Compare Care vs HDFC ERGO Health Insurance Plans
| Care | HDFC ERGO Health | |
|---|---|---|
| Claims Settlement Ratio ** | 95.2% | 89.50% |
| Number of Lives Covered * | 1,07,13,000 | 51,16,000 |
| Network Hospitals | 16500 + | 10,000 + |
| ||
 |
|
 |
|
|
|---|---|---|---|---|
| Maternity health insurance - JOY | Care - Care | Easy Health | Optima Restore | Arogya Sanjeevani |
| In-patient Treatment | ||||
| Covered | Covered | Covered up to sum insured | Covered | Covered |
| Room Rent | ||||
| Single private room with AC | 3 & 4 Lakhs: 1% of sum insured per day 5 to 10 Lakhs: Single private room 15 to 75 Lakhs: Single private room,upgradable to next level |
Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day |
| ICU Charges | ||||
| Covered | 3 & 4 Lakhs: 2% of sum insured per day 5 to 75 Lakhs: No limit |
Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day |
| Pre-hospitalization | ||||
| 30 days before the date of admission to the hospital | Up to 30 days | Covered up to 60 Days | Covered up to 60 Days | 30 days before the date of admission to the hospital |
| Post-hospitalization | ||||
| 60 days after discharge from the hospital | Up to 60 days | Covered up to 90 Days | Covered up to 180 Days | 60 days after discharge from the hospital |
| Day Care Procedures | ||||
| Covered | Covers more than 540 day Care treatments | All day care treatments covered | All day care treatments covered | 142 day care expenses covered |
| Domiciliary Treatment | ||||
| Not covered | Up to 10% of sum insured | Covered | Covered upto sum insured | Not Covered |
| Emergency Ambulance | ||||
| Up to a limit of Rs.1,000 per claim | 3 & 4 Lakhs: Rs.1,500 per hospitalisation 5 to 10 Lakhs: Rs.2,000 per hospitalisation 15 to 40 Lakhs: Rs.2,500 per hospitalisation 50 to 75 Lakhs: Rs.3,000 per hospitalisation |
Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation |
| Dental Treatment | ||||
| Not covered | Not covered | Individual - Standard & Exclusive: Not Covered Platinum (4 lakhs to 10 lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000 Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.7,500 Family - Standard & Exclusive: Not Covered Platinum (4 to 10 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000 Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.10,000 (waiting period: 3 years) |
Not Covered | Dental treatment, necessitated due to disease or injury |
| Bariatric Surgery | ||||
| Not covered | Not covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | ||||
| Not covered | Covers Non Allopathic treatment like Ayurveda, Homeopathy, Unani & Sidha | Standard: Up to Rs.20,000 Exclusive & Platinum (3 to 10 Lakhs): Up to Rs.25,000 Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.50,000 |
Not Covered | Covered |
| Maternity Benefits | ||||
3 Lakhs: Up to Rs.35,000 5 Lakhs: Up to Rs.50,000(Waiting period: 9 months) |
3 & 4 Lakhs: Not covered 5 to 10 Lakhs: Not covered 15 to 40 Lakhs: Not covered 50 to 75 Lakhs: Covered (Waiting period: 24 months) |
Standard: Not Covered Exclusive & Platinum (3 to 10 Lakhs): Normal Delivery Rs.15,000, Caesarean Delivery Rs.25,000 Exclusive & Platinum (15 to 50 Lakhs): Normal Delivery Rs.30,000, Caesarean Delivery Rs.50,000 (Waiting Period: 4 Years) |
Not Covered | Not Covered |
| New Born baby cover | ||||
3 lakhs: Up to Rs 30,000 5 lakhs: Up to Rs 50,000 |
Not covered | Standard: Not Covered Exclusive & Platinum: Additional Benefit on payment of additional premium |
Not Covered | Not Covered |
| Vaccination of the new born baby | ||||
| Not covered | Covered | Not Covered | Not Covered | Not Covered |
| Organ Donor Expenses | ||||
| Not covered | Covered(Optional) |
Covered | Covered up to sum insured | Not Covered |
| Vaccination (In case of post bite treatment) | ||||
| Not covered | Covered | Not Covered | Not Covered | Not Covered |
| Health Check-up | ||||
