HDFC Ergo myHealth Koti Suraksha vs HDFC Ergo myHealth Suraksha Platinum
Introduction
Before we start comparing these two policies we have to set out some ground rules.
For starters, both policies, myHealth Koti Suraksha and myHealth Suraksha Platinum 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 have massive differences in their core structure. myHealth Koti Suraksha is quite basic. It offers little protection and may not be entirely suitable if you are looking for robust protection. However, myHealth Suraksha Platinum is more comprehensive. It covers a lot more use cases and doesn’t have any egregious conditions. So fundamentally, they’re two very different products.
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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Compare Insurances Insurance Parameters Recommended Not Recommended | ||
---|---|---|
Network hospitals | 12,500+ | 12,500+ |
Claim settlement ratio (avg. of last 3 years) | 98% | 98% |
Co-payment | 20% | No |
Room rent | Single Private room | Any Room |
Disease sub-limit | Yes | No |
Pre existing diseases waiting | 3 years | 3 years |
Pre/Post hospitalization | 60/180 days | 60/180 days |
No claim bonus | 10% per year (up to 100%) | 25% per year (up to 200%) |
Domiciliary | ||
Ayush treatments | ||
Restoration benefit | 100% restoration (once for any illness) | |
Health check-up | Once every year | Once every year |
Maternity | ||
Out Patient Department | ||
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. However in this case myHealth Koti Suraksha if purchased after turning 61 or during PED Waiting Period whereas myHealth Suraksha Platinum doesn’t impose a mandatory co-payment clause.
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, myHealth Koti Suraksha only lets you stay in a single private room but you can pick any room you want with myHealth Suraksha Platinum.
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, myHealth Koti Suraksha imposes disease-wise sub-limits on Cataract, Benign - Tumours/Cysts/Nodule/Polyp, Stone in Urinary System, Hernia Related, Appendectomy, Hysterectomy whereas myHealth Suraksha Platinum doesn’t impose a disease wise sub-limit.
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. This cooling period is referred to as the Pre-existing-disease waiting period. In this case, myHealth Koti Suraksha imposes a 3 year waiting period on pre-existing diseases and myHealth Suraksha Platinum will similarly tell you to wait 3 years before making a claim related to your pre-existing diseases
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, myHealth Koti Suraksha covers expenses incurred 60 days before hospitalization and expenses incurred 180 days post-hospitalization. Meanwhile, myHealth Suraksha Platinum covers expenses incurred 60 days before hospitalization and expenses incurred 180 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, myHealth Koti Suraksha offers a no-claim bonus of 10% whereas myHealth Suraksha Platinum offers a no-claim bonus of 25%. And the no-claim bonus may be capped at different levels too.
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, myHealth Koti Suraksha offers domiciliary cover. And myHealth Suraksha Platinum also coves domiciliary expenses.
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, myHealth Koti Suraksha covers Ayush procedures and myHealth Suraksha Platinum 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 myHealth Koti Suraksha offers maternity cover nor does myHealth Suraksha Platinum.
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 myHealth Koti Suraksha extends coverage for outpatient consultations, nor does myHealth Suraksha Platinum.
Final Conclusion
After considering all the features on hand, we believe that myHealth Suraksha Platinum is a better alternative to myHealth Koti Suraksha for most use cases that we’ve evaluated so far.
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