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What is Covered in Aditya Birla Health Insurance? Diseases, Treatments and Plans

Wish

Written by Kritika Singh

Updated Jul 24, 2024

Aditya Birla Health Insurance is a part of Aditya Birla Capital Limited and there is a joint venture between Aditya Birla Group And MMI Holdings of South Africa. It was started in 2015 and since then the company has covered 2.1 Cr+ lives. The health insurance company is operating its business in 5000 cities in India.

Aditya Birla Health Insurance Coverage

Aditya Birla Health Insurance plans gives good coverage to their customers and provides various types of benefits like basic coverage, wellness discounts, mental health services, and chronic care.

Coverage that are given in Aditya Birla Health Insurance are:

  • OPD Expenses
    Aditya Birla Health Insurance provides OPD expenses to its customers which means if the insured person gets hospitalised and doesn’t require hospitalisation more than 24Hrs then the treatment given to the patient within 24 Hrs will get covered.
  • Hospitalisation Cost
    Hospitalisation costs are the cost which occurs in the hospital during the treatment like doctor visits, drugs, tests, etc all this is covered by the Aditya Birla Health Insurance according to the plan selected by the customer.
  • Cashless Hospitalisation
    Cashless services at network hospitals are given by Aditya Birla Health Insurance which means you do not have to pay any cash at the time of treatment. After treatment, if the bill amount is equal to less than the sum insured then the bill will be cleared by Aditya Birla Health Insurance.
  • Ayush Treatment
    Aditya Birla Health Insurance covers the treatment of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) with these customers get an option to take the treatment of their choice.
  • Critical Illness Cover
    Critical illness coverage is given to the customer by Aditya Birla Health Insurance. Mentioned critical illness in the policy document is covered by the company.

Critical Disease Covered Under Aditya Birla Health Plans

Aditya Birla Health Plans covers 60 critical diseases and some of the major critical diseases are:

For more information regarding critical illness visit Aditya Birla Critical Illness Plans - Health Insurance 

Pre Existing Disease Cover

What is Covered in Aditya Birla Health Insurance?

There are different types of Pre-existing diseases that Aditya Birla Health Insurance Covers. Some PED come with a base plan and for some PED like Blood Pressure and Diabetes, you have to take riders.

The pre-existing disease that gets covered under base are as follows:

  • Hernia
  • Piles
  • Knee Replacement
  • Joint Replacement 
  • Hip Replacement 
  • Cataract

Aditya Birla Health Insurance Plans 

There are 10+ plans of Aditya Birla Health Insurance Available in the market for their customers and here are some plans which are popular for their coverage and benefits.

Plan Name 

Type 

Age Eligibility

Sum Insured

Activ Assure Diamond

Family and individual

91 days - 65 years

Rs.1 lakh - Rs.30 lakh

Activ fit-plus

Family and individual

5 years - 45 years

Rs.3 lakh - Rs.10 lakh

Active care

Family and individual(especially for senior citizens)

55 years-80 years)

Rs.3 lakh-Rs.25 lakh

Activ Health

Family and individual

For individuals- 5 years

For floater- 91 days

Up to Rs.2 crore

Exclusion Under Aditya Birla Insurance Plans

There are different kinds of exclusion available in the plans offered by Aditya Birla Health Insurance and those are:

  • Attempted suicide, intentional self-injury, or any act of self-destruction is excluded by Aditya Birla Health Insurance.
  • Any accident or injury caused due to alcohol, drugs, or intoxicants.
  • Any disease or disability caused due to sexually transmitted diseases.

FAQs

Ques 1. Which disease is covered in Aditya Birla health insurance?

Ans. Aditya Birla Health Insurance covers different types of diseases according to the plans and riders purchased by any customers. The diseases that are covered by Aditya Birla depend on which type of disease it is, whether it is PED or critical disease. In PED diseases like hernia, piles, knee replacement and in critical diseases cancer, loss of speech, and kidney failure are covered.

Ques 2. What is the limit of Aditya Birla health insurance?

Ans. The age limit of Aditya Birla Health Insurance is from 91 days to the age of 65 years old and the sum insured limit is from Rs.1 lakh to up to Rs. 2 crore.

Ques 3. Can we claim dental expenses in Aditya Birla Health Insurance?

Ans. Aditya Birla Health Insurance covers dental expenses for accidental injuries in all its health plans.

Ques 4. Which diseases are covered after 2 years in health insurance?

Ans. slow-growing diseases which are also known as  Pre-existing diseases are covered after 2 years in health insurance in which the policyholder has to serve a 2 year waiting period and diseases like piles, hernia, knee replacements etc.

Ques 5. What is the claim rate for Aditya Birla health insurance?

Ans. The claim settlement ratio of Aditya Birla Health Insurance is 96%.

Wish

Written by Kritika Singh

Kritika Singh is a marketing professional with over 10 years of work experience in the field of insurtech, health, FMCG, renewables, and public policy. KrRead More

Disclaimer

This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.
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