HDFC ERGO Health | Bharti AXA | |
---|---|---|
Claims Settlement Ratio** | 89.50% | 98.27% |
Number of Lives Covered* | 51,16,000 | |
Network Hospitals | 10,000 + | 4,500 + |
|
Easy Health | Optima Restore | Arogya Sanjeevani | Smart Health Assure | Smart Super Health |
---|---|---|---|---|
In-patient Treatment | ||||
Covered up to sum insured | Covered | Covered | Covered up to sum insured | Covered up to sum insured |
Room Rent | ||||
Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day | Covered | Covered |
ICU Charges | ||||
Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day | Covered | Covered |
Pre-hospitalization | ||||
Covered up to 60 Days | Covered up to 60 Days | 30 days before the date of admission to the hospital | 60 days(Covered up to sum insured) | 60 days(Covered up to sum insured) |
Post-hospitalization | ||||
Covered up to 90 Days | Covered up to 180 Days | 60 days after discharge from the hospital | 90 days(Covered up to sum insured) | 90 days(Covered up to sum insured) |
Day Care Procedures | ||||
Covered | All day care treatments covered | All day care treatments covered | Up to sum insured as per list provided in policy document | Up to sum insured as per list provided in policy document |
Domiciliary Treatment | ||||
Covered | Covered upto sum insured | Not Covered | Covered up to sum insured | 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 | Rs.3,000 per event | Rs.3,000 per event |
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 | As per specified limit and plan opted | Not Covered |
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 | Covered up to sum insured | 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:4 Years) |
Not Covered | Not Covered | Covered | Covered |
New Born baby cover | ||||
Standard: Not Covered Exclusive & Platinum: Additional Benefit on payment of additional premium |
Not Covered | Not Covered | Covered | 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 up to sum insured | 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 | Not Covered | As per specified limit and plan opted |
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 health check-up available | Annual health check-up available |
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 | As per specified limit and plan opted | As per specified limit and plan opted |
Co-pay | ||||
NIL Co-pay under this plan | NIL Co-pay under this plan | 5% Co-pay applicable on all claims | NIL co-pay | NIL co-pay |
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 4 years of continuous coverage | Covered after 4 years of continuous coverage |
Restore Benefit | ||||
NIL Restoration Benefit under this plan | Up to 100% of Base Sum Insured per year | NIL Restoration benefit | Up to 100% of Base Sum Insured | Up to 100% of Base Sum Insured |
General waiting period | ||||
30 days | 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 | Covered | For age below 45 years 50% of expiring policy sum insured not exceeding 100% For age above 45 years 20% of expiring policy sum insured not exceeding 100% |
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 | Not Covered | As per specified limit and plan opted |
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.3 & 4 Lakhs | Value: Rs.5 & 7.5 Lakhs Classic: Rs.10 to 20 Lakhs Uber: Rs.30 & 50 Lakhs above |
Policy can be purchased for | ||||
1/2 years | 1/2 years | 1 year | 1/2/3 years | 1/2/3 years |
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) | 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 |
Renewability | ||||
Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life |
Claims loading | ||||
Loading | Loading | No Loading | Loading | 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 |
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