Is there an age limit for opting for a Critical Illness plan?

The minimum entry age is 5 years and the maximum entry age is 65 years.

I want to cover my 4 family members. Do I get any discounts?

You can avail a discount of 10% on premium on covering 2 or more family members in a single policy.

Who can I purchase the policy for?

You can purchase the policy for yourself and include your spouse up to four children, and yours and your spouse’s parents.

How should I claim benefit under the Critical Illness plan?

You need to submit the following documents to us within 30 days of occurrence of the event: 1.Completed Claim form, 2.Medical certificate confirming the diagnosis of Critical Illness, 3.Certificate confirming that the claim doesn’t relate to Pre-Existing Disease or any Illness/ Injury which was diagnosed within the first 90 days, 4.Photocopy of indoor case papers (if applicable), 5.In the cases where Critical Illness arises due to an Accident, FIR copy or medico legal certificate, 6.Specific documents (if any) listed under the respective Critical Illness

Is there a death benefit under this plan?

On first diagnosis of the covered critical illness, we will a lump sum amount of sum insured. There is no death benefit provided

ACTIV ONE NXT

100% Health. 100% Health Insurance.

In a world of instant groceries and fingertip finance, accessing insurance tailored to your health & health insurance goals is equally important. Meet Activ One NXT Health Insurance Plan from Aditya Birla Health Insurance — a health insurance plan which aims to provide a seamless personalized experience to enable your journey of health insurance while rewarding you for staying healthy.

Premium for Activ One NXT starting at

₹5,630* /annum

10% Exclusive Discount

UNIQUE FEATURES OF THE ACTIV ONE NXT PLAN

Up to 100% HealthReturns™

Apart from the adrenaline rush, a fit body, and a fitter mind you get by staying active, Activ One also rewards you for adopting a healthier lifestyle! You can earn up to 100% of your premium back as HealthReturns™ by just walking 10,000 steps or burning 300 calories daily.

Super Reload

When uncertain times come knocking and you need more than your Sum Insured, this plan has got you covered. You can get 2X Sum Insured available from Day 1 and unlimited times refill up to 100% of base Sum Insured from 2nd claim itself for all subsequent claims in a policy year.

No Capping on Hospitalization Expenses

Why should you have to worry about what kind of room your policy covers or to what extent will ICU charges be reimbursed in a claim? With the no capping on Hospitalization expenses, expenses for Room rent, ICU charges, Modern treatments, HIV/AIDS cover, Mental illness cover , Obesity treatment, Organ donor expenses, Domiciliary hospitalization, Home health care, AYUSH treatment, Road ambulance cover, etc. are covered as per actuals up to base sum insured.

HLTH Meter (Optional)

HLTH Meter empowers you to monitor, evaluate, and manage your mental health. It includes Assessment of mental health, Stress detection and management with a wearable device, Complimentary consultations for mental health, Unlimited tele/online support and Steps & calorie tracking for rewards with a wearable device.

Super Credit (Optional)

Every positive step you take toward your family's health and well-being is acknowledged and rewarded! When you renew your policy each year, we enhance your coverage by adding 100% of SI per year, up to 500% of Base Sum Insured, up to a maximum of 3 crores, irrespective of claims.

Claim Protect - Non-Medical Expense Waiver (Optional)

Put aside your worries around Non-Medical Expenses accrued during your hospital stay. This optional cover with Activ One NXT ensures complete coverage of all Non-Medical Expenses listed in Annexure 1, so that you can focus on health and well-being, not the burden of unexpected expenses.

UNDERSTAND ACTIV ONE NXT PLAN BETTER

HealthReturns™

Did you know that by just walking 10,000 steps or burning 300 calories daily, you can earn up to 100% of your premium back in the form of HealthReturnsTM. Here’s all that you need to know:

1. Complete your complimentary Health Assessment on our Activ Health App and generate your healthy heart score
2. Start your fitness journey to earn Active Dayz*
3. Earn HealthReturns™ based on accumulated Active Dayz and your Healthy Heart Score

*1 Active Dayz = Walking 10,000 steps daily or burning 300 calories a day or 30 min gym session at any of our affiliated gyms across the country.

