Overview
Aditya Birla’s Activ Care Standard is a health insurance policy tailored for senior citizens, offering sum insured options from ₹3 lakhs to ₹10 lakhs. Key features include a 50% reload of the sum insured for unrelated claims, coverage for 586 daycare procedures, and cashless home treatment (Up to ₹25,000 for 3L & 4L S.I.; Up to ₹50,000 for 5L S.I. and above) for illnesses like dengue and chemotherapy. It also provides a second e-opinion for major illnesses, HealthReturns™ rewards for active lifestyles, and health coaching sessions (2 sessions per year) for chronic conditions. The plan emphasizes affordable yet comprehensive care for elderly individuals.
Experts Review
Written by Nikhil Nair
Senior Writer
The Aditya Birla Activ Care Standard plan is a well-rounded health insurance solution for senior citizens. It's 50% reload benefit ensures financial security during multiple claims within a policy year, making it ideal for individuals with recurring medical needs. The inclusion of cashless home treatment enhances convenience, particularly for seniors who prefer home-based care. Coverage for 586 daycare procedures further broadens its scope by supporting minor treatments without extended hospitalization. Health coaching sessions, health return,s and wellness discounts promote preventive care and lifestyle management.
Compared to the Activ Care Premier plan, the Standard variant offers lower sum insured options (up to ₹10 lakhs vs. ₹25 lakhs in Premier) and a reduced reload benefit (50% vs. 100%). While both plans include cashless home treatment and daycare coverage, the Premier plan provides additional benefits like domiciliary hospitalization (up to SI), organ donor expenses (up to SI), and comprehensive health checkup (once a policy year), making it more suitable for comprehensive health care needs.
The Standard plan has other limitations like room rent restrictions that limit them to shared accommodations, which may reduce comfort during hospitalization. At the same time, it has a co-payment clause of 20% also, its premiums can escalate with optional add-ons like advanced health check-ups or room upgrades.
Pros
Insurer has a solid track record with great claim and service metrics.
Cons
Not very feature-rich.
Premiums are relatively high.
Your insurer doesn’t provide free health check-ups, which is a notable gap.
Maternity benefits not offered, which could be a drawback for some.
Doctor consultations are not covered, which is a key feature. 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 upto 5% of sum insured for about 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
Your insurer doesn’t provide free health check-ups.
Maternity benefits not offered.
Doctor consultations are not covered. Need to opt add-on for doctor consultations.
Customer Reviews
S
Suresh Rathi
The coverage feels comprehensive, daycare treatments bhi included hai jo bahut helpful hota hai.
K
Kavya Rao
Premium thoda high lagta hai jab age barhta hai, not easy for pensioners.
A
Arvind Malhotra
Bought this for my mother, mujhe laga sum insured options are flexible and lifetime renewability is a big relief.
N
Nisha Thomas
Room rent limit kaafi restrictive hai, extra kharcha apne pocket se karna pada.
P
Pooja Deshpande
Support team explained all terms clearly, easy to understand for elders. Online renewal process is very convenient.
A
Anita Chhabra
Policy is transparent, no hidden charges. Documentation was fast aur mujhe timely approval mil gaya claim ke liye.
V
Vikas Menon
Very good option for seniors, plan covers ambulance and hospital expenses nicely. Gives peace of mind.
S
Sneha Iyer
Premium is quite reasonable aur benefits bhi kaafi acche hai for senior citizens. Claim process was simple and smooth.
R
Rajeev Khanna
I feel this policy is very suitable for my parents, coverage is wide including pre and post hospitalization. Cashless network really helps in emergency.
D
Deepak Jain
Cashless claim mila but bahut paperwork karna pada, process could be simpler.
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Frequently Asked Questions
Does Activ Care Standard 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 Standard have room rent restrictions?
Does Activ Care Standard offer a restoration benefit?
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