Oriental Insurance Health of Privileged Elders vs Star Health Red Carpet Senior Citizens
Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Health of Privileged Elders is sold by Oriental Insurance and Red Carpet Senior Citizens is sold by Star Health. So any meaningful comparison should include a comparison of the product alongside the insurers 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.
Let’s start with Health of Privileged Elders. The product comes from Oriental Insurance’s stable:
Oriental Insurance is a government-owned company that offers health, vehicle, business, and farmer insurance. The company is a fully-owned component of the Oriental Government Security Life Assurance Company Ltd.
Now because it is a government-owned insurance firm, you can’t expect operational efficiencies across the board. Although, the company does boast a fairly high claim settlement ratio with over 3,264 network hospitals across the country.
Red Carpet Senior Citizens meanwhile comes from Star Health’s stable:
Star Health Insurance is India's first standalone health insurance firm. And with an army of retail advisors pushing their products across the country, they’ve managed to capture a fair share of the Indian market.
The company also boasts a network of over 14,000+ hospitals and a decent claim settlement ratio of 83%.
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Compare Insurances Insurance Parameters Recommended Not Recommended | ||
---|---|---|
Network hospitals | 3,264 | 14,000+ |
Claim settlement ratio (avg. of last 3 years) | 96% | 83% |
Co-payment | 20% | 30% |
Room rent | Any Room (up to 1% of sum insured) | Any Room (up to 1% of sum insured) |
Disease sub-limit | Yes | Yes |
Pre existing diseases waiting | 2 years | 1 years |
Pre/Post hospitalization | 30/60 days | 30/60 days |
No claim bonus | ||
Domiciliary | ||
Ayush treatments | ||
Restoration benefit | ||
Health check-up | Once every 4 years | Once every year |
Maternity | ||
Out Patient Department | Up to ₹1,000 (cap of ₹200 on each consultation) | |
Day care |
Feature Comparison
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. In this case, however, Health of Privileged Elders imposes a mandatory co-payment of 20% whereas Red Carpet Senior Citizens imposes a mandatory co payment of 30% and 50% for pre existing diseases.
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, Health of Privileged Elders only lets you stay in a room whose rent doesn’t exceed 1% of the sum insured. And Red Carpet Senior Citizens does the same i.e. it only lets you stay in a room whose rent doesn’t exceed 1% of the sum insured.
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, Health of Privileged Elders imposes disease-wise sub-limits on Accident Injury, Knee Replacement, Cardio Vascular Diseases, Chronic Renal Failure, Cancer, Hepato-Biliary Disorders, Chronic Obstructive Lung Diseases, Stroke, Benign Prostrate, Orthopaedic Diseases, Opthalmic Diseases whereas Red Carpet Senior Citizens imposes sub-limits on Heart diseases, Major surgeries
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, Health of Privileged Elders imposes a waiting period of 2 years on pre-existing diseases while Red Carpet Senior Citizens extends a waiting period of 1 years on existing conditions.
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, Health of Privileged Elders covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Red Carpet Senior Citizens covers expenses incurred 30 days before hospitalization and expenses incurred 60 after hospitalization, although there may be different sub-limits
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. In this case, however, Health of Privileged Elders doesn’t offer a no-claim bonus and neither does Red Carpet Senior Citizens.
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, Health of Privileged Elders offers domiciliary cover whereas Red Carpet Senior Citizens doesn’t offer domiciliary protection.
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, Health of Privileged Elders covers Ayush procedures and Red Carpet Senior Citizens also extends coverage for Ayush treatments.
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 Health of Privileged Elders offers maternity cover nor does Red Carpet Senior Citizens.
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, Health of Privileged Elders doesn’t offer OPD protection whereas Red Carpet Senior Citizens offers OPD cover.
Final Conclusion
After considering all the features on hand and the claim settlement ratio of Oriental Insurance, we believe that Health of Privileged Elders is a better alternative to Red Carpet Senior Citizens for most use cases that we’ve evaluated so far.
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