HealthReturns™ can be used to pay your premium from the first renewal of your policy. Furthermore, they can be utilized for buying medicines or for surgical interventions which are not covered due to a waiting period or exclusions as per policy documents.

Click here to know more about HealthReturns.

Health Assessment

Evaluate and access your MER (Medical Examination Report) on demand including BP (Blood Pressure), BMI (Body Mass Index) HWR, Smoking Status, Blood Sugar, and Total Cholesterol with a complimentary Health Assessment feature on our Activ Health app. On getting a Healthy Heart Score, you become eligible for multiple rewards.

Super Credit (Optional)

When you successfully renew your policy on a timely basis, you will be eligible to earn a Super Credit i.e., a 100% increase in your Sum Insured per year without any associated increase in premium (maximum up to 500% of Sum Insured or up to INR 3 crore.)This is irrespective of a claim in a policy year.

Super Reload of Sum Insured

Your policy will be your friend in times of need with the Super Reload feature. If your Base Sum Insured, inclusive of the accumulated Super Credit (if applicable) is exhausted/insufficient for covering a claim, we will provide Reload of Sum Insured from Day 1, thus providing 2X coverage from the start. Further, we will also provide refills up to 100% of Base Sum Insured unlimited number of times for subsequent claims in a policy year.

Claim Protect (Optional)

Listed Non-Payable Items (All 4 lists in Annexure I) usually make up 10-20% of the total hospital bill amount during hospitalization. With Claim Protect, these expenses are included in the coverage, ensuring that you don’t have to worry about unexpected costs.
Know list of expenses here

Modern Treatment Methods and Advancements in Technologies

If in the future, you need to undergo a treatment which requires the use of advanced technologies or robotic surgeries, you need not worry about the medical expenses.

The Activ One NXT Health Insurance Plan provides coverage for listed modern treatment methods like robotic surgeries, oral chemotherapy, stem cell therapy and more as a part of In-patient hospitalization or daycare treatments.

In-Patient Hospitalization

In case of a planned treatment or an unforeseen emergency which leads to hospitalization for more than 24 hours, Activ One NXT will cover expenses like room rent, doctor’s fees, operation theater expenses, medicines, drugs and other consumables up to Base Sum Insured.

Daycare Treatment

Due to advancements in medical science, certain medical procedures like dialysis, may not require a 24-hour hospitalization. Such procedures will also be covered under the Activ One NXT plan.

Domiciliary Hospitalization

For the times when you may consider taking medical treatment at home rather than at a hospital (if one cannot be moved to the hospital or in situations where no hospital beds are available), we would want you to receive the best quality treatment. With Activ One NXT, you can get covered, up to Sum Insured, for medical treatment at home for a period exceeding at least 3 consecutive days which would otherwise have necessitated hospitalization.

HLTH Meter (Optional)

Road Ambulance Cover

We will ensure there is no roadblock to providing you speedy and quality treatment by covering ambulance costs up to the Base Sum Insured.

Organ Donor Expenses

All medical expenses for organ transplantation ranging from harvesting organs to transplantation surgeries will be covered as per the Sum Insured for the donor.

AYUSH Treatment

Your Activ One plan will cover medical expenses incurred towards in-patient hospitalization under AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy). We will cover reasonable and customary charges up to Base Sum Insured.

Mental Illness Hospitalization

Mental well-being is as crucial as physical health. With Activ One, hospitalization as well as pre- and post-hospitalization expenses for mental illnesses are covered up to Base Sum Insured. Focus on holistic health and enjoy peace of mind!

Please note that the mental illness needs to be clinically significant and should not be related to intentional self-inflicted injury or attempted suicide by any means.

Obesity Treatment

Obesity can be a deterrent to leading a healthy and productive life. It can also have a negative impact on your physical and mental well-being. Hence, medical expenses for Bariatric Surgery, if found to be medically necessary on the written advice of a medical practitioner, are covered under Activ One. However, prior approval from us is mandatory before the surgery is performed. The minimum age of the patient at the time of the surgery needs to be 18 years.

Home Health Care Expenses

Avail home healthcare treatment for any illness/injury up to the Sum Insured on a cashless basis. This service can only be availed through our provider network/from empaneled service providers offering such facilities.

