HDFC ERGO Health vs Raheja QBE Health Insurance Plans
| HDFC ERGO Health | Raheja QBE | |
|---|---|---|
| Claims Settlement Ratio** | 89.50% | 100% |
| Number of Lives Covered* | 51,16,000 | 135 |
| Network Hospitals | 10,000 + | 5,000 + |
| ||
 |
|
|
 |
|
|---|---|---|---|---|
| Easy Health | Optima Restore | Arogya Sanjeevani | Health QuBE | Arogya Sanjeevani |
| 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 | Basic: 1% of sum insured Comprehensive: No Limit Super Saver: 1% of sum insured |
Up to 2% of the sum insured subject to maximum of Rs.5,000 per day |
| ICU Charges | ||||
| Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day | Basic: 2% of sum insured Comprehensive: No Limit SuperSaver: 2% of sum insured |
Up to 5% of the sum insured subject to maximum of Rs.10,000 per day |
| Pre-hospitalization | ||||
| Covered up to 60 Days | Covered up to 60 Days | 30 days before the date of admission to the hospital | Basic: 1 to 2 Lakhs: 30 days 3 to 50 Lakhs: 60 days Comprehensive: 3 to 50 Lakhs: 60 days SuperSaver: 1 to 2 Lakhs: 30 days 3 to 50 Lakhs: 60 days |
30 days before the date of admission to the hospital |
| Post-hospitalization | ||||
| Covered up to 90 Days | Covered up to 180 Days | 60 days after discharge from the hospital | Basic: 1 to 2 Lakhs: 60 days 3 to 50 Lakhs: 90 days Comprehensive: 3 to 50 Lakhs: 90 days SuperSaver: 1 to 2 Lakhs: 60 days 3 to 50 Lakhs: 90 days |
60 days after discharge from the hospital |
| Day Care Procedures | ||||
| Covered | All day care treatments covered | All day care treatments covered | Covered | All the day care treatments |
| Domiciliary Treatment | ||||
| Covered | Covered upto sum insured | Not Covered | Basic: 1 to 2 Lakhs: Rs.15,000 3 to 9 Lakhs: Rs.25,000 10 to 20 Lakhs: Rs.50,000 25 to 50 Lakhs: Rs.150,000 Comprehensive: 3 to 9 Lakhs: Rs.25,000 10 to 20 Lakhs: Rs.50,000 25 to 50 Lakhs: Rs.150,000 SuperSaver: 1 to 2 Lakhs: Rs.15,000 3 to 9 Lakhs: Rs.25,000 10 to 20 Lakhs: Rs.50,000 25 to 50 Lakhs: Rs.150,000 |
Not Covered |
| Emergency Ambulance | ||||
| Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Basic: 1 to 2 Lakhs: Rs.1,000 per hospitalisation 3 to 9 Lakhs: Rs.1,500 per hospitalisation 10 to 50 Lakhs: Rs.2,500 per hospitalisation Comprehensive: 3 to 9 Lakhs: Rs.1,500 per hospitalisation 10 to 50 Lakhs: Rs.2,500 per hospitalisation SuperSaver: 1 to 2 Lakhs: Rs.1,000 per hospitalisation 3 to 9 Lakhs: Rs.1,500 per hospitalisatio 10 to 50 Lakhs: Rs.2,500 per hospitalisation |
Covered up to Rs.2,000 per hospitalisation |
| 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 | Dental Treatment, dentures or surgery of any kind unless necessitated due to an accident | Dental treatment, necessitated due to disease or injury |
| 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 | Not Covered | Covered |
| 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 | 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 |
| Vaccination of the new born baby | ||||
| Not Covered | 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 up to sum insured | Not Covered | Basic: 1 to 2 Lakhs: Not Covered 3 to 50 Lakhs: 20% of sum insured Comprehensive: 3 to 50 Lakhs: 20% of sum insured SuperSaver: 1 to 2 Lakhs: Not Covered 3 to 50 Lakhs: 20% of sum insured |
Not Covered |
| Cataract Treatment | ||||
| Not Covered | Not Covered | Up to 25% of Sum insured or Rs.40,000, whichever is lower, per eye, under one policy year (Waiting period: 2 years) |
Up to Rs.50,000 (inclusive of lens charges) (Waiting period: 2 years) |
Up to 25% of Sum insured or Rs.40,000, whichever is lower, per eye, under one policy year (Waiting period: 2 years) |
| Vaccination (In case of post bite treatment) | ||||
| Not Covered | Not Covered | Not Covered | Not Covered | 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 | Avilable only once a year | Not Covered |
| 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 | Basic: 1 to 2 Lakhs: Rs.500 per day 3 to 50 Lakhs: Not Covered Comprehensive: 3 to 50 Lakhs: Not Covered SuperSaver: 1 to 2 Lakhs: Rs.500 per day 3 to 50 Lakhs: 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 | 20% co-pay above 60 years | 5% co-pay on all claims |
| 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 | Covered after a waiting period of 4 years |
| 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 paid for all illness | Not Covered |
| 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 | 5% every year, maximum up to 50% of Sum Insured |
| 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 | Not Covered |
| 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 | Basic: Rs.1 to 50 Lakhs Comprehensive: Rs.3 to 50 Lakhs SuperSaver: Rs.1 to 50 Lakhs |
Rs.1 to 5 Lakhs |
| Policy can be purchased for | ||||
| 1/2 years | 1/2 years | 1 year | 1/2/3 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) | Adults from 18 to 65 years (dependents 91 days to 17 years) | 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 |
| Claims loading | ||||
| Loading | Loading | No 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 |