| Not covered | Covered | Standard: Every 4 years 1% of sum insured, up to Rs.5,000, irrespective of claim Exclusive: Every 3 years 1% of sum insured, up to Rs.5,000, irrespective of claim Platinum: Every 2 years 1% of sum insured, up to Rs.5,000, irrespective of claim |
Individual - 3 Lakhs: Not Covered 5 Lakhs: Up to Rs.1,500 10 Lakhs: Up to Rs.2,000 15 Lakhs: Up to Rs.4,000 20 to 50 Lakhs: Up to Rs.5,000 Family - 3 Lakhs: Not covered 5 Lakhs: Up to Rs.2,500 10 Lakhs: Up to Rs.5,000 15 Lakhs: Up to Rs.8,000 20 to 50 Lakhs : Up to Rs.10,000 |
Covered |
| Hospital daily allowance | ||||
| Not covered | Fixed lump sum amount for each completed day of hospitalisation payable for a maximum of 5 consecutive days | Standard: Rs.500 per day, maximum Rs.3,000 Exclusive & Platinum (3 to 5 Lakhs): Rs.500 per day, maximum Rs.3,000 Exclusive & Platinum (7.5 to 10 Lakhs): Rs.800 per day, maximum Rs.4,800 Exclusive & Platinum (15 to 50 Lakhs): Rs.1,000 per day, maximum Rs.6,000 (Choosing shared accommodation) |
3 to 15 Lakhs: Rs.800 per day, maximum Rs.4,800 20 to 50 Lakhs: Rs.1,000 per day, maximum Rs.6,000 (Choosing shared accommodation) |
Not Covered |
| Co-pay | ||||
| 20% co-pay above 60 years | 20% co-pay above 60 years | NIL Co-pay under this plan | NIL Co-pay under this plan | 5% Co-pay applicable on all claims |
| Pre-existing diseases coverage | ||||
| Covered after 4 years of continuous coverage. | Covered after 4 years of continuous coverage. | Covered after a waiting period of 3 years | Covered after a waiting period of 3 years | Covered after a waiting period of 4 years |
| Restore Benefit | ||||
| Not covered | Recharge up to 100% of Base sum insured per year |
NIL Restoration Benefit under this plan | Up to 100% of Base Sum Insured per year | NIL Restoration benefit |
| General waiting period | ||||
| 30 days | 30 days | 30 days | 30 days | 30 days |
| Renewal Benefit / Cumulative Bonus | ||||
Covered(Optional) |
10% for every claim free year up to 50% of sum insured | 10% on base sum insured for every claim free year and up to 100% | 50% for every claim free year up to 100% of basic sum insured | 5% for every claim free year up to 50% of sum insured |
| Emergency Air Ambulance | ||||
| Not covered | Covered (Optional) |
Standard: Not Covered Exclusive & Platinum (3 to 10 lakhs): Not Covered Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.2.5 lakhs per hopsitalisation |
3 to 5 Lakhs: Not Covered 10 to 50 Lakhs: Covered up to Rs.2.5 lakhs per hospitalization and maximum up to sum insured in an year |
Not Covered |
| Available sum insured options | ||||
| 3 & 5 Lakhs | 3 to 75 Lakhs | Individual - Standard Plan: Rs.1 to 15 Lakhs Exclusive Plan: Rs.3 to 50 Lakhs Platinum Plan: Rs.4 to 50 Lakhs Family - Standard Plan: Rs.2 to 15 Lakhs Exclusive Plan: Rs.3 to 50 Lakhs Platinum Plan: Rs.4 to 50 Lakhs |
Individual: Rs.50,000 to 10 Lakhs Floater: Rs.2 to 10 Lakhs |
Rs.1 to 5 Lakhs |
| Policy can be purchased for | ||||
| 1/2/3 years | 1/2/3 years | 1/2 years | 1/2 years | 1 year |
| Eligibility criteria | ||||
| Adults from 18 to 65 years (dependents 91 days to 17 years) | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | Adults from 18 to 65 years (dependents 91 days to 17 years) |
| Renewability | ||||
| Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life |
| Daily Cash for Accompanying an Insured Child | ||||
| Not covered | Not covered | Standard: Not Covered Exclusive & Platinum (3 to 5 Lakhs): Rs.300 per day, maximum Rs.9,000 Exclusive & Platinum (7.5 to 10 Lakhs): Rs.500 per day, maximum Rs.15,000 Exclusive & Platinum (15 to 50 Lakhs): Rs.800 per day, maximum Rs.24,000 |
Not Covered | Not Covered |
| Claims loading | ||||
| No Loading | Loading | Loading | Loading | No Loading |
| Portablity(At the time of renewal) | ||||
| Yes | Yes | Yes | Yes | Yes |
| Tax Benefits Limit | ||||
| Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D |
