Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Cardiac Care Platinum is sold by Star Health and Care Heart is sold by Care. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.
Second, we know that both products are built specifically for people suffering from heart ailments. So you’ll have to keep that in mind while comparing the two policies.
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 Cardiac Care Platinum. The product comes from Star Health’s stable:
Star Health Insurance is India's first standalone health insurance firm. And with an army of retail advisors pushing their products across the country, they’ve managed to capture a fair share of the Indian market.
The company also boasts a network of over 14,000+ hospitals and a decent claim settlement ratio of 83%.
Care Heart meanwhile comes from Care’s stable:
Care Health Insurance (formerly Religare Health Insurance) was founded in 2012. And in that time, they’ve managed to corner a large part of the Indian Insurance market.
What’s more impressive?
Care Health Insurance has a remarkable claim settlement ratio of 90% and a network of more than 11,400+ hospitals.
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Compare Insurances Insurance Parameters Recommended Not Recommended | ||
---|---|---|
Network hospitals | 14,000+ | 11,400+ |
Claim settlement ratio (avg. of last 3 years) | 83% | 90% |
Co-payment | No | 20% |
Room rent | Single Private room | Single Private room |
Disease sub-limit | Yes | Yes |
Pre existing diseases waiting | 3 years | 2 years |
Pre/Post hospitalization | 30/60 days | 30/60 days |
No claim bonus | 10% per year (up to 100%) | 10% per year (up to 50%) |
Domiciliary | ||
Ayush treatments | ||
Restoration benefit | 100% restoration (once for different illness) | 100% restoration (once for different illness) |
Health check-up | Once every year | Once every year |
Maternity | ||
Out Patient Department | Up to ₹2,500 | |
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, Cardiac Care Platinum doesn’t impose a co-payment clause whereas Care Heart imposes a co payment of 20% if you're under the age of 70 and 30% if you're 71 and above.
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, Cardiac Care Platinum lets you stay in a single private room and Care Heart also lets you stay in a single private room. Nothing fancy.
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, Cardiac Care Platinum imposes disease-wise sub-limits on Cardio vascular conditions, Cataracts, Modern Treatments whereas Care Heart imposes sub-limits on Knee Replacement, Hernia, Hysterectomy, Benign Prostate, Treatment of Cerebrovascular disorders, Treatment of Cancer
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, Cardiac Care Platinum imposes a waiting period of 3 years on pre-existing diseases while Care Heart extends a waiting period of 2 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, Cardiac Care Platinum covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Care Heart 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. And in this case, Cardiac Care Platinum offers a no-claim bonus of 10% and Care Heart similarly extends a 10% no-claim bonus.
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, Cardiac Care Platinum doesn’t offer domiciliary protection whereas Care Heart offers domiciliary cover.
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, Cardiac Care Platinum covers Ayush procedures and Care Heart 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 Cardiac Care Platinum offers maternity cover nor does Care Heart.
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, Cardiac Care Platinum offers OPD cover whereas Care Heart doesn’t offer OPD protection.
Final Conclusion
After considering all the features on hand and the claim settlement ratio of Care, we believe that Care Heart is a better alternative to Cardiac Care Platinum for most use cases that we’ve evaluated so far.
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