Niva Bupa Health Premia Silver vs New India Assurance Premier Mediclaim Plan
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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 Premia Silver is sold by Max Bupa and Premier Mediclaim Plan is sold by New India Assurance. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.
Second, we know that both products have massive differences in their core structure. Health Premia Silver is a premium policy tailored to cover as many use cases as possible. However, Premier Mediclaim Plan is quite basic. It offers little protection and may not be entirely suitable if you are looking for robust protection. So in all honesty, you are comparing apples and oranges here.
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 Premia Silver. The product comes from Niva Bupa (erstwhile Max Bupa)’s stable:
Founded in 2008, Niva Bupa (erstwhile Max Bupa) is one of the leading health insurance companies in India. While they have had a bit of a tumultuous time with their promoters, they still sell an impressive suite of products across multiple categories.
And they also boast a claim settlement ratio of 91%, with a network of more than 10,000+ hospitals.
Premier Mediclaim Plan meanwhile comes from New India Assurance’s stable:
New India Assurance, is a government-owned insurance firm that was established in 1919. Their insurance portfolio includes Health, Motor, Travel, and Marine products. But despite being in the business for so long, they’re not the most efficient when it comes to processing your application and dealing with your claims.
And that means, even with a relatively high claim settlement ratio and 3,139 network hospitals, the company isn’t exactly a stellar performer.
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Compare Insurances Insurance Parameters Recommended Not Recommended | Health Premia Silver | Premier Mediclaim Plan |
|---|---|---|
| Network hospitals | 10,000+ | 3,139 |
| Claim settlement ratio (avg. of last 3 years) | 91% | 99% |
| Co-payment | No | No |
| Room rent | Any Room (Except suite) | Any Room |
| Disease sub-limit | No | Yes |
| Pre existing diseases waiting | 2 years | 3 years |
| Pre/Post hospitalization | 90/180 days | 60/90 days |
| No claim bonus | 10% per year (up to 100%) | |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 100% restoration (once for any illness) | |
| Health check-up | Once every year | |
| Maternity | Available (up to ₹40,000 after 2 years) | Available (up to ₹50,000 after 3 years) |
| Out Patient Department | Up to ₹5,000 (Annually) | |
| 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 Premia Silver doesn’t impose a co-payment clause. And neither does Premier Mediclaim Plan.
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, however, Health Premia Silver only lets you pick a room so long as it isn’t a Suite room but you can pick any room you want with Premier Mediclaim Plan .
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 Premia Silver doesn’t impose a disease wise sub-limit whereas Premier Mediclaim Plan imposes disease-wise sub-limits on Cataracts, Modern treatments.
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 Premia Silver imposes a waiting period of 2 years on pre-existing diseases while Premier Mediclaim Plan extends a waiting period of 3 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 Premia Silver covers expenses incurred 90 days before hospitalization and expenses incurred 180 days post-hospitalization. Meanwhile, Premier Mediclaim Plan covers expenses incurred 60 days before hospitalization and expenses incurred 90 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 Premia Silver offers a no-claim bonus whereas Premier Mediclaim Plan doesn’t offer a no-claim bonus.
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 Premia Silver offers domiciliary cover whereas Premier Mediclaim Plan 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 Premia Silver covers Ayush procedures and Premier Mediclaim Plan 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, Health Premia Silver offers maternity cover and Premier Mediclaim Plan offers maternity cover too, although the sub-limits for normal delivery and C-section procedures may be different, including the waiting period.
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 Premia Silver doesn’t offer OPD protection whereas Premier Mediclaim Plan offers OPD cover.
Final Conclusion
Since this isn’t a fair comparison, to begin with, we will only tell you this much. If you want something that’s affordable, you could go for Premier Mediclaim Plan. However, if you want top-class protection, then it’s a no brainer, Health Premia Silver is your go-to option.
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