Overview
The Aditya Birla Activ Care Classic plan is a health insurance policy designed for individuals aged 55 to 80 years, offering sum insured options from ₹3 lakhs to ₹10 lakhs. It covers inpatient hospitalization, pre- and post-hospitalization expenses (30 and 60 days), 586 daycare treatments, and organ donor expenses up to 50% of the sum insured. The plan includes a personal health coach (for SI 5L & above), home nursing benefits as an ptional add-on (maximum up to 1,500/day for 15 days per policy year), and coverage for domiciliary hospitalization (up to 10% of SI). Additionally, it provides a no-claim bonus of up to 10% per annum (max up to 50% of Base SI).
Experts Review
Written by Nikhil Nair
Senior Writer
The Aditya Birla Activ Care Classic plan is an excellent choice for senior citizens seeking comprehensive coverage with features catering to their specific healthcare needs. The standout benefit is the short waiting period of two years for pre-existing conditions, which is particularly advantageous for individuals managing chronic illnesses like diabetes or hypertension. Coverage for 586 daycare procedures ensures financial support for minor treatments requiring less than 24-hour hospitalization. The inclusion of cashless home care treatment and domiciliary hospitalization enhances convenience, especially for seniors preferring treatment at home.
The plan also offers unique features like nursing at home (₹1,500/day for 15 days) and portable medical equipment coverage, which are valuable additions for elderly care available as optional add-ons. HealthReturns™ rewards incentivize active lifestyles by offering up to 21% of the premium back based on fitness activities.
That said, the plan has limitations. Room rent is restricted to shared accommodations, which may limit comfort during hospitalization. The plan also has a co-payment clause of 20% and comes with disease-wise sub-limits. Additionally, premiums can escalate significantly with optional add-ons like advanced health check-ups or lifestyle equipment coverage.
Pros
Insurer has a solid track record with great claim and service metrics.
Cons
Not very feature-rich.
Premiums are relatively high.
Maternity benefits not offered, which is a notable gap.
Doctor consultations are not covered, which could be a drawback for some. Need to opt add-on for doctor consultations.
Aditya Birla
Key Insights
Founded
2016
Aditya Birla was established 9 years ago, making it a relatively new entrant with a developing track record.
Claims Experience
95% claims settled in 30 Days
Aditya Birla settles 95% of all claims it receives demonstrating strong credibility.
Network Hospitals
12,000+
Aditya Birla has a strong network with over 12,000 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
22 complaints per 10,000 claims registered
Aditya Birla experiences a moderate number of complaints, indicating room for improvement in addressing customer concerns.
Features
All
Great
Good
Bad
Co-payment
The policy will only cover 80% of the final bill. The rest is on you. They call this a co-payment.
Room Rent
Tough luck if you are thinking about opting for a single private room. Because the policy only lets you stay in a shared room. If you still want to pick a better room, then be ready to pay a lot more when the final bill shows up.
Customisable
Change Shared Room to Single Private Room.
Disease sub-limit
Your insurer won’t bear the full costs if you are treated for Heart diseases, Cancer, cataract, breakage of bones and a few other complications. In fact, you will have to bear 20% of the cost in the event you are hospitalized for these illnesses.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after just 2 years. It’s probably the best deal you can get to be honest.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Add-ons
Future Secure
Recommended
Cover increases in line with inflation, consumables covered, and No Claim Bonus is protected if total claim amount is less than 25% of sum insured.
Advanced Health Check-up
Recommended
Get additional tests like Mammography, PAP smear, Thyroid function test, TMT, Chest X ray and Sonography Abdomen, etc on cashless basis.
Room Modifier
Recommended
Change Shared Room to Single Private Room.
Cancer Booster
Get additional coverage up to 100% of Sum Insured for medical expenses linked to Cancer of Specified Severity.
Tele-OPD Consultation
Each insured member can get unlimited e-consultations from General Physicians.
Nursing at home
Get a certain amount each day for medical services of a nurse at residence for a maximum of 15 days post hospitalization.
Lifestyle support equipment
Get coverage for expenses of Lifestyle support equipment like ICU bed, wheelchair, walker, belts, collars, etc as per the written recommendation of your doctor.
Portable medical equipment
Get coverage for expenses of portable medical equipment like oxygen cylinders, ventilators, CPAP etc as per the written recommendation of your doctor.
Vaccine Cover
Get coverage against vaccination for diseases declared as pandemic or epidemic up to specified limits per insured person.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Parkinson disease
Venereal disease, all sexually transmitted disease or Illness including but not limited to HPV, Genital Warts, Syphilis, Gonorrhoea, Genital Herpes, Chlamydia, Pubic Lice and Trichomoniasis.
“AIDS” (Acquired Immune Deficiency Syndrome) and/or infection with HIV (Human Immunodeficiency Virus) including Opportunistic infections but not limited to any conditions related to or arising out of HIV/AIDS such as ARC (AIDS Related Complex), Lymphomas in brain, Kaposi’s sarcoma, tuberculosis, Pneumocystis Carinii Pneumoniae etc.
Use of Radio Frequency (RF) probe for ablation or other procedure unless specifically approved by Us in writing in advance.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Cataract
Glaucoma
Refractive Error Correction
Sinusitis
Rhinitis
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
2 years Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
After a close look at the waiting periods, we can say that the waiting periods on this policy are excellent. Especially the PED waiting period which is better than usual.
What's missing in the policy
Maternity benefits not offered.
Doctor consultations are not covered. Need to opt add-on for doctor consultations.
Customer Reviews
R
Ramesh
Good plan for seniors, covers important things like hospitalization.
S
Shanta
Personal health coach is a nice touch, helps stay healthy.
A
Alok
Home nursing benefit is very useful for recovery at home.
V
Vimala
Wish the co-payment wasn't mandatory.
N
Nirmala
The 20% co-payment for older people is a bit high.
G
Gayatri
Organ donor expense coverage is important.
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Frequently Asked Questions
Does Activ Care Classic have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 2-year waiting period for any pre-existing disease you may have while buying the policy.
Does Activ Care Classic have room rent restrictions?
Does Activ Care Classic offer a restoration benefit?
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