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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 Care Classic is sold by Aditya Birla and Medicare Premier is sold by TATA AIG. 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 Care Classic is specifically designed for senior citizens. However, Medicare Premier is a premium policy built for people who want to leave no stone unturned when it comes to their health. It’s expensive and it does pretty much everything you expect a good policy to do. 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 Care Classic. The product comes from Aditya Birla’s stable:

Aditya Birla started 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).

The company holds a claim settlement ratio of 95% along with a network of more than 12,000+ hospitals, and extremely interesting products for young people with a focus on fitness. And considering their track record has been improving rapidly they are emerging as a top health insurer in the market.


Medicare Premier meanwhile comes from TATA AIG’s stable:

Tata AIG Health Insurance company is a joint venture between the Tata Group and American International Group. It was founded in 2001 and it’s one of the few companies that market products that are truly comprehensive, albeit expensive.

The company also boasts a claim settlement ratio of 96% with over 10,000 network hospitals across India.

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Insurance Parameters

Recommended
Not Recommended
Network hospitals
12,000+
10,000+
Claim settlement ratio

(avg. of last 3 years)

95%
96%
Co-payment

20%

No

Room rent

Shared Room

Any Room

Disease sub-limit

Yes

No

Pre existing diseases waiting

2 years

2 years

Pre/Post hospitalization

30/60 days

60/90 days

No claim bonus

10% per year

(up to 50%)

50% per year

(up to 100%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(once for different illness)

100% restoration

(once for any illness)

Health check-up
Once every year
Once every year
Maternity

Available

(up to ₹50,000 after 4 years)

Out Patient Department

Up to ₹5,000

(Annually)

Day care

Feature Comparison

coPay

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 Care Classic imposes a mandatory co-payment of 20% . And Medicare Premier doesn’t impose a co-payment clause.

roomRent

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, however, Activ Care Classic only lets you stay in a shared room but you can pick any room you want with Medicare Premier.

diseaseSublimit

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 Care Classic imposes disease-wise sub-limits on null whereas Medicare Premier doesn’t impose a disease wise sub-limit.

ped

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. This cooling period is referred to as the Pre-existing-disease waiting period. In this case, Activ Care Classic imposes a 2 year waiting period on pre-existing diseases and Medicare Premier will similarly tell you to wait 2 years before making a claim related to your pre-existing diseases

prePost

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 Care Classic covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Medicare Premier covers expenses incurred 60 days before hospitalization and expenses incurred 90 after hospitalization, although there may be different sub-limits

ncb

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 Care Classic offers a no-claim bonus of 10% whereas Medicare Premier offers a no-claim bonus of 50%. And the no-claim bonus may be capped at different levels too.

domiciliary

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 Care Classic offers domiciliary cover. And Medicare Premier also coves domiciliary expenses.

ayush

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 Care Classic covers Ayush procedures and Medicare Premier also extends coverage for Ayush treatments.

maternity

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, however, Activ Care Classic doesn’t offer protection for maternity-related hospitalizations whereas Medicare Premier offers maternity cover.

opd

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, Activ Care Classic doesn’t offer OPD protection whereas Medicare Premier offers OPD cover.

Final Conclusion

Since this isn’t a fair comparison, to begin with, we will only tell you this much. If you want something that’s all encompassing, you could go for Medicare Premier. However, if you are specifically looking to buy a policy for senior citizens, then you may want to consider Activ Care Classic.

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