NPS Swasthya top-up benefit explained: How much cover do you get under Aditya Birla Health Insurance plan?
Aditya Birla Health Insurance (ABHI) has become the first insurer to launch NPS Swasthya in partnership with the Pension Fund Regulatory and Development Authority (PFRDA), the company said.
Here's a look at the Top-Up Benefit under ABHI’s Group Activ Health plan for NPS Swasthya account holders.
Last month, PFRDA Chairman Sivasubramanian Ramann told reporters the pension authority would likely launch its new health-focused pension product in October.
According to the document, the company defines plans for one adult, two adults, one adult and a child, one adult and two children, two adults and one child, and two adults and children, under which the NPS Swasthya Account Holder (subscriber), spouse, and up to two children are covered.
As per the company, the beneficiary has to be between 91 days (around three months) and 70 years of age, with renewability up to lifetime. Further, subscriber and spouse age entry is between 18 and 70 years.
For children, it covers up to two financially dependent natural / legally adopted children between the ages of 91 days and 25 years.
The policy is valid for Indian citizens and is applicable only to lives associated with NPS Swasthya (account holders), with exclusions and other conditions as per the ABHI Group Activ Health policy wording.
| Coverage Description: Group Activ Health | |
|---|---|
| Top Up Family Floater Sum Insured | Aggregate Deductible |
| ₹1,00,000 | ₹10,000 |
| ₹5,00,000 | ₹50,000 |
| ₹10,00,000 | ₹1,00,000 |
| ₹30,00,000 | ₹3,00,000 |
Here's a look at what the Aditya Birla Health Insurance policy for NPS Swasthya account holders covers:
| Specifics | Coverage |
|---|---|
| Age Band & Entry Age | Child: 91 Days - 25 Years | Adult: 18 Years - 70 Years |
| PED Cover | Covered after a waiting period of 12 months with Good Health Declaration (GHD) |
| 30 Days Initial Waiting Period | Applicable |
| Specified Disease / Procedure Waiting Period | Applicable (1 Year) |
| Room rent | Covered upto Single Private Room for normal hospitalization & ICU as per actuals. All other charges in accordance to room rent limits. |
| AYUSH Treatment | Covered |
| Mental Illness | Covered |
| Modern Treatments | Covered |
| HIV | Covered |
| Road Ambulance | Covered upto `2,500 per incident in case of an emergency |
| Day Care Procedures | Covered |
| Domiciliary Hospitalization | Covered |
| Pre & Post Hospitalization | 30 & 60 Days respectively covered |
| Premium Revision | Annual |
- Digital Health Assessment: 1 Face Scan assessment from home with health insights including blood pressure, heart rate and oxygen.
- Activ Age and Lifestyle Score: Saturation, respiration rate and BMI. Activ Age assessment once every three months to compare biological age with actual age, along with a dynamic Lifestyle Score based on daily habits and wellness activities,
- Health Tracking Suite: Track steps, water intake, medicines, nutrition, calories and mood through a single platform.
- Mental Wellness Support: Guided breathing exercises, meditation content, Activ Mind assessment and 1 complimentary counselling session with discounted follow-up consultations.
- Doctor Consultations: 5 GP tele-consultations during the policy year.
- Wellness Content Library: Access to health articles, wellness videos, podcasts and expert-guided health content.
- Wellness Saver Card: Access exclusive savings including up to 60% off on pharmacy and nutraceutical products, 20% off on diagnostic tests and health check-ups, 15% off on medicines, 60% off on smart wearables, 25% off on fitness subscriptions, 10% off on home healthcare services, complimentary eye check-ups & discounts on dental treatments & chronic care programs.
Jocelyn Fernandes is a journalist and editor with nearly 13 years of experience covering the business, corporate, economy and markets beats in news.<br> As chief content producer for around three years at Livemint (Hindustan Times), Jocelyn publishes breaking stories, explainers, features and live blogs on a range of business and economy topics, including the Budget, corporate developments, stock markets, income tax, money and personal finance, cryptocurrency, government policy, impact of US tariffs, international developments and more.<br> Jocelyn's writing philosophy is focused on delivering news in an accurate and accessible format for readers. She thus focuses her news coverage on explainers and FAQs in order to breakdown business, corporate, economic, and policy topics that are of importance to everyday readers.<br> She holds a Bachelors in Mass Media (BMM) and Post Graduate Diploma (PGD) in Journalism and Communication and has previously written for online business and markets news site Moneycontrol (Network18), Business-to-business (B2B) trade publications — the industry magazines Power Today and Solar Today (ASAPP Media), and the national news agency United News of India (UNI).<br> Outside of work, Jocelyn keeps up-to-date with local and international news, enjoys reading fiction books, novels and short stories, and enjoys movies, travelling and art. <br> She can be found on X and LinkedIn, and reached by email: <a href="jocelyn.fernandes@htdigital.in">jocelyn.fernandes@htdigital.in</a> <br> X/ Twitter handle: <a href="https://x.com/scribeJocelyn">@scribeJocelyn</a> <br> LinkedIn: <a href="https://in.linkedin.com/in/jocelyn-fernandes-journalist">LinkedIn</a>
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