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 Standard is sold by Aditya Birla and Health Insurance Platinum is sold by Edelweiss. 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. Activ Care Standard is specifically designed for senior citizens. However, Health Insurance Platinum is a premium policy built for people who want to leave no stone unturned when it comes to their health. It’s expensive and it does pretty much everything you expect a good policy to do. 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 Activ Care Standard. 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 Insurance Platinum meanwhile comes from Edelweiss’s stable:
Edelweiss Health Insurance company was founded in 2017 when they were hived off the homegrown Edelweiss Financial Services Limited. The company provides an array of products across multiple categories and they boast a claim settlement ratio of almost 94.57% with more than 3,281 network hospitals.
The only problem is - They’re still trying to find a firm foothold in the market.
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Compare Insurances |  Aditya Birla Activ Care Standard |  Edelweiss Health Insurance Platinum |
|---|---|---|
| Network hospitals | 10,051+ | 3,281 |
| Claim settlement ratio (avg. of last 3 years) | 87.54% | 94.57% |
| Co-payment | 20% | No |
| Room rent | Shared Room | Single Private room |
| Disease sub-limit | Yes | No |
| Pre existing diseases waiting | 2 years | 2 years |
| Pre/Post hospitalization | 30/60 days | 90/180 days |
| No claim bonus | 10% per year (up to 50%) | 50% per year (up to 100%) |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 50% restoration (once for different illness) | 100% restoration (once for different illness) |
| Health check-up | Once every year | |
| Maternity | Available (up to ₹2,00,000 after 4 years) | |
| 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 Activ Care Standard imposes a mandatory co-payment of 20% whereas Health Insurance 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, Activ Care Standard only lets you stay in a shared room and Health Insurance Platinum lets you stay in a single private room. 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 Standard imposes disease-wise sub-limits on null whereas Health Insurance 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, Activ Care Standard imposes a 2 year waiting period on pre-existing diseases and Health Insurance Platinum will similarly tell you to wait 2 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, Activ Care Standard covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Health Insurance Platinum covers expenses incurred 90 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, Activ Care Standard offers a no-claim bonus of 10% whereas Health Insurance Platinum offers a no-claim bonus of 50%. 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, Activ Care Standard doesn’t offer domiciliary protection whereas Health Insurance Platinum offers domiciliary cover.
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 Standard doesn’t extend coverage for Ayush treatments whereas Health Insurance Platinum covers 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, however, Activ Care Standard doesn’t offer protection for maternity-related hospitalizations whereas Health Insurance Platinum offers maternity cover.
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 Activ Care Standard extends coverage for outpatient consultations, nor does Health Insurance Platinum.
Final Conclusion
It should be obvious by now. Health Insurance Platinum is packed with features, while Activ Care Standard is specifically meant for senior citizens. But considering Aditya Birla has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that Edelweiss has to offer, if the policy is made available to you.
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