Tips for buying best mediclaim insurance
India health insurance tips and tricks to choose the best medical insurance in India
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 Medicare Protect |
Medicare |
Medicare Premier |
 Health Suraksha |
Gold Smart |
Platinum Smart |
|---|---|---|---|---|---|
| In-patient Treatment | |||||
| Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury |
| Room Rent | |||||
| Shared Accommodation / 10% co pay for higher Room category | Shared Accommodation (with 10% co-pay)/ Single Private A/c Room | NIL Room Rent restrictions | Covered | Covered | Covered |
| ICU Charges | |||||
| Covered | Covered | Covered | At Actuals | At Actuals | At Actuals |
| Pre-hospitalization | |||||
| 30 days before the date of admission to the hospital | 60 days before the date of admission to the hospital | 60 days before the date of admission to the hospital | 60 days before the date of admission to the hospital | 60 days before the date of admission to the hospital | 60 days before the date of admission to the hospital |
| Post-hospitalization | |||||
| 60 days after discharge from the hospital | 90 days after discharge from the hospital | 90 days after discharge from the hospital | 180 days after discharge from the hospital | 180 days after discharge from the hospital | 180 days after discharge from the hospital |
| Day Care Procedures | |||||
| 540+ listed Day Care Treatment covered | 540+ listed Day Care Treatment covered | 540+ listed Day Care Treatment covered | Covered | Covered | Covered |
| Domiciliary Treatment | |||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | Covered | Covered |
| Emergency Ambulance | |||||
| Up to Rs 1,000 per hospitalisation | Up to Rs 3,000 per hospitalisation | Up to Rs 5,000 per hospitalisation | Pays for expenses for utilizing ambulance services in an emergency | Pays for expenses for utilizing ambulance services in an emergency | Pays for expenses for utilizing ambulance services in an emergency |
| Dental Treatment | |||||
| Not Covered | Covers expenses incurred towards hospitalization for dental treatment under anesthesia necessitated due to an accident/ injury/illness | 10,000 (OPD Dental) | Not Covered | Not Covered | Not Covered |
| Bariatric Surgery | |||||
| Not Covered | Covered | Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | |||||
| Covered up to Sum Insured | Covered up to Sum Insured | Covered up to Sum Insured | Pays for medical expenses for in-patient treatment taken under Ayurveda, Unani, Sidha or Homeopathy | Pays for medical expenses for in-patient treatment taken under Ayurveda, Unani, Sidha or Homeopathy | Pays for medical expenses for in-patient treatment taken under Ayurveda, Unani, Sidha or Homeopathy |
| Maternity Benefits | |||||
| Not Covered | Not Covered | Up to Rs.50,000 (Rs.60,000 in case of girl child) per policy. (Waiting period 4 years) |
Covered | Covered | Covered |
| New Born baby cover | |||||
| Not Covered | Not Covered | If a claim is admitted under the maternity benefit, then the company covers for medical expenses incurred on the treatment of new born baby up to Rs.10,000 for complications related to delivery. |
Covered | Covered | Covered |
| Vaccination of the new born baby | |||||
| Not Covered | Not Covered | Upto Rs.10,000 (Rs.15,000 in case of girl child) up to one year after the birth of the child |
Covered | Covered | Covered |
| Organ Donor Expenses | |||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Pays for medical expenses for an organ donor's treatment in the event of organ transplantation | Pays for medical expenses for an organ donor's treatment in the event of organ transplantation | Pays for medical expenses for an organ donor's treatment in the event of organ transplantation |
| Vaccination (In case of post bite treatment) | |||||
| Not Covered | Covered | Covered | Not Covered | Not Covered | Not Covered |
| Health Check-up | |||||
| Up to 1% of previous sum insured subject to a maximum of Rs. 10,000/ policy | Up to 1% of previous sum insured per policy | Up to 1% of sum insured subject to a maximum of Rs. 10,000 policy | Covered | Covered | Covered |
| Hospital daily allowance | |||||
| Not Covered | If the insured is hospitalized in shared accommodation in a network hospital for more than 24 hours. Then the company pays 0.25% of base sum insured and maximum of Rs.2,000 per day. |
If the insured is hospitalized in shared accommodation in a network hospital for more than 24 hours. Then the company pays 0.25% of base sum insured and maximum of Rs.2,000 per day. |
Not Covered | Not Covered | Not Covered |
| Daily Cash for Accompanying an Insured Child | |||||
| Not Covered | If an insured child aged 12 years or less is hospitalized. The company pays 0.25% of base sum insured and maximum of Rs.2,000/ day for one accompanying adult for 24 hours. |
If an insured child aged 12 years or less is hospitalized. The company pays 0.25% of base sum insured and maximum of Rs.2,000/ day for one accompanying adult for 24 hours. |
Not Covered | Not Covered | Not Covered |
| Co-pay | |||||
| No co-pay | No co-pay | No co-pay | No co-pay for all treatment, Optional Co pay available between 10%/20%; | No co-pay for all treatment, Optional Co pay available between 15%/25%; | No co-pay for all treatment, Optional Co pay available between 15%/25% |
| Pre-existing diseases coverage | |||||
| Pre-existing diseases covered after 4 years of continuous coverage. | Pre-existing diseases covered after 3 years of continuous coverage. | Pre-existing diseases covered after 2 years of continuous coverage. | Pre-existing diseases covered after 3 years of continuous coverage. | Pre-existing diseases covered after 3 years of continuous coverage. | Pre-existing diseases covered after 3 years of continuous coverage. |
| Restore Benefit | |||||
| 100% of base sum insured for you and your family members | 100% of base sum insured for you and your family members | 100% of base sum insured for you and your family members | Not Covered | Not Covered | Not Covered |
| General waiting period | |||||
| 30 days | 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% on base sum insured for every claim free year and up to 100%. Reduced by 50% and up to 100% in case of claim. | 50% on base sum insured for every claim free year and up to 100%. Reduced by 50% and up to 100% in case of claim. | 10% on base sum insured for every claim free year and up to 100%; | 10% on base sum insured for every claim free year and up to 200%. | 25% on base sum insured for every claim free year and up to 200%. |
| Emergency Air Ambulance | |||||
| Not Covered | Not Covered | Covered | Not Covered. | Up to 2 lakhs. | Up to 5 lakhs. |
| Available sum insured options | |||||
| 2 to 5 Lakhs | 3 to 20 Lakhs | 5 to 50 Lakhs | 2 to 5 Lakhs | 7.5 to 15 Lakhs | 20 to 75 Lakhs |
| Policy can be purchased for | |||||
| 1/2/3 years | 1/2/3 years | 1/2/3 years | 1/2/3 Years | 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 | 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 | Renewal for whole life |
| Claims loading | |||||
| No Loading | No Loading | No Loading | Loading | Loading | No Loading |
| Portablity(At the time of renewal) | |||||
| Yes | 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 | Income tax benefit under section 80D |
| Useful Links | |||||
| TATA AIG | HDFC ERGO | |
|---|---|---|
| Claims Settlement Ratio** | 80.61% | 85.97% |
| Number of Lives Covered* | 22,48,000 | 96,05,000 |
| Network Hospitals | 4,000 + | 10,000 + |
| ||
India health insurance tips and tricks to choose the best medical insurance in India
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