Executive Summary: The restore/refill/recharge benefit and the no claim bonus/ multiplier benefit are unique features of some of the existing health insurance plans today. Max Bupa’s Health Companion plan, Apollo Munich’s Optima Restore plan and Religare’s Care Health Insurance plan are some such health insurance options which have been compared in this article. Each of the plans also has certain benefits over the other. One’s individual needs and situation would determine which of the three policies to opt for.
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The market today is flushed with options for health insurance. It is often witnessed that clients are confused as to which plan to choose, as the features are more or less the same across plans. While claim settlement and premium charged are important factors to be considered, it is sometimes the additional / unique features which distinguish a health plan. Three such health insurance plans have been compared – Max Bupa’s Health Companion plan, Apollo Munich’s Optima Restore plan and Religare’s Care Health Insurance plan. The following are the features of these three plans:
Parameter |
Max Bupa’s Health Companion Family Floater Plan |
Apollo Munich’s Optima Restore Plan |
Religare’s Care Health Insurance Plan
|
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Coverage
|
Self, spouse, upto 4 children*
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Self, spouse, dependent children, dependent parents / parents in law ( Max of 2 adults & 5 children, upto 6 members in a single policy)
|
Self, spouse, dependent children,
|
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Variant available
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3 variants, with different sum insured options
|
Not available
|
4 options with different sum insured options & benefits; Can either opt for Normal Care Policy or Super No Claim Bonus Policy
|
|
Entry age
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91 days
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91 days – 65 years
|
91 days
|
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Maximum Renewal Age
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Lifelong renewal
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Lifelong renewal
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Lifelong renewal
|
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Sum Insured
Options |
Variant1: Rs. 2, 3 & Rs.4 Lakhs
Variant2: Rs. 5, 7.5, 10 & Rs. 12.5 Lakhs Variant3: Rs. 15, 20, 30, 50 Lakhs & 1 Crore |
Rs. 3, 5, 10, 15, 20, 25, 50 Lakhs
|
Option 1: Rs. 3, 4 Lakhs
Option 2: Rs. 5, 7, 10 Lakhs Option 3: Rs. 15, 20, 25 Lakhs Option 4: Rs. 50, 60, Lakhs |
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Premium (Rs. 10 Lakhs cover for self, spouse & 2 Children )
|
Rs. 18,087 for 1 year
Rs. 34,113 for 2 year |
Rs. 19,184 for 1 year
Rs. 37,774 for 2 year |
1 year
Rs.17,339 for Care Rs.19,073 for Super No Claim Bonus 2 year Rs.32,17,339 for Care Rs.35, 285 for Super No Claim Bonus |
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Top up & Deductible
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Available: Deductible options of Rs. 1, 2, 3, 4, 5 Lakhs
|
Not available
|
Not available
|
|
Pre hospitalization coverage
|
30 days
|
60 days
|
30 days
|
|
Post hospitalization coverage
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60 days
|
180 days
|
60 days
|
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Pre existing diseases coverage
|
Variant 1 : 48 months
Variants 2 & 3 : 36 months |
3 years
|
4 years
|
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Day care treatment
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Available
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Available
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Available
|
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Refill / Restore benefits
|
Available
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Available
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Available
|
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Conditions for refill / restore/auto recharge
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Additional sum insured equal to base. Sum insured is available for a subsequent claim in the same year.provided is for an unrelated illness.
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Automatic re-instatement of basic sum insured, if the basic sum insured and multipier benefit have been exhausted during the policy year.
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Entire sum insured is recharged at no extra cost.
Recharge can be used for future claims and not against an illness for which claim has already been made in a policy year. |
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Medical tests
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Necessary. For sum insured upto Rs.4 lakhs , applicant needs to bear 50% of expenses
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Necessary
|
Necessary after purchase if the member insured is > 45 years or sum insured is >= Rs. 15 lakhs
|
|
Alternative medicine cover
|
Available for Ayurveda, Unani, Siddha and homeopathy upto Base Sum Insured
|
Not available
|
Not available
|
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No Claim Bonus / Multiplier Benefit
|
20 % increase in Sum Insured, up to 100 % of Base Sum Insured for every claim free year.
In the case of claim, the accumulated bonus does not get reduced |
Bonus of 50 % of the basic sum insured for every claum free year, maximum up to 100 %.
