Overview
Aditya Birla’s Activ Care Premier is a premium health insurance policy for senior citizens. It offers sum insured options from ₹5 lakhs to ₹25 lakhs. The plan includes a 100% reload of the sum insured for unrelated claims, cashless home treatment, and coverage for advanced health check-ups (as an add-on). It also provides annual health assessments, HealthReturns™ rewards of up to 21%, and second opinions on major illnesses. With room rent flexibility (single private rooms), the plan ensures comprehensive care for elderly individuals.
Experts Review
Written by Nikhil Nair
Senior Writer
The Aditya Birla Activ Care Premier plan is an advanced health insurance product for senior citizens seeking extensive coverage. Its 100% reload benefit ensures financial security during multiple claims, making it ideal for individuals with recurring medical needs. The inclusion of advanced health check-ups and cashless home treatment enhances its utility for proactive and home-based care. HealthReturns™ incentivize healthy living, offering up to 21% of the premium back based on fitness activities, while second e-opinions add value by providing access to expert medical advice.
Compared to the Activ Care Classic and Standard variants, the Premier plan offers higher sum insured options (₹5-25 lakhs vs. ₹3-10 lakhs in Standard & Classic) and a full 100% reload benefit (vs. 50% in Standard). It also includes OPD cover ( up to 2,500 over and above SI) and room rent flexibility (single private rooms), which are absent in lower variants.
On the downside, the plan’s premiums are significantly higher due to its enhanced features, which may deter budget-conscious buyers. Additionally, co-payment clauses (10%) apply to all treatments, and disease-wise sub-limits are present, increasing out-of-pocket expenses during claims.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
Premiums are relatively high.
Maternity benefits not offered, which is a notable gap.
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 90% of the final bill. The rest is on you. They call this a co-payment.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Customisable
Change Single Private Room to Any Room except suite & above.
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 Single Private Room to Any Room except suite & above.
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.
Customer Reviews
K
Kamal Saxena
Excellent plan for seniors! The 100% reload for unrelated claims is fantastic.
L
Lata Iyer
Cashless home treatment is such a convenient feature for elderly parents.
M
Mohanlal Gupta
Advanced health check-ups and annual assessments show they care about senior health.
T
Tarun Varma
Need to check if the 'unrelated claims' for reload has any complex conditions.
R
Ramesh S. Pillai
Being a premium senior plan, the premiums might be on the higher side for some.
P
Priya K. Menon
The second e-opinion from world-class practitioners is a very valuable benefit.
Compare Policies
Still confused?
Talk to our expert
advisor for
instant clarity
Frequently Asked Questions
Does Activ Care Premier 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 Premier have room rent restrictions?
Does Activ Care Premier offer a restoration benefit?
TALK TO OUR ADVISORS
Get real help from advisors who listen, guide and go the extra mile for you.