Aditya Birla Health Insurance (ABHI) has introduced a Group Activ Health Top-Up cover specifically for NPS Swasthya account holders. This health insurance plan provides additional coverage options with premiums starting at ₹1,732 annually. It covers the subscriber, their legally married spouse, and up to two financially dependent children.
- Who is eligible for the cover?
- What family combinations are available?
- How are premiums structured by age and coverage amount?
- What are the waiting periods and coverage benefits?
Who can apply for the ABHI Group Activ Health Top-Up cover?
The policy is available to Indian citizens who hold an NPS Swasthya account or are associated with an account holder. The subscriber and spouse must be between 18 and 70 years old. Children covered can range from 91 days to 25 years of age.
What family coverage options does the policy offer?
The policy supports several family combinations including:
- 1 Adult (1A)
- 2 Adults (2A)
- 1 Adult + 1 Child (1A+1C)
- 1 Adult + 2 Children (1A+2C)
- 2 Adults + 1 Child (2A+1C)
- 2 Adults + 2 Children (2A+2C)
How are the premiums calculated?
Premiums vary based on the age of adult members, family combination, and the chosen coverage amount. The coverage options include ₹1 lakh, ₹5 lakh, ₹10 lakh, and ₹30 lakh.
For example, for 1 Adult with ₹1 lakh coverage, the annual premium is ₹4,123 for ages 18–40, ₹6,004 for ages 41–60, and ₹11,787 for ages 61–70. For the ₹30 lakh cover, premiums start as low as ₹1,732 for the youngest age group.
Premiums increase with the number of family members and coverage amount. For 2 Adults + 2 Children with ₹30 lakh coverage, the annual premium ranges from ₹4,002 to ₹11,441 depending on age.
What are the waiting periods and coverage benefits?
The policy includes a 30-day initial waiting period and a one-year waiting period for specified diseases and procedures. Pre-existing diseases are covered after a 12-month waiting period, provided a Good Health Declaration is submitted.
Coverage benefits include:
- Single Private Room for normal hospitalisation
- ICU coverage as per actual expenses
- AYUSH treatments
- Mental illness coverage
- Modern treatments and day-care procedures
- Domiciliary hospitalisation
- Road ambulance cover up to ₹2,500 per emergency
- Pre-hospitalisation cover for 30 days and post-hospitalisation cover for 60 days
What are the policy terms and renewability?
A Good Health Declaration is mandatory for all members covered under the policy. The plan offers a 30-day free-look period, allowing policyholders to review the terms. Renewability is available up to a lifetime, providing long-term protection.
This health top-up cover is designed to complement the existing NPS Swasthya benefits by offering additional financial protection against health-related expenses for the subscriber and their family.
Disclaimer: This article is for informational purposes only and does not constitute investment advice. Readers should conduct their own research or consult a registered financial advisor before making insurance or investment decisions.