Annual Health Check-up Program (Optional)

Do you skip your mandatory annual health check-ups? We suggest you keep a tab on your health with a preventive listed health check-up, once per policy year for Insured person(s)aged 18 years and above on a cashless basis.

Chronic Care - Day 1 In-Patient Hospitalization - (Optional)

Leave behind worries of mounting healthcare expenses and hospitalization due to chronic conditions. This benefit provides Day 1 In-Patient Hospitalization for listed chronic conditions such as:

Asthma
Hypertension
Hyperlipidemia
Diabetes mellitus
Chronic Obstructive Pulmonary Disease (COPD)
Obesity
Coronary Artery Disease (PTCA done prior to 1 year.)

Chronic Care Management Program (OPD) - (Optional)

Illnesses can come knocking at any point in life, but we promise to be there with you at all times. Our Chronic Care Management Program (OPD) is specially designed to keep these lifestyle conditions in check and enable you and your loved ones to lead an empowered life. Under this benefit you will get access to fixed number of Medical Practitioners consultations and Diagnostic tests.

Note: For details of the applicability and number of consultations / tests available to the Insured Person, please refer Annexure IV of this Policy

Personal Accident Cover (Optional)

Unforeseen events, which come in the shape of accidents and injuries, may often cause setbacks. With the personal accident cover, you can secure yourself and your family from the financial implications of severe accidents. The payout under this cover will be as per the Sum Insured. Accidental death, permanent total disablement and permanent partial disablement are covered under personal accident cover.

Critical Illness Cover (Optional)

Any critical illness poses a great risk. Along with physical and emotional stress, it can drain you financially. With this optional cover of the Activ One NXT plan, you get covered for up to 20 listed critical illnesses.

A short survival period of 15 days is required following the initial diagnosis of a critical illness and an initial waiting period of 60 days is applicable.

Cancer Booster (Optional)

Under this cover, you'll get additional coverage for medical expenses linked to 'Cancer of Specified Severity' claims during hospitalization, including pre and post-hospitalization expenses, along with coverage for Day Care Treatment expenses up to the sum insured.

Durable Equipment Cover (Optional)

You can opt for the Durable Equipment Cover to receive coverage for listed items such as Wheelchairs and Ventilators that are prescribed or recommended by a qualified healthcare professional. A combined Sum Insured of INR 5 lacs or up to Base Sum Insured, whichever is lower, is applicable on this cover.

Compassionate Visit (Optional)

When you opt for this choice, in case of Hospitalization exceeding 10 days within a Policy Year at a non-home location, we'll cover the cost of a two-way economy class air ticket or travel fare up to INR 50,000.

Second Medical Opinion for listed Major Illness (Optional)

You may feel the need to take a second opinion in case of major illnesses (such as cancer or kidney failure). We extend you the benefit of seeking a second medical opinion for listed 27 Major Illnesses through our consortium of doctors and medical experts at our network hospitals.

Annual Screening Package for Cancer Diagnosed Patients (Optional)

When you choose this option, we will reimburse Medical Expenses for an Annual Screening Package, applicable to Insured Person(s) diagnosed with Cancer, provided certain conditions are met, including confirmation by a pathologist.

Back

Check Eligibility
Waiting Period

Entry Age(Adult)	Minimum - 18 Years, Maximum - No capping
Entry Age (Child)	Dependent Child (Floater / Multi Individual) - 91 Days to 25 Years Individual – minimum age of entry - 5 Years
Policy Type	Individual & Family Floater
Tenure	1 / 2 / 3 Years
Family Definition	Up to 2 Adults, 4 Children
Relationship Covered	Individual: Self, legally married spouse or live-in partner (same or opposite sex), son, daughter, brother,sister, grandson, granddaughter, son-in-law, daughter-in-law, brother-in-law, sister-in-law, nephew, niece, parents and parents-in-law Floater: Self, legally married spouse or live-in partner(same or opposite sex), dependent Children(Natural / legally adopted), parents and parents-in-law
Base Sum Insured (INR)	5 Lacs( Zone 2 and 3 only), 7 Lacs, 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs, 50 Lacs, 75 Lacs, 1 Crore, 2 Crores

Pre-Existing Diseases Waiting Period	3 years
Specific Diseases Waiting Period	2 years
Initial Waiting Period (Excluding Accidental Hospitalization)	30 days

LIST OF EXCLUSIONS

1. Investigation & Evaluation

Expenses solely for diagnostic evaluation; Non-related diagnostic expenses not incidental to current treatment.

