<img height="1" width="1" style="display:none" src="https://www.facebook.com/tr?id=7698356820180471&ev=PageView&noscript=1" />

Introduction

Before we start comparing these two policies we have to set out some ground rules.

Both products are marketed by different insurance companies. Individual Platinum Plan is sold by United India and Medicare Senior 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. Individual Platinum Plan is quite basic. It offers little protection and it’s a generic policy that anybody could pick off the shelf. However, Medicare Senior is specifically designed for null. 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 Individual Platinum Plan. The product comes from United India’s stable:

United India General Insurance company is an amalgamation of 22 different entities. The insurer has played an integral part in underwriting numerous government insurance schemes like - Maharashtra Government’s Mahathma Jyothiba Phule Jan Arogya Yojana Health Insurance Scheme (2020) & Prime Minister Suraksha Bima Yojana.

However, since it is a government-owned insurance firm, it’s not the most nimble insurance company out there.


Medicare Senior 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.

talk to us

Talk to IRDAI-certified experts

If you want help with selecting the best health policy tailored to your needs, book a FREE call with our experts today by clicking here.

Compare Insurances

Insurance Parameters

Recommended
Not Recommended
Network hospitals
3,043
10,000+
Claim settlement ratio

(avg. of last 3 years)

94%
96%
Co-payment

No

15%

Room rent

Any Room

(up to 1% of sum insured)

Shared Room

Disease sub-limit

No

Yes

Pre existing diseases waiting

4 years

4 years

Pre/Post hospitalization

30/60 days

30/60 days

No claim bonus
Domiciliