Policy explained · Aditya Birla
Aditya Birla Activ One (NXT): what your policy covers
Aditya Birla Activ One (NXT) has no room rent limit (conditions apply). It has a 24-month wait for knee & hip replacement and a 36-month wait for pre-existing conditions, and it does not cover consumables. On a typical ₹4,50,000 knee & hip replacement bill, the insurer pays about ₹4,05,000 to ₹4,36,500 and you pay about ₹13,500 to ₹45,000 (estimate).
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At a glance
- 🛏️No capRoom rentNo limit; conditions apply, see the termsPolicy wordings, page 46, read 28 Aug 2026
- ⏳24 monthsKnee & hip replacement waitOver by month 30Policy wordings, page 10, read 28 Aug 2026
- ⏳36 monthsPre-existing conditions waitNot over at month 30Policy wordings, page 47, read 28 Aug 2026
- 🩹Not coveredConsumablesThese are yours to pay; conditions apply, see the termsPolicy wordings, page 34, read 28 Aug 2026
Waiting periods, month by month
- Pre-existing conditions36 monthsNot over at month 30
- Knee & hip replacement24 monthsOver by month 30
- Spine surgery24 monthsOver by month 30
- Prostate surgery24 monthsOver by month 30
- Hysterectomy24 monthsOver by month 30
Worked example: a knee & hip replacement bill
The example person joined the policy before age 61, is treated at a network hospital in the zone their policy covers, has no add-ons, and has a ₹5,00,000 sum insured on a policy running 30 months.
Room rent ₹9,000 a day for 4 days (example), a semi-private room, on a typical NCR knee & hip replacement bill of ₹4,50,000 (estimate).
₹13,500 to ₹45,000 could go either way: non-payable items, 3% to 10% of the bill because consumables are not covered (estimate)
| Step | Amount (estimate) |
|---|---|
| Bill total | ₹4,50,000 |
| Insurer's share before non-payable items and co-pay | ₹4,50,000 |
| Non-payable items, 3% to 10% of the bill because consumables are not covered | minus ₹13,500 to ₹45,000 |
| Insurer pays | ₹4,05,000 to ₹4,36,500 |
| You pay | ₹13,500 to ₹45,000 |
The terms, with the policy text
10 terms read from the Aditya Birla Activ One (NXT) documents (UIN ADIHLIP27048V022627). Open a source to read the policy text, its conditions and the page.
| Term | What it means | Policy text and source |
|---|---|---|
| Room rent limit | No limit (No limit) | Policy wordings, page 46Condition: Room rent is paid at actual cost up to the sum insured. An optional room-type add-on can set a room category instead. Actuals up to Sum Insured |
| ICU limit | No limit (No limit) | Policy wordings, page 46Actuals up to Sum Insured |
| Consumables (gloves, masks and other non-medical items) | Not covered: these are yours to payNot covered | Policy wordings, page 34Condition: This is the NXT edition. The MAX, MAX+ and VYTL editions include Claim Protect, which pays these items. On availing this Optional Cover, the Company shall indemnify the Non-Medical Expenses listed under Annexure I (all 4 lists) to this Policy |
| Costs before and after the hospital stay | 90 days before admission, 180 days after dischargeCovered | Policy wordings, page 46Pre-Hospitalization Expenses (up to Sum Insured) 90 Days Post-Hospitalization Expenses (up to Sum Insured) 180 Days |
| Waiting period for pre-existing conditions | 36 months of continuous coverNot over at month 30 | Policy wordings, page 47Pre-Existing Diseases Waiting Period 3 Years |
| Waiting period for knee & hip replacement | 24 months of continuous coverOver by month 30 | Policy wordings, page 10Expenses related to the treatment of the listed Conditions, surgeries / treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. |
| Waiting period for spine surgery | 24 months of continuous coverOver by month 30 | Policy wordings, page 10Prolapse of the intervertebral disc |
| Waiting period for prostate surgery | 24 months of continuous coverOver by month 30 | Policy wordings, page 11Benign Hypertrophy / Enlargement of Prostate (BHP / BEP) |
| Waiting period for hysterectomy | 24 months of continuous coverOver by month 30 | Policy wordings, page 10Dysfunctional Uterine Bleeding (DUB) Endometriosis Menorrhagia Pelvic Inflammatory Disease |
| Exclusion rule for bariatric surgery | Covered when the policy's conditions are metConditions apply | Policy wordings, page 11D.1.6 Obesity / Weight Control (Code- Excl06) Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions: a) Surgery to be conducted is upon the advice of the Doctor. b) The surgery / Procedure conducted should be supported by clinical protocols. c) The member has to be 18 years of age or older and |
Questions
What does no room rent capping mean on Aditya Birla Activ One (NXT)?
There is no limit on the Aditya Birla Activ One (NXT) plan: the policy wordings set no daily limit on room rent (Policy wordings, page 46, read 28 Aug 2026). The room you choose does not trigger a proportionate cut, but co-pay, waiting periods, sub-limits and non-payable items still apply.
Check your own policy
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Sources
- Aditya Birla Activ One (NXT): policy wordings (accessed 28 Aug 2026)
- Aditya Birla Activ One (NXT): customer information sheet (cis) (accessed 28 Aug 2026)