2. Rest, Cure, Rehabilitation and Respite Care

Expenses for enforced bed rest admissions; Custodial care for daily living; Services for terminally ill individuals' needs.

3. Obesity/ Weight Control

Self-initiated obesity surgery without the advice of a doctor; Inclusion criteria for surgery: BMI ≥ 40, age > 18, clinical-protocol supported surgery; BMI 35+ with comorbidities like severe sleep apnea, coronary heart disease, Obesity-related cardiomyopathy, uncontrolled Type-2 Diabetes Mellitus covered after failed non-invasive weight loss methods.

4. Change-of-Gender treatments

Expenses for changing body characteristics to opposite sex

5. Cosmetic or plastic Surgery

Cosmetic/plastic surgery unless for reconstruction after Accident, Burn, Cancer, or to remove immediate health risk, certified by Medical Practitioner.

6. Hazardous or Adventure sports

Treatment due to participation in hazardous/adventure sports, e.g., mountaineering, scuba diving, motor racing; Not limited to specified activities.

7. Breach of law

Treatment resulting from Insured Person's criminal acts.

8. Excluded Providers

Treatment from providers listed on website; Emergency care paid till stabilization, not full claim.

9. Treatment for, Alcoholism, drug or substance abuse or any addictive condition

10. Treatments received in heath hydros, nature cure clinics, spas or similar establishments

11. Dietary supplements and substances

Over-the-counter dietary supplements; Exceptions for prescribed supplements during hospitalization or day care

12. Refractive Error

Treatment for refractive error < 7.5 dioptres

13. Unproven Treatments

Unproven treatments, services, supplies lacking medical documentation

14. Sterility and Infertility

Expenses for sterility, infertility treatments, contraception, assisted reproduction, gestational surrogacy, sterilization reversal.

15. Maternity Expenses

Childbirth-related medical expenses (except ectopic pregnancy); Miscarriage expenses (unless due to accident) and lawful pregnancy termination

16. Circumstantial Exclusion

Any illness or injury due to war, rebellion, armed resistance, acts of terrorism and nuclear or radiological emissions.

17. Behavioural Exclusions

Suicide/self-harm, illegal acts, injury from alcohol/intoxicating substance use, and non-prescription drug use.

18. Medical Exclusions

Routine exams and check-ups, except as specified in Annual Health Check-up terms
Circumcisions, unless medically necessary or part of an illness or injury treatment plan.
Conditions treatable on an outpatient basis without hospitalization
Preventive care, vaccinations (except post bite), and physical/psychiatric/physiological examinations or testing
External Abnormalities to a new-born baby
Dental/oral treatment for natural teeth and gingiva, unless required during Hospitalization due to an Accident
Any form of AYUSH treatment, unless expressly mentioned in the policy document

19. Prosthesis and Devices Exclusion

Hearing aids, spectacles, wigs, prosthesis, medical equipment, and cochlear implants, unless specified in optional coverage*- Durable Medical Equipment Cover.

20. Non-Medical expenses

Items listed in Annexure (I) Lists I, II, III, and IV are not covered unless they are part of in-patient hospitalization; this exemption does not apply if Claims Protect is included in the base benefit or opted as an optional cover* and specified in the Policy Schedule.

21. Specific treatment Exclusion

Involving Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP) , Treatment involving Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy, KTP Laser Surgeries, Cyber Knife Treatment, Femto Laser Surgeries, Bioabsorbable Stents, Bioabsorbable Valves, Bioabsorbable Implants. Use of Radio Frequency (RF) probe for ablation

22. Activities and Profession Exclusions: Unrecognised Physician/Hospital

Treatment by unregistered practitioners, unlicensed and unauthorized practitioners' fees, and treatments by family members or resident practitioners without pre-approval.