverage on medical expenses for Bariatric Surgery.
International Coverage for Major Illnesses: Get coverage for listed 16 major illnesses whilst in a different country; get covered with a sum insured of ₹3 Crores. and ₹6 Crores. (Disclaimer-Optional cover, available with base S.I. of 10L & above only)
Second E-opinion on Critical Illness: In case of major illnesses like cancer, kidney failure, heart attack, etc., get a second opinion from qualified specialists, and the associated costs will be covered by this policy.
Home Care Treatment Expenses: Get homecare treatment expenses on a cashless basis for listed injuries and illnesses such as dengue, and hepatitis among others.
Optional Critical Illness Cover: Get coverage for up to listed 20 specified Critical Illnesses, and the policy also provides a one-year premium waiver if you are diagnosed with any of the listed Critical Illnesses.
OPD cover: Get coverage for outpatient consultations, diagnostic tests and pharmacy expenses up to ₹1000 for a sum insured of ₹15 lakhs or above.

Discover our network hospital list effortlessly by clicking here. Alternatively, for direct assistance, you can call our toll-free number at 1800 103 1033.

In certain situations, we may not be able to provide cashless facility for hospitalisation. This can happen if there is not enough coverage in your policy, insufficient information for approval, or if the treatment is not covered. In such cases, you might need to pay for the treatment and then submit a reimbursement claim to us. This will be considered based on the terms and conditions of your policy.

During cashless hospitalisation, it is necessary to settle all non-admissible expenses, co-payments, and deductibles directly with the hospital.

If you opt for claim reimbursement, we will pay you the admissible claim amount after adjusting for co-pay, deductible, and any earned HealthReturns™.

Disclaimer

Aditya Birla Health Insurance Co. Limited. IRDAI Reg.153. CIN No. U66000MH2015PLC263677. ^Fitness assessment is not available in case of annual slabs under HealthReturnsTM. Product Name: Activ Health. Activ Health has Activ Health Platinum Enhanced, Activ Health Platinum Premiere and Activ Health Platinum Essential variants. Product UIN: ADIHLIP24102V052324, Advertisement UIN: ABHI/LF/22-23/1386. Regd. Office address: 9th Floor, Tower 1, One World Centre, Jupiter Mills Compound, 841, Senapati Bapat Marg, Elphinstone Road, Mumbai 400013. Email: care.healthinsurance@adityabirlacapital.com, Website: adityabirlahealthinsurance.com, Telephone: 1800 270 7000.

For more details on risk factors, terms and conditions please read terms and conditions carefully before concluding a sale. Trademark/Logo Aditya Birla Capital is owned by Aditya Birla Management Corporation Private Limited and Trademark/logo HealthReturns, Healthy Heart Score and Active Dayz are owned by Momentum Metropolitan Life Limited (Formerly known as MMI Group Limited). These trademark/Logos are being used by Aditya Birla Health Insurance Co. Limited under licensed user agreement(s). Coronavirus is covered for Inpatient treatment as per policy wordings of the Product. For details on more optional covers such as Preferred Provider Network (PPN) Discount, Maternity expenses, OPD expenses and Hospital Cash benefit, please refer to policy wordings. The benefits mentioned can be availed under Activ Health Platinum Enhanced version.

*For annexure 1 please refer PBT/Policy wording

Benefits are conditional to Sum Insured/Plan opted, please refer the policy wordings/PBT for more details.