Mediclaim | Premier Mediclaim | Floater Mediclaim | Arogya Sanjeevani | Activ Assure Diamond | Activ Health Platinum |
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In-patient Treatment | |||||
Covered | Covered | Covered | Covered | Covered | Covered |
Room Rent | |||||
Not exceeding 1% of the sum insured per day | Covered | Not exceeding 1% of the sum insured per day | 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 | |||||
Not exceeding 2% of the Sum Insured per day | Covered | Not exceeding 2% of the Sum Insured per day | Up to 5% of 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 | |||||
30 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 | 30 days before the date of admission to the hospital | 30 days | 60 days |
Post-hospitalization | |||||
60 days after discharge from the hospital | 90 days after discharge from the hospital | 60 days after discharge from the hospital | 60 days after discharge from the hospital | 60 days | 180 days |
Day Care Procedures | |||||
139 Day Care procedures are covered | Covered | Covered | Covered | 586 listed procedures covered up to SI | Covered up to Sum Insured |
Domiciliary Treatment | |||||
Not Covered | Not Covered | Not Covered | Covered | Up to 10% of SI | Covered up to Sum Insured |
Emergency Ambulance | |||||
1% of the Sum Insured | Covered | 1% of the Sum Insured | 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 | |||||
Not Covered | Not Covered | 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 | Not Covered |
Ayush Benefit | |||||
Up to 25% of sum insured | Up to 20% of Sum Insured | Up to 25% of sum insured | 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 | |||||
5 Lakhs and Above: 10% of the sum insured(Waiting period: 36 months) (Optional) |
Plan A: Up to Rs.50,000 Plan B: Up to Rs.100,000 |
5 Lakhs and Above: 10% of the sum insured(Waiting period: 36 months) (Optional) |
Not Covered | Not Covered | Not Covered |
New Born baby cover | |||||
Covered | Covered for any Illness or Injury | Covered | Not Covered | Not Covered | Not Covered |
Organ Donor Expenses | |||||
Covered | Covered hospitalisation expenses (excluding cost of organ) |
Covered hospitalisation expenses (excluding cost of organ) |
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 | Up to 10,000 (Applicable for SI of `1 crore and above) | Not Covered |
Health Check-up | |||||
Health check up for every 3 claim free years | Health check up for every 3 claim free years | Covered | Not Covered | Annual | Available, once in a policy year |
Hospital daily allowance | |||||
0.1% Sum Insured per day, up to a maximum of 1% Sum Insured | Plan A: Rs.2,000 per day Plan B: Rs.4,000 per day |
0.1% Sum Insured per day, up to a maximum of 1% Sum Insured | Not Covered | Not Covered | Not Covered |
Co-pay | |||||
Option of Co-pay up to 20% on certain mediclaim plans | 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 4 years of continuous coverage | Covered after 3 years of continuous coverage | Covered after 4 years of continuous coverage | Covered after 4 years of continuous coverage | Covered after a waiting period of 4 years | Pre-existing disease waiting period: 48 months |
Restore Benefit | |||||
NIL Restoration benefit | NIL Restoration benefit | NIL Restoration benefit | NIL Restoration benefit | NIL restoration benefit | Not covered |
General waiting period | |||||
30 days | 30 days | 30 days | 30 days | 30 days | |
Renewal Benefit / Cumulative Bonus | |||||
25% for every claim free year up to 50% of sum insured | Not Covered | 25% for every claim free year up to 50% of sum insured | 5% for every claim free year up to 50% of sum insured | Not covered | |
Emergency Air Ambulance | |||||
Not Covered | Up to Rs. 1,00,000 for any one illness | Not Covered | Not Covered | Available | Available |
Available sum insured options | |||||
Rs.1 to 15 Lakhs | Rs.15 Lakhs to 1 Crore | Rs.2 to 15 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 | |||||
1/2/3 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) | 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) | 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 | Renewal for whole life | - | - |
Daily Cash for Accompanying an Insured Child | |||||
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
Portablity (At the time of renewal) |
|||||
Yes | 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 | Income tax benefit under section 80D |
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