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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. Medi Classic is sold by Star Health and Senior Citizen Mediclaim 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. Medi Classic is quite basic. It offers little protection and it’s a generic policy that anybody could pick off the shelf. However, Senior Citizen Mediclaim is specifically designed for senior citizens. So in many ways, you’re 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 Medi Classic. The product 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%.


Senior Citizen Mediclaim 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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Insurance Parameters

Recommended
Not Recommended
Network hospitals
14,000+
3,139
Claim settlement ratio

(avg. of last 3 years)

83%
99%
Co-payment

10%

(if purchased after turning 61)

No

Room rent

Any Room

(max ₹5,000)

Any Room

(up to 1% of sum insured)

Disease sub-limit

Yes

Yes

Pre existing diseases waiting

3 years

1.5 years

Pre/Post hospitalization

30/60 days

30/60 days

No claim bonus

5% per year

(up to 25%)

5% per year

(up to 30%)

Domiciliary
Ayush treatments
Restoration benefit

200% restoration

(once for different illness)

Health check-up
Once every 4 years
Once every 4 years
Maternity
Out Patient Department
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. In this case, however, Medi Classic requires you to co-pay a part of the bill 10% if you purchase after turning 61 whereas Senior Citizen Mediclaim doesn’t impose a co-payment clause

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, Medi Classic imposes disease-wise sub-limits on Cataracts, Modern Treatments whereas Senior Citizen Mediclaim imposes sub-limits on Appendicectomy, Angiography, Tonsillectomy, Hysterectomy

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, Medi Classic imposes a waiting period of 3 years on pre-existing diseases while Senior Citizen Mediclaim extends a waiting period of 1.5 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, Medi Classic covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Senior Citizen Mediclaim 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, Medi Classic offers a no-claim bonus of 5% and Senior Citizen Mediclaim similarly extends a 5% 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, neither Medi Classic offers domiciliary cover nor does Senior Citizen Mediclaim

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, Medi Classic covers Ayush procedures and Senior Citizen Mediclaim 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 Medi Classic offers maternity cover nor does Senior Citizen Mediclaim.

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, neither Medi Classic extends coverage for outpatient consultations, nor does Senior Citizen Mediclaim.

Final Conclusion

If you’re specifically looking to buy a policy for senior citizens, Senior Citizen Mediclaim makes a lot of sense. But considering Star Health has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that New India Assurance has to offer, if the policy is made available to you.

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