HDFC Ergo Optima Secure or Aditya Birla Health Activ One: Which Health Insurance Policy Offers Better Coverage?

health insurance plan comparison in this article HDFC Ergo health insurance’s flagship plan “HDFC Optima Secure ” and Birla Health Insurance’s newly launched plan “Activ One Max”, the features of both the plans are good and claim settlement is also good. It will depend on the individual customer which one to prefer. In this article helps to decide which one is better for them.

Sr. No	Basis of Comparison	HDFC Ergo Optima Secure	Aditya Birla Health- Activ One Max
1	Entry Age Adult	Minimum 18 Years & Maximum No Capping	Minimum 18 Years & Maximum No Capping
2	Entry Age Child	91 Days to 25 years	91 Days to 25 years
3	Family Floater Combination	2 Adults + 3 Kids	2 Adults & 4 Kids, Self, legally married spouse OR live-in partner (same or opposite sex),dependent Children (Natural/legally adopted)
4	Multi-Individual Combination	2 Adults & 4 Kids, Self, legally married spouse OR live-in partner (same or opposite sex), dependent Children (Natural/legally adopted)	Self, legally married spouse OR live-in partner (same or opposite sex), son, daughter, brother, sister, grandson, granddaughter, son-in-law, daughter-in-law, brother-in-law, sister-in-law, nephew, niece, parents and parents-in-law
5	Base Sum Insured offer	10 Lakh to 2 Cr (Family Floater, Individual and Multi-Individual)	10 Lakh to 2 Cr (Family Floater, Individual and Multi-Individual)
6	Room Type	Any Room	For any Room, Single Pvt AC Room and Shared Room, the premium will vary depending upon the room type selection
7	ICU Coverage	Upto Base Sum Insured and Earned NCB	Upto Base Sum Insured and Earned Super Credit
8	Road Ambulance	Upto Base Sum Insured and Earned NCB	Upto Base Sum Insured and Earned Super Credit
9	Modern/Advance Medical Treatment	Upto Base Sum Insured and Earned NCB	Upto Base Sum Insured and Earned Super Credit
10	HIV/AIDS and STD Coverage	Upto Base Sum Insured and Earned NCB	Upto Base Sum Insured and Earned Super Credit
11	Mental Illness Hospitalisation	Upto Base Sum Insured and Earned NCB	Upto Base Sum Insured and Earned Super Credit
12	Obesity Treatment	Upto Base Sum Insured and Earned NCB	Upto Base Sum Insured and Earned Super Credit
13	Pre-Hospitalisation	60 days before the Hospitalization	90 days before the Hospitalization
14	Post-Hospitalisation	180 days after the discharge from the Hospital	180 days after the discharge from the Hospital
15	Non-Medical Expenses Waiver	Only Annexure A is Covered	Non-payable items will be covered, all 4 lists prescribed by IRDA and include 146 items that are defined by IRDA as non-medical Expenses Waiver
16	Domiciliary Hospitalisation	Yes, up to the Sum Insured / earned NCB with some terms and conditions	Yes, up to the Sum Insured / earned Super Credit with some terms and conditions
17	Home Care Treatment	Not Available	the insurance company will provide AYUSH Treatment for inpatient hospitalisation and AYUSH Day Care Treatment, up to the sum insured and earn NCB
18	AYUSH Treatment	The insurance company will provide AYUSH Treatment for inpatient hospitalisation and AYUSH Day Care Treatment, up to the sum insured and earn NCB	The insurance company will provide AYUSH Treatment for inpatient hospitalisation and AYUSH Day Care Treatment, up to sum insured and earn Super Credit
19	Organ Donar Expenses	The company pays the expenses for organ donor treatment procedures only for harvesting and the below is not cover:- pre-post hospitalization of the donor, organ transportation & preservation and any medical complications of the donor	The company pays the expenses for organ donor treatment procedures only for harvesting and the below is not cover:- pre-post hospitalization of the donor, organ transportation & preservation and any medical complications of the donor
20	Annual Health Checkups	Family Floater policies limits will be for 5 Lakh SI Rs.2500, 10 Lakh SI Rs. 5000, 15 Lakh SI Rs. 8000, for 20,25 and 50 Lakh SI Rs. 10000 and 1 Cr & 2 Cr SI Rs. 15000 per policy year after 1st renewal of the policy, only on Reimbursement basis	Yes, available on a cashless pre-design package and it will vary upon the base sum insured, from day 1 of policy issuance per year for all 18 years and above members
21	Super Reload	As an Optional Cover, if opted will work 2X of Base Sum Insured from 1st Claim	Yes, unlimited times up to Base SI, per hospitalisation for all insured members
22	Super Credit / No Claim Bonus	100% upto 400%	100% of Basic Sum Insured up to 500%, irrespective of claim
23	Chronic Medical Conditions Coverage	Not Available	Asthma, BP, Cholesterol, Diabetic-Type -II, COPD, Obesity and PTCA are done before one year, but keep in mind it there will be very stringent medical underwriting before issuance of this policy, once issuance is done, coverage starts from Day 1 for these conditions
24	Health Returns	Not Available	This is very popular across the industry that company allowed to discount 100% on their net premium every year
25	Maternity Cover	Not Available	Not Available
26	Zonal Premim Applicability	Yes, Urban (Zone-I), Semi-Urban (Zone-II) and Rural (Zone-III), premiums will be lower for lower Zones	Yes, Urban (Zone-I), Semi-Urban (Zone-II) and Rural (Zone-III), premiums will be lower for lower Zones
27	PED Waiting Periods	36 Months	36 months, except for the Chronic Medical Conditions, mentioned in point no-23
28	Specific Surgery Waiting Periods	24 months, for listed specific surgery / procedures	24 months, for listed specific surgery/procedures
29	Premium Payment Options	1 year, 2 years with 7.5% discount for both years and 3 years with 10% discount for all three years	1 year, 2 years with 7.5% discount for both years and 3 years with 10% discount for all three years
30	Day Care	Cover for all listed Day Care up to SI and Earn NCB	Cover for all listed Day Care up to SI and Earn Super Credit
31	After 5 renewals Policy Sum Insured	4 times of Sum Insured	6 times of Sum Insured for lifetimes
32	Premium waiver	Not Available	Inbuilt for Listed 20 Critical Illnesses, which diagnosed for any Adults Member, next year renewal premium will be waived
33	Hospital Cash	In Optional Basis only	In Optional Basis only
34	Customer Review	4.7 by InsuranceDekho,	4.7 by InsuranceDekho

Conclusion: After a detailed comparison between the two plans we can say both plans are good in the industry, but for buying health insurance plans, we will consider various factors life claim settlement ratio (it will be changing time to time), Smoothness of Claim Process ( it will be got though the real experience by the customer only), Premium is also an important factor, nowadays due to heavy claim ratios of Insurance company, they are increasing the premiums from time to time, so it will also be considerable. For more personal consultation, please contact us.

Disclaimer: all the above information mentioned on the professional experience and insurance company multiple product literature.