Aditya Birla Activ Health Platinum Essential vs National Insurance National Senior Citizen Mediclaim policy
VS
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 Essential is sold by Aditya Birla and National Senior Citizen Mediclaim policy is sold by National Insurance. 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 Essential is quite basic. It offers little protection and it’s a generic policy that anybody could pick off the shelf. However, National Senior Citizen Mediclaim policy is specifically designed for senior citizens. 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 Essential. 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.
National Senior Citizen Mediclaim policy meanwhile comes from National Insurance’s stable:
National Insurance is the country's oldest general insurance firm and is wholly owned by the Government of India. That means, despite a claim settlement ratio of 94.14% and over 7,012 network hospitals it can be a bit difficult to reach the insurer when you need them the most. Perhaps due to the fact that they are still a public sector enterprise.
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 Health Platinum Essential | National Insurance National Senior Citizen Mediclaim policy |
|---|---|---|
| Network hospitals | 10,051+ | 7,012 |
| Claim settlement ratio (avg. of last 3 years) | 87.54% | 94.14% |
| Co-payment | 20% | No |
| Room rent | Single Private Room | Any Room (up to 1% of sum insured) |
| Disease sub-limit | Yes | No |
| Pre existing diseases waiting | 4 years | 2 years |
| Pre/Post hospitalization | 30/60 days | 30/60 days |
| No claim bonus | 10% per year (up to 100%) | 5% per year (up to 50%) |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | ||
| 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. In this case, however, Activ Health Platinum Essential imposes a mandatory co-payment of 20% . And National Senior Citizen Mediclaim policy doesn’t impose a 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, Activ Health Platinum Essential lets you stay in Single Private Room. And National Senior Citizen Mediclaim policy does the same i.e. it only lets you stay in a room whose rent doesn’t exceed 1% of the sum insured.
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 Essential imposes disease-wise sub-limits on Angioplasty, Knee replacement, Cataract whereas National Senior Citizen Mediclaim policy 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 Health Platinum Essential imposes a waiting period of 4 years on pre-existing diseases while National Senior Citizen Mediclaim policy 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 Essential covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, National Senior Citizen Mediclaim policy 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 Health Platinum Essential offers a no-claim bonus of 10% whereas National Senior Citizen Mediclaim policy offers a no-claim bonus of 5%. 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 Health Platinum Essential offers domiciliary cover. And National Senior Citizen Mediclaim policy 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 Essential doesn’t extend coverage for Ayush treatments whereas National Senior Citizen Mediclaim policy 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, neither Activ Health Platinum Essential offers maternity cover nor does National Senior Citizen Mediclaim policy.
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 Essential extends coverage for outpatient consultations, nor does National Senior Citizen Mediclaim policy.
Final Conclusion
If you’re specifically looking to buy a policy for senior citizens, National Senior Citizen Mediclaim policy 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 National Insurance has to offer, if the policy is made available to you.
Other Aditya Birla Activ Health Platinum Essential Comparisons
Other National Insurance National Senior Citizen Mediclaim policy 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!