“Comparing Aditya Birla Health Activ One Max and Activ Health Platinum Essentials: Which Plan is Right for You?”

Is it logical to choose the lowest features of health insurance plans instead of comprehensive ones in some situations?

The answer is yes, but it depends on a few situations, like:-

When the applicant’s age is too high

All insurance companies increase the premium of health insurance plans every 2-3 years, citing medical inflation. In some policies, the premium increases even when the age band changes and in some plans, the premium increases every year with the increase in age. In this situation, the premium is more likely too high due to higher age.

Suffering from Chronic Medical Conditions or co-morbid medical conditions

If a person already has some medical condition that is never cured, such as Asthma, Hypertension, Hyperlipidemia, Diabetes etc. In such a situation, the insurance company increases the premium of the policy because the person suffering from these medical conditions has more risk of getting other diseases as compared to a healthy person.

Affordability

In India, affordability issues are common as most Indians are middle-class family background

Insurance Planning should be a very smart decision, So, choose it wisely.

Now, we have the choice of very affordable health insurance exclusively designed for 55 Years and above persons. It is “Aditya Birla’s “Activ Health Platinum Essential Plan” For a better understanding of the features of this plan we are comparing it with Aditya Birla’s Flagship Plan “Activ One Max

Comparison FeaturesActiv One MaxActiv Health Platinum Essential
Entry Age Adults18 years to Any age55 & above (at least one member should be 55 Years)
Tenure1/2/3 Years1/2/3 Years
Family Definition2 Adults and 4 Kids2 Adults and 3 Kids
Cover TypeFamily Floater, Individual & Multi-IndividualFamily Floater, Individual & Multi-Individual
Premium TypeAge BandedEvery Year
Premium 3  ZonesZone I,II & IIIZone I,II & III
Basic Sum Insured7 Lakh to 2 Cr5 Lakh to 2 Cr
Room RentActuals Upto Base Sum Insured upto Any RoomAny Room, Single Room & Shared Room, Premium will vary accordingly
ICU ChargesActuals Upto Base Sum InsuredActuals Upto Base Sum Insured
Road AmbulanceActuals Upto Base Sum Insured per hospitalisationActual through Network Hospital and 3K through Non-Network Hospital
Day Care TreatmentActuals up to Sum InsuredActuals up to Sum Insured
Modern Procedures / TreatmentsActuals up to the Sum Insured for listed proceduresUpto SI for Listed Procedures, but 50% Co-Payment will be applicable for robotic Surgery
HIV / AIDS and STD CoverActuals up to Sum InsuredNot Cover
Mental Illness HospitalizationActuals up to Sum InsuredMaximum 1 Lakh
Obesity TreatmentActuals up to Sum InsuredActuals up to Sum Insured
Pre-Hospitalization Expenses90 Days up to Sum Insured30 Days up to Sum Insured
Post-Hospitalization Expenses180 Days up to Sum Insured60 Days up to Sum Insured
Claim Protect (Non-Medical Expense Waiver)Non-payable items will be covered (all 4 lists of Annexure I)Not Cover
Domiciliary- HospitalizationActuals up to Sum InsuredActuals up to Sum Insured
Home Health CareActuals up to Sum InsuredUpto 50K
AYUSH TreatmentActuals up to Sum InsuredActuals up to Sum Insured
Organ Donor ExpensesActuals up to Sum InsuredNot Cover
Annual Health Check-upCover Listed & CashlessCover Listed & Cashless
Super Reloadfrom 2nd Claims onwards upto Base Sum InsuredNot Cover
Super Credit  (Increases Irrespective of Claim)/ No Claim Bonus100% of SI per year, up to 500% of Base Sum Insured (up to Max of 3 Cr under this benefit)No Claim Bonus  10% upto 100%, will reduce with the same % if claimed
HealthReturnsUpto 100%Upto 50%

Some Important Questions & Answers

Question- Is it covered on an optional basis if a person has Asthma, BP, Cholesterol and Diabetes?

Answer – Yes, these medical conditions are covered on an optional basis and the company charges some extra premium as loading, as per the medical underwriting and chronicity of the person’s complete medical history

Question- Are there any waiting periods on these above medical conditions, if the policy is accepted?

Answer – If hospitalization is accurate for the above-mentioned medical conditions, then no specific waiting periods are applicable.

Question-Is there any sub-limits for specific surgery and treatment?

Answer – There are no sub-limits for specific surgery or treatment for the Activ One Max Plan but sub-limits are applicable for essential plans as per the policy wording.

Question- Is any Co-Payment applicable for the Essential Plan?

Answer- Yes a mandatory 20% Co-payment is applicable for admissible claims in the Essential Plan, but a co-payment waiver rider is available to waive off.

Conclusion

The essentials plan is very much cheaper than any comprehensive plan but fewer features and sub-limits are applicable so choose as per your affordability in your lifetime

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