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 Health Platinum Enhanced is sold by Aditya Birla and Care Freedom plan is sold by Care. 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 Health Platinum Enhanced is quite comprehensive. It offers considerable protection and it doesn’t impose as many restrictions. However, Care Freedom plan is specifically designed for people suffering from complicated ailments. 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 Health Platinum Enhanced. 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.
Care Freedom plan meanwhile comes from Care’s stable:
Care Health Insurance (formerly Religare Health Insurance) was founded in 2012. And in that time, they’ve managed to corner a large part of the Indian Insurance market.
What’s more impressive?
Care Health Insurance has a remarkable claim settlement ratio of 91.8% and a network of more than 9,400+ hospitals.
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Compare Insurances |  Aditya Birla Activ Health Platinum Enhanced |  Care Care Freedom plan |
|---|---|---|
| Network hospitals | 10,051+ | 9,400+ |
| Claim settlement ratio (avg. of last 3 years) | 87.54% | 91.8% |
| Co-payment | No | 20% |
| Room rent | Any Room | Shared Room |
| Disease sub-limit | No | Yes |
| Pre existing diseases waiting | 3 years | 2 years |
| Pre/Post hospitalization | 60/180 days | 10% of hospitalization expenses |
| No claim bonus | 50% per year (up to 100%) | |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 100% restoration (once for different illness) | 100% restoration (once for different illness after complete exhaustion of sum insured) |
| 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 Activ Health Platinum Enhanced doesn’t impose a mandatory co-payment clause whereas Care Freedom plan imposes a co payment of 20% if you're under the age of 70 and 30% if you're 70 and above.
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 Health Platinum Enhanced lets you stay in Any Room whereas Care Freedom plan lets you stay in a shared room and nothing fancy. 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 Health Platinum Enhanced doesn’t impose a disease wise sub-limit whereas Care Freedom plan imposes disease-wise sub-limits on Knee replacement, Heart diseases, Cerebrovascular disorders.
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 Health Platinum Enhanced imposes a waiting period of 3 years on pre-existing diseases while Care Freedom plan extends a waiting period of 2 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 Health Platinum Enhanced covers expenses incurred 60 days before hospitalization and expenses incurred 180 days post-hospitalization. Meanwhile, Care Freedom plan covers 10% of hospitalization expenses incurred, 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 Health Platinum Enhanced offers a no-claim bonus whereas Care Freedom plan 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 Health Platinum Enhanced offers domiciliary cover. And Care Freedom plan 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 Activ Health Platinum Enhanced covers Ayush treatments whereas Care Freedom plan 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 Health Platinum Enhanced offers maternity cover nor does Care Freedom plan.
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 Health Platinum Enhanced extends coverage for outpatient consultations, nor does Care Freedom plan.
Final Conclusion
If you’re specifically looking to buy a policy for people suffering from complicated ailments, Care Freedom plan makes a lot of sense. 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 Care has to offer, if the policy is made available to you.
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