Aditya Birla Activ Health Platinum Enhanced vs Aditya Birla Activ Health Platinum Essential
Introduction
Before we start comparing these two policies we have to set out some ground rules.
For starters, both policies, Activ Health Platinum Enhanced and Activ Health Platinum Essential are marketed by the same insurance company. So in some ways, a lot of the differences within the product will be limited to the features themselves.
Second, we know that both products have massive differences in their core structure. Activ Health Platinum Enhanced is quite comprehensive. It offers considerable protection and it doesn’t impose as many restrictions. However, Activ Health Platinum Essential 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.
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Compare Insurances Insurance Parameters Recommended Not Recommended | ||
---|---|---|
Network hospitals | 11,000+ | 11,000+ |
Claim settlement ratio (avg. of last 3 years) | 95% | 95% |
Co-payment | No | 20% |
Room rent | Any Room | Any Room |
Disease sub-limit | No | Yes |
Pre existing diseases waiting | - | - |
Pre/Post hospitalization | 60/180 days | 30/60 days |
No claim bonus | 50% per year (up to 100%) | 10% per year (up to 100%) |
Domiciliary | ||
Ayush treatments | ||
Restoration benefit | 100% restoration (once for different illness) | |
Health check-up | Once every year | Once every year |
Maternity | ||
Out Patient Department | Available | |
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 Enhanced doesn’t impose a co-payment clause. And Activ Health Platinum Essential imposes a mandatory co-payment of 20% .
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 Enhanced doesn’t impose a disease wise sub-limit whereas Activ Health Platinum Essential imposes disease-wise sub-limits on Angioplasty, Knee or hip replacement, Cataract, Cholecystectomy.
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 Health Platinum Enhanced imposes a null year waiting period on pre-existing diseases and Activ Health Platinum Essential will similarly tell you to wait null years before making a claim related to your pre-existing diseases
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 Enhanced covers expenses incurred 60 days before hospitalization and expenses incurred 180 days post-hospitalization. Meanwhile, Activ Health Platinum Essential 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 Enhanced offers a no-claim bonus of 50% whereas Activ Health Platinum Essential offers a no-claim bonus of 10%. 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 Enhanced offers domiciliary cover. And Activ Health Platinum Essential 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 Enhanced covers Ayush procedures and Activ Health Platinum Essential also extends coverage for 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 Enhanced offers maternity cover nor does Activ Health Platinum Essential.
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 Health Platinum Enhanced offers OPD cover whereas Activ Health Platinum Essential doesn’t offer OPD protection.
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 comprehensive, you could go for Activ Health Platinum Enhanced. However, if you are specifically looking to buy a policy for senior citizens, then you may want to consider Activ Health Platinum Essential.
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