Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Care Freedom plan is sold by Care and Health Gain is sold by Star Health. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.
Second, we know that both products are built for very different use cases. Care Freedom plan is built for people suffering from complicated ailments. Health Gain is built for those seeking outpatient coverage. And that means you’re comparing very different products here. So analysis will be tainted by this distinction.
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 Care Freedom plan. The product 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 16,000+ hospitals.
Health Gain meanwhile 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%.
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Compare Insurances Insurance Parameters Recommended Not Recommended | ||
---|---|---|
Network hospitals | 16,000+ | 14,000+ |
Claim settlement ratio (avg. of last 3 years) | 90% | 83% |
Co-payment | 20% | 20% (if purchased after turning 61) |
Room rent | Shared Room | Any Room (up to 1% of sum insured) |
Disease sub-limit | Yes | Yes |
Pre existing diseases waiting | 2 years | 4 years |
Pre/Post hospitalization | 10% of hospitalization expenses | 30/60 days |
No claim bonus | ||
Domiciliary | ||
Ayush treatments | ||
Restoration benefit | 100% restoration (once for different illness) | |
Health check-up | Once every year | |
Maternity | ||
Out Patient Department | ||
Day care |
Feature Comparison
![coPay](/static/aeda66c86d59dde2f685fc4e49f887c9/da848/CoPay.png)
![coPay](/static/aeda66c86d59dde2f685fc4e49f887c9/da848/CoPay.png)
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, Care Freedom plan imposes a co payment of 20% if you're under the age of 70 and 30% if you're 71 and above whereas Health Gain imposes a co-payment clause of 20% if you purchase after turning 61.
![roomRent](/static/46397637a71f36b088231f5ecadae6d8/da848/RoomRent.png)
![roomRent](/static/46397637a71f36b088231f5ecadae6d8/da848/RoomRent.png)
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, Care Freedom plan lets you stay in Shared Room. And Health Gain does the same i.e. it only lets you stay in a room whose rent doesn’t exceed 1% of the sum insured.
![diseaseSublimit](/static/93da39f0f25a303549a8c756a92f36f8/da848/SubLimit.png)
![diseaseSublimit](/static/93da39f0f25a303549a8c756a92f36f8/da848/SubLimit.png)
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, Care Freedom plan imposes disease-wise sub-limits on Cataract, Knee Replacement, Hernia, Hysterectomy, Benign Prostate Hypertrophy, Renal Stones, Cancer, Cerebrovascular & Cardiovasular disorders whereas Health Gain imposes sub-limits on null
![ped](/static/aa7ae49eb240b53028159d03deabc097/da848/PedWaiting.png)
![ped](/static/aa7ae49eb240b53028159d03deabc097/da848/PedWaiting.png)
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, Care Freedom plan imposes a waiting period of 2 years on pre-existing diseases while Health Gain extends a waiting period of 4 years on existing conditions.
![prePost](/static/49df58ecab7e5338207151e77985ec6a/da848/PrePost.png)
![prePost](/static/49df58ecab7e5338207151e77985ec6a/da848/PrePost.png)
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, Care Freedom plan covers 10% of hospitalization expenses incurred. Meanwhile, Health Gain covers expenses incurred 30 days before hospitalization and expenses incurred 60 after hospitalization, although there may be different sub-limits
![ncb](/static/7f8dd86dc2916196f202009cb6c2f588/da848/NoClaimBonus.png)
![ncb](/static/7f8dd86dc2916196f202009cb6c2f588/da848/NoClaimBonus.png)
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, Care Freedom plan doesn’t offer a no-claim bonus and neither does Health Gain.
![domiciliary](/static/0e0b24ceee6fda1fda96274d8212937c/da848/HomeCare.png)
![domiciliary](/static/0e0b24ceee6fda1fda96274d8212937c/da848/HomeCare.png)
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, Care Freedom plan offers domiciliary cover whereas Health Gain doesn’t offer domiciliary protection.
![ayush](/static/ddccf665fc0330cffe71982d5e37241e/da848/Ayush.png)
![ayush](/static/ddccf665fc0330cffe71982d5e37241e/da848/Ayush.png)
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 neither Care Freedom plan nor Health Gain extend coverage for Ayush treatments.
![maternity](/static/9e5c3f6bbc5a41d33bb99ed3eda125e0/da848/Maternity.png)
![maternity](/static/9e5c3f6bbc5a41d33bb99ed3eda125e0/da848/Maternity.png)
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 Care Freedom plan offers maternity cover nor does Health Gain.
![opd](/static/4b7a7e071e5ad247e7e2113fa102c90f/da848/Opd.png)
![opd](/static/4b7a7e071e5ad247e7e2113fa102c90f/da848/Opd.png)
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, Care Freedom plan doesn’t offer OPD protection whereas Health Gain offers OPD cover.
Final Conclusion
It should be fairly obvious by now. Care Freedom plan is best suited for people suffering from complicated ailments while Health Gain makes a lot of sense if you are looking to cover those seeking outpatient coverage. However, considering Star Health has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that Care has to offer, if the policy is made available to you.
Other Care Freedom plan Comparisons
Other Star Health Health Gain Comparisons
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