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Introduction

Before we start comparing these two policies we have to set out some ground rules.

For starters, both policies, Activ Care Premier and Activ Health Platinum Essential are marketed by the same insurance company. So in some ways, a lot of the differences within the product will be limited to the features themselves.

Second, we know that both products are built specifically for senior citizens. So you’ll have to keep that in mind while comparing the two policies.

And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?

That’s something you’ll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.

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Insurance Parameters

Recommended
Not Recommended
Network hospitals
11,000+
11,000+
Claim settlement ratio

(avg. of last 3 years)

95%
95%
Co-payment

10%

20%

Room rent

Single Private room

Any Room

Disease sub-limit

Yes

Yes

Pre existing diseases waiting

2 years

-
Pre/Post hospitalization

30/60 days

30/60 days

No claim bonus

10% per year

(up to 50%)

10% per year

(up to 100%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(once for different illness)

Health check-up
Once every year
Once every year
Maternity
Out Patient Department

Up to ₹2,500

(Annually)

Day care

Feature Comparison

coPay

Co payment

With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. However in this case Activ Care Premier imposes a mandatory co-payment clause of 10% and Activ Health Platinum Essential also follows the same standard by imposing a mandatory co-payment of 20%.

roomRent

Room rent

If the policy does impose room rent restrictions then the insurer may only let you stay in a room of a certain specification or impose a cap on the total room rent. If you were to breach either criterion then the insurance company may ask you to pay a portion of all the expenses you incurred while staying in the room. In this case, Activ Care Premier lets you stay in a single private room and Activ Health Platinum Essential lets you stay in Any Room. In effect, both policies impose restrictions on the kind of room you can pick.

diseaseSublimit

Sub limits

Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, Activ Care Premier imposes disease-wise sub-limits on null whereas Activ Health Platinum Essential imposes sub-limits on Angioplasty, Knee or hip replacement, Cataract, Cholecystectomy

ped

Waiting periods for pre-existing diseases

If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. In this case, Activ Care Premier imposes a waiting period of 2 years on pre-existing diseases while Activ Health Platinum Essential extends a waiting period of null years on existing conditions.

prePost

Pre and post Hospitalization expenses

Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, Activ Care Premier covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Activ Health Platinum Essential covers expenses incurred 30 days before hospitalization and expenses incurred 60 after hospitalization, although there may be different sub-limits

ncb

No claim bonus

Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. And in this case, Activ Care Premier offers a no-claim bonus of 10% and Activ Health Platinum Essential similarly extends a 10% no-claim bonus.

domiciliary

Domiciliary

Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, Activ Care Premier offers domiciliary cover. And Activ Health Platinum Essential also coves domiciliary expenses.

ayush

Ayush treatments

Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case, Activ Care Premier covers Ayush procedures and Activ Health Platinum Essential also extends coverage for Ayush treatments.

maternity

Maternity benefits

If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, neither Activ Care Premier offers maternity cover nor does Activ Health Platinum Essential.

opd

Out Patient Department (OPD)

Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, Activ Care Premier offers OPD cover whereas Activ Health Platinum Essential doesn’t offer OPD protection.

Final Conclusion

After considering all the features on hand, we believe that Activ Health Platinum Essential is a better alternative to Activ Care Premier for most use cases that we’ve evaluated so far.

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