Aditya Birla
Activ Health Platinum Essential
Activ health platinum essential is fairly economical and it does an okay job. But once you're hospitalized, they'll make you split the bill, they might not offer the full cover for some treatments and they'll make you wait 3 years before covering complications arising out of pre-existing illnesses.
What's good here?
Restrictions on the rooms you can pick and much more
When selecting the policy you were probably asked about your choice of room. It could have been a single private room, a shared room or even a general ward. And so long as you stay in a room you picked at the time, it’s all good. But if you picked one room and then opted to stay in a more expensive room, then you’ll have to co-pay a part of the bill. Read more here
When selecting the policy you were probably asked about your choice of room. It could have been a single private room, a shared room or even a general ward. And so long as you stay in a room you picked at the time, it’s all good. But if you picked one room and then opted to stay in a more expensive room, then you’ll have to co-pay a part of the bill. Read more here
Reasonable waiting period for pre-existing diseases
If you are already dealing with Asthma, Hypertension, Hyperlipidemia, Diabetes, then the insurer will cover you from day 1. However, if you are dealing with other pre-existing diseases including thyroid, kidney stones, etc., then you’ll have to wait 3 years before they start covering these complications.
Day Care treatments covered
If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.
Full coverage even if you are forced to hospitalize at home
The insurer will bear the costs even if you are hospitalized at home due to a condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.
Pre & Post hospitalization expenses covered
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Free Health Checkups every year
If you’re planning on getting a full body checkup every year just to make sure you’re in fine working condition, the insurer will cover the costs.
Covers Alternative Medicine
Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.
What's bad here?
Has disease wise sub-limits
Your insurance cover won’t be fully available in case you are treated for Angioplasty, Knee or hip replacement, Cataract, Cholecystectomy and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
Your insurance cover won’t be fully available in case you are treated for Angioplasty, Knee or hip replacement, Cataract, Cholecystectomy and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
You will have to pay a portion of the bill
The policy will only cover 80% of the final bill. The rest is on you. They call this a co-payment.
The policy will only cover 80% of the final bill. The rest is on you. They call this a co-payment.
What's okay here?
Special Bonus for being healthy and not claiming insurance
Your sum insured increases by 10% each year, so long as you make no claims during this period. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 100%. Also, the bonus amount will reduce at same rate each time you make a claim. But hey, it's still a bonus.
Your sum insured increases by 10% each year, so long as you make no claims during this period. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 100%. Also, the bonus amount will reduce at same rate each time you make a claim. But hey, it's still a bonus.
What's lacking here?
No Restoration Benefit
Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.
Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.
Add-ons
Future Secure
With this add-on, the insurer will increase your cover in line with inflation every year, your bonus amount will not be affected if the claim is less than 25% of base sum insured in the entire year and you also get extended coverage for generally excluded items like syringes, gloves, PPE kits etc.
Hospital Cash
The insurer pays a lumpsum by adding a fixed sum (daily cash) every day until the day of discharge so you can deal with any potential loss in income during this time. The money will be reimbursed to you after you submit the required documents post-discharge, and while this looks like a neat benefit to have, we don’t recommend it since the benefit doesn’t compensate for the extra premium you pay.
International
With this paid add-on benefit, the insurer gives coverage for planned treatments abroad up to a specified limit.
Room Modifier
With this add-on, the insurance company modifies the room rent restriction and lets you choose between Shared Room, Single Private Room or Any Room.
Cancer Booster
With this add-on, the insurance company will give additional coverage up to 100% of Sum Insured for medical expenses linked to Cancer of Specified Severity.
Tele-OPD Consultation
With this add-on, the insurance company provide coverage for teleconsultation from network facilities.
OPD
With this add-on, you can get coverage for outpatient along with coverage for prescribed diagnostics and pharmacy upto defined limits based on the amount chosen for the OPD coverage.
Critical Illness
With this add-on, you get a lump sum payment in the event you are diagnosed with critical illnesses such as ike cancer, open heart replacement, kidney failure, stroke, organ transplant, etc.
Personal Accident cover
With this add-on, the insurance company will payout a lumpsum amount based on the cover chosen, in case the selected insured member of the policy passes away in an accident.
Waiver of Mandatory co-payment
With this add-on, you get the mandatory co-payment waived off.
Vaccine Cover
With this add-on, the insurance company provides coverage against vaccination for diseases declared as pandemic or epidemic up to specified limits per insured person.
Frequently Asked Questions
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