Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Activ Care Classic is sold by Aditya Birla and Health Gain 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 for very different use cases. Activ Care Classic is built for senior citizens. Health Gain is built for those seeking outpatient coverage. And that means you’re comparing very different products here. So analysis will be tainted by this distinction.
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 Activ Care Classic. The product comes from Aditya Birla’s stable:
The company only began operations in the year 2016 as a subsidiary of Aditya Birla Capital Ltd., which in turn happens to be a joint venture between the famed Aditya Birla Group and MMI Holdings (South Africa).
While the company boasts a claim settlement ratio of 87.54% along with a network of more than 10,051+ hospitals, do remember they’ve only been in the market for a few years now. So they don’t have an extensive track record.
Health Gain 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 13,000+ hospitals and a decent claim settlement ratio of 83.07%.
Talk to IRDAI-certified experts
If you want help with selecting the best health policy tailored to your needs, book a FREE call with our experts today by clicking here.
Compare Insurances |  Aditya Birla Activ Care Classic |  Star Health Health Gain |
|---|---|---|
| Network hospitals | 10,051+ | 13,000+ |
| Claim settlement ratio (avg. of last 3 years) | 87.54% | 83.07% |
| Co-payment | 20% | 20% (if purchased after turning 61) |
| Room rent | Shared Room | Any Room (up to 1% of sum insured) |
| Disease sub-limit | Yes | No |
| Pre existing diseases waiting | 2 years | 4 years |
| Pre/Post hospitalization | 30/60 days | 30/60 days |
| No claim bonus | 10% per year (up to 50%) | |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 100% restoration (once for different illness) | |
| Health check-up | 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. In this case, however, Activ Care Classic imposes a mandatory co-payment of 20% , whereas Health Gain imposes a co-payment clause of 20% if you purchase after turning 61.
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, Activ Care Classic lets you stay in a shared room and nothing fancy whereas Health Gain only lets you stay in a room whose rent doesn’t exceed 1% of the sum insured. In effect, both policies impose restrictions on the kind of room you can pick.
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, Activ Care Classic imposes disease-wise sub-limits on null whereas Health Gain 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. In this case, Activ Care Classic imposes a waiting period of 2 years on pre-existing diseases while Health Gain extends a waiting period of 4 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, Activ Care Classic covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Health Gain 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, Activ Care Classic offers a no-claim bonus whereas Health Gain 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, Activ Care Classic offers domiciliary cover whereas Health Gain 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 Activ Care Classic covers Ayush treatments whereas Health Gain doesn’t extend 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 Activ Care Classic offers maternity cover nor does Health Gain.
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, Activ Care Classic doesn’t offer OPD protection whereas Health Gain offers OPD cover.
Final Conclusion
It should be fairly obvious by now. Activ Care Classic is best suited for senior citizens while Health Gain makes a lot of sense if you are looking to cover those seeking outpatient coverage. However, 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 Aditya Birla has to offer, if the policy is made available to you.
Other Aditya Birla Activ Care Classic Comparisons
Other Star Health Health Gain Comparisons
Select the best plan with our help!
Get in touch to find out what plan works best for you. Zero fuss. Zero spam. Zero charges. Book a call now. Limited slots available!