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.
