Aditya Birla Activ Health Platinum Enhanced vs Manipal Cigna ProHealth Plus
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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 Health Platinum Enhanced is sold by Aditya Birla and ProHealth Plus is sold by Manipal Cigna. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.
Second, we know that both products have subtle differences in their core structure. Activ Health Platinum Enhanced is reasonably comprehensive. Sure, it doesn’t have all the bells and whistles, but it also doesn’t impose any mindless restrictions. ProHealth Plus, meanwhile, is a relatively expensive premium policy tailored to cover as many use cases as possible. So while the differences in features may be subtle, the pricing could be drastically different depending on the cover amount you pick.
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 Health Platinum Enhanced. 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 11,000+ 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.
ProHealth Plus meanwhile comes from Manipal Cigna’s stable:
ManipalCigna Health Insurance Company is a collaborative partnership between Manipal Group and Cigna and together they have over 200 years of expertise in the healthcare business. And while the company has shown some potential recently, it still only corners a small part of the Indian market.
Also, they have a settlement ratio of 90% with more than 8,500+ network hospitals in tow.
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Compare Insurances Insurance Parameters Recommended Not Recommended | Activ Health Platinum Enhanced | ProHealth Plus |
|---|---|---|
| Network hospitals | 11,000+ | 8,500+ |
| Claim settlement ratio (avg. of last 3 years) | 95% | 90% |
| Co-payment | No | 20% (if purchased after turning 65) |
| Room rent | Any Room | Any Room (Except suite) |
| Disease sub-limit | No | No |
| Pre existing diseases waiting | - | 3 years |
| Pre/Post hospitalization | 60/180 days | 60/180 days |
| No claim bonus | 50% per year (up to 100%) | 10% per year (up to 200%) |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 100% restoration (once for different illness) | 100% restoration (unlimited no. of times for different illness) |
| Health check-up | Once every year | Once every year |
| Maternity | Available (up to ₹25,000 after 4 years) | |
| Out Patient Department | Available | Up to ₹2,000 (Annually) |
| 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 whereas ProHealth Plus requires you to co-pay a part of the bill 20% if you purchase after turning 65
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 Health Platinum Enhanced lets you stay in Any Room, whereas ProHealth Plus lets you stay in any room except a Suite.
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, neither Activ Health Platinum Enhanced imposes disease-wise sub-limits nor does ProHealth Plus
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. In this case, Activ Health Platinum Enhanced imposes a waiting period of null years on pre-existing diseases while ProHealth Plus extends a waiting period of 3 years on existing conditions.
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, ProHealth Plus covers expenses incurred 60 days before hospitalization and expenses incurred 180 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 ProHealth Plus 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 ProHealth Plus 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 ProHealth Plus 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, however, Activ Health Platinum Enhanced doesn’t offer protection for maternity-related hospitalizations whereas ProHealth Plus offers maternity cover.
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 coverage, and ProHealth Plus also offers OPD coverage, although the sub-limits may be different.
Final Conclusion
It should be obvious that ProHealth Plus offers better protection and extends a whole host of benefits that Activ Health Platinum Enhanced simply doesn’t offer. But considering Manipal Cigna has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that Aditya Birla has to offer.
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