In the case of claim, bonus reduced by 50 % of Sum Insured at renewal. |
Super No Claim Plans: Bonus of 50% of the sum insured every year for claim free year, up to 100%
Other Plans: Bonus of 10 % of the sum insured every year for claim free year, upto 50% In the case of claim, accumulated bonus is reduced by 10 % |
|
Complementary health checkup
|
Variant 1 : Available once in 2 years
Variant 2 & 3 : Available annually. |
Available only if sum insured is > 15 lakhs; availbale upto 1 % of sum insured once in 2 years.
|
Available every year.
|
|
Discount on Premium
|
12.5 % if policy is taken for 2 years
|
7.5 % if policy is taken for 2 years
|
7.5 % if policy is taken for 2 years
|
|
Hospital cash
|
Available up to 30 days of hospitalization.
|
Daily cash available if shared accomodation is opted for
|
Option 1 : Rs. 500 per day up to 5 days.
Options 2 – 4 : Not available. |
|
Domiciliary Treatment
|
Available
|
Available
|
Available up to 10% of sum insured
|
|
Cashless Facility
|
Available at network hospitals
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Available on pre authorization
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Available at network hospitals
|
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Other Conditions
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Some conditions are covered only after 24 months waiting period.
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Some conditions are covered only after 2 years waiting period
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No co-payment if insured is less than 61 years at the time of 1st buy or if policy of Rs. 3 or 4 lakhs is chosen. Other cases co – payment is applicable.
|
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Coverage and other additional benefits
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In patient hospitalization, hospital accommodation ( without cap on room rent charges). day care treatments, emergency ambulance, organ transplant, vaccination for animal bites.
|
In patient hospitalization, day care treatments, emergency ambulance, organ transplant,
second opinion from a medical practitioner in case of critical illness ( once a year ) , up to 10 % discount at apollo pharmacies, access to online health risk assessment tool and monthly health newsletter. |
In patient hospitalization, ambulance and organ donor expenses, ICU charges, room rent,
second opinion ( for option2 – 4 ) |
|
Link to policy website
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* Option to include parents and extended family under the Family First option
Which plan should be opted for? As seen in the above table, the policies have their own unique features. To briefly state the benefits of one plan over the other, Max Bupa’s Health Companion plan has a larger option for Sum Insured, has no maximum age for entry and renewal, has a top up option, covers alternative medicine, has a higher frequency of complimentary health checks, gives a higher discount if the policy is taken for 2 years and offers hospital cash irrespective of type of accommodation. Apollo Munich’s Optima Restore plan has a higher time period for covering pre and post hospitalization expenses, offers free second opinion for critical illnesses, offers discount at Apollo pharmacies and gives one access to online health tools and newsletters. Religare’s Care plan has no maximum entry age, has a high no claim bonus option (for a Super No Claim plan) and offers a higher frequency of complimentary health check up. As regards the premium, it is slightly lower for the Care plan compared to the other two plans for the same Sum Insured. All the plans offer Restore Benefit and a No Claim benefit (although known by different terminologies). However, the multiplier benefit is higher in the case of Optima Restore. On the other hand, for the Health Companion plan, the accumulated bonus does not get reduced even if there is a claim, unlike the Optima Restore plan. If one opts for the Super No Claim Bonus option of the Religare Care plan, the bonus component is high in this case as well. However, in this plan, co-payment is sometimes applicable depending on the age of the insured and the sum insured option.
Which plan should be opted for? As seen in the above table, the policies have their own unique features. To briefly state the benefits of one plan over the other, Max Bupa’s Health Companion plan has a larger option for Sum Insured, has no maximum age for entry and renewal, has a top up option, covers alternative medicine, has a higher frequency of complimentary health checks, gives a higher discount if the policy is taken for 2 years and offers hospital cash irrespective of type of accommodation. Apollo Munich’s Optima Restore plan has a higher time period for covering pre and post hospitalization expenses, offers free second opinion for critical illnesses, offers discount at Apollo pharmacies and gives one access to online health tools and newsletters. Religare’s Care plan has no maximum entry age, has a high no claim bonus option (for a Super No Claim plan) and offers a higher frequency of complimentary health check up. As regards the premium, it is slightly lower for the Care plan compared to the other two plans for the same Sum Insured. All the plans offer Restore Benefit and a No Claim benefit (although known by different terminologies). However, the multiplier benefit is higher in the case of Optima Restore. On the other hand, for the Health Companion plan, the accumulated bonus does not get reduced even if there is a claim, unlike the Optima Restore plan. If one opts for the Super No Claim Bonus option of the Religare Care plan, the bonus component is high in this case as well. However, in this plan, co-payment is sometimes applicable depending on the age of the insured and the sum insured option.
Get well soon !
Which of the three policies one chooses depends on his/her individual needs and situation. If one needs a higher sum insured or a top up option, he can opt for the Health Companion plan. On the other hand, if one views the benefits of Optima Restore plan or Care plan as useful, then these can be opted for.
The author can be reached at [email protected]
The author can be reached at [email protected]
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