Tips for buying best mediclaim insurance
India health insurance tips and tricks to choose the best medical insurance in India
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 JOY Maternity health insurance |
Care NCB |
 Health Suraksha |
Gold Smart |
Platinum Smart |
|---|---|---|---|---|
| In-patient Treatment | ||||
| Covered | Covered | Covered | 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 |
At actual | Capping on room rent | Up to 2% of the sum insured subject to maximum of Rs.5,000/day. |
| ICU Charges | ||||
| Covered | 3 & 4 Lakhs: 2% of sum insured per day 5 to 75 Lakhs: No limit |
At actuals | Covered | Up to 5% of sum insured subject to maximum of Rs.10,000/day. |
| Pre-hospitalization | ||||
| 30 days before the date of admission to the hospital | Up to 30 days | 60 days before the date of admission to the hospital | 60 days before the date of admission to the hospital | 30 days before the date of admission to the hospital |
| Post-hospitalization | ||||
| 60 days after discharge from the hospital | Up to 60 days | 180 days after discharge from the hospital | 180 days after discharge from the hospital | 60 days after discharge from the hospital |
| Day care Procedures | ||||
| Covered | Covers more than 540 day care treatments | Covered | Covered | Covered |
| Domiciliary Treatment | ||||
| Not covered | Up to 10% of sum insured | Covered | Covered | 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 |
Silver Smart: Rs.2,000; Gold Smart: Rs.3,500; Platinum Smart: Sum insured 20 to 50 lakhs: Rs.3,500; Sum insured 50 & 75 lakhs: Rs.15,000 |
Covered | Maximum of Rs. 2,000/hospitalisation |
| Dental Treatment | ||||
| Not covered | Not covered | Not covered | 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 | Covered | Covered | Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy. |
| 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) |
Covered (Waiting period: 3 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 | Up to parent care sum insured(Optional) | Not covered | Not covered |
| Organ Donor Expenses | ||||
| Not covered | Covered |
Covered | Covered | Not covered |
| Vaccination (In case of post bite treatment) | ||||
| Not covered | Covered | Not covered | Not covered | Not covered |
| Health Check-up | ||||
| Not covered | Covered | Covered | 1% of sum insured after every 4 consecutive and continuous claim free years with us (Subject to a maximum up to Rs.5,000) |
Not covered |
| Hospital daily allowance | ||||
| Not covered | Fixed lump sum amount for each completed day of hospitalisation payable for a maximum of 5 consecutive days | Covered up to sum insured | Covered up to sum insured | Not covered |
| Co-pay | ||||
| 20% co-pay above 60 years | 20% co-pay above 60 years | Silver Smart: No co-pay for all treatment, Optional Co pay available between 10%/20%; Gold Smart: No co-pay for all treatment, Optional Co pay available between 15%/25%; Platinum Smart: No co-pay for all treatment, Optional Co pay available between 15%/25% |
NIL / co-pay applicable up to 20% for treatment in higher class cities | 5% co-pay on all claims |
| Pre-existing diseases coverage | ||||
| Covered after 4 years of continuous coverage. | Covered after 4 years of continuous coverage. | Pre-existing diseases covered after 3 years of continuous coverage. | Pre-existing diseases covered after 4 years of continuous coverage. | Pre-existing diseases covered after 4 years of continuous coverage. |
| Restore Benefit | ||||
| Not covered | Recharge up to 100% of Base sum insured per year |
Sum Insured Rebound up to 100% of sum insured per year | Not covered | Not covered |
| General waiting period | ||||
| 30 days | 30 days | 30 days | 30 days | 30 days |
| Renewal Benefit / Cumulative Bonus | ||||
Covered |
10% for every claim free year up to 50% of sum insured | Silver Smart & Gold Smart: 10% on base sum insured for every claim free year and up to 100%; Platinum Smart: 25% on base sum insured for every claim free year and up to 200%. |
5% on base sum insured for every claim free year and up to 50% | 5% on base sum insured for every claim free year and up to 50% |
| Emergency Air Ambulance | ||||
| Not covered | Covered(Optional) |
Silver Smart: Not covered; Gold Smart: Up to 2 lakhs; Platinum Smart: Up to 5 lakhs. |
Not covered | Not covered |
| Available sum insured options | ||||
| 3 & 5 Lakhs | 3 to 75 Lakhs | Silver Smart: 3 to 5 Lakhs; Gold Smart: 7.5 to 15 Lakhs; Platinum Smart: 20 to 75 Lakhs |
3 to 50 Lakhs | 1 to 5 Lakhs |
| Policy can be purchased for | ||||
| 1/2/3 years | 1/2/3 years | 1/2/3 Years | 1/2/3 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 | Adults from 18 Years to lifetime entry (dependents 91 days to 25 years) | Adults from 18 Years to lifetime entry (dependents 91 days to 25 years) | Adults from 18 to 65 years (dependents 91 days to 25 years).If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage in the subsequent renewals |
| 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 | Covered up to sum insured | Covered up to sum insured | 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 |
| Useful Links | ||||
| Care Health | HDFC ERGO | |
|---|---|---|
| Claims Settlement Ratio ** | 95.2 % | 85.97% |
| Number of Lives Covered * | 1,07,13,000 | 96.05,000 |
| Network Hospitals | 16,500 + | 10,000 + |
| ||
India health insurance tips and tricks to choose the best medical insurance in India
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