Tips for buying best mediclaim insurance
India health insurance tips and tricks to choose the best medical insurance in India
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 Easy Health |
Optima Restore |
Arogya Sanjeevani |
 Activ Assure Diamond |
Activ Health Platinum |
|---|---|---|---|---|
| In-patient Treatment | ||||
| Covered up to sum insured | Covered | Covered | Covered | Covered |
| Room Rent | ||||
| Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day | 1% of SI per day# - for SI 2 lakhs, 3 lakhs and 4 lakhs Single Private A/C Room - for SI 5 lakhs, 7 lakhs, 10 lakhs Single Private A/C Room - for SI 15 lakhs and above (Upgradable to next level, only if Single Private A/C Room is not available) |
Covered |
| ICU Charges | ||||
| Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day | 2% of SI per day - for SI 2 lakhs, 3 lakhs and 4 lakhs Up to SI - for SI 5 lakhs and above |
Covered |
| Pre-hospitalization | ||||
| Covered up to 60 Days | Covered up to 60 Days | 30 days before the date of admission to the hospital | 30 days | 60 days |
| Post-hospitalization | ||||
| Covered up to 90 Days | Covered up to 180 Days | 60 days after discharge from the hospital | 60 days | 180 days |
| Day care Procedures | ||||
| Covered | All day care treatments covered | All day care treatments covered | 586 listed procedures covered up to SI | Covered up to Sum Insured |
| Domiciliary Treatment | ||||
| Covered | Not Covered | Covered | Up to 10% of SI | Covered up to Sum Insured |
| Emergency Ambulance | ||||
| Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | 1,500 - for SI 2 lakhs, 3 lakhs, 4 lakhs per event • 2,000 - for SI 5 lakhs - 10 lakhs 2,500 - for SI 15 lakhs - 40 lakhs 3,000 - for SI 50 lakhs - 75 lakhs 5,000 - for SI 1 Crore - 2 Crores |
Available |
| Dental Treatment | ||||
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 | Not Covered | Available for Sum Insured 15 lakhs and above |
| Bariatric Surgery | ||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | ||||
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 | 15,000 - for SI 2 lakhs, 3 lakhs, 4 lakhs 20,000 - for SI 5 lakhs - 10 lakhs 30,000 - for SI 15 lakhs - 40 lakhs 40,000 - for SI 50 lakhs - 75 lakhs 50,000 - for SI 1 Crore - 2 Crores |
Covered up to Sum Insured |
| Maternity Benefits | ||||
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: 4years) |
Not Covered | Not Covered | Not Covered | Not Covered |
| New Born baby cover | ||||
Standard: Not Covered Exclusive & Platinum: Additional Benefit on payment of additional premium |
Not Covered | Not Covered | Not Covered | Not Covered |
| Daily Cash for Accompanying an Insured Child | ||||
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 | Not covered | Not covered |
| Organ Donor Expenses | ||||
| Covered | Covered | Not Covered | Covered up to sum insured | Covered up to sum insured |
| Vaccination (In case of post bite treatment) | ||||
| Not Covered | Not Covered | Not Covered | Up to 10,000 (Applicable for SI of `1 crore and above) | Not Covered |
| Health Check-up | ||||
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 | Annual | Available, once in a policy year |
| Hospital daily allowance | ||||
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 | Not Covered | Not Covered |
| Co-pay | ||||
| NIL Co-pay under this plan | NIL Co-pay under this plan | 5% Co-pay applicable on all claims | No co-pay | For Sum Insured 3 lakhs and below - Zone II to Zone I: 10% Zone III to Zone II: 15% Zone III to Zone I: 25% For Sum Insured 4 lakhs and above - Not Applicable |
| Pre-existing diseases 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 | Covered after a waiting period of 4 years | Pre-existing disease waiting period: 48 months |
| Restore Benefit | ||||
| NIL Restoration Benefit under this plan | Up to 100% of Base Sum Insured per year | NIL Restoration benefit | NIL restoration benefit | Not covered |
| General waiting period | ||||
| 30 days | 30 days | 30 days | 30 days | |
| Renewal Benefit / Cumulative Bonus | ||||
| 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 | Not covered | |
| Emergency Air Ambulance | ||||
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 | Available |
| Available sum insured options | ||||
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 | Rs.2 to 2 Crores | 2 lakhs, 3 lakhs, 4 lakhs, 5 lakhs, 6 lakhs, 7 lakhs, 8 lakhs, 9 lakhs, 10 lakhs, 15 lakhs, 20 lakhs, 25 lakhs, 30 lakhs, 40 lakhs, 50 lakhs, 100 lakhs, 150 lakhs, 200 lakhs |
| Policy can be purchased for | ||||
| 1/2 years | 1/2 years | 1 year | - | - |
| Eligibility criteria | ||||
| 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) | Individual : Minimum entry age 5 yrs and there is no maximum age of entry Family Floater : We cover up to 6 members (2 Adults + 4 Children) comprising of Self, Spouse and Dependent children (up to 25 yrs) in a single policy - Dependent children from 91 days to 5 yrs will be covered only if one adult is covered in the floater policy - There is no maximum age of entry |
Family Floater Policy - 91 days – Dependent child - 18 years – Adult, Individual Policy - 5 years |
| Renewability | ||||
| Renewal for whole life | Renewal for whole life | Renewal for whole life | - | - |
| Portablity (At the time of renewal) | ||||
| Yes | Yes | Yes | No | No |
| 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 |
India health insurance tips and tricks to choose the best medical insurance in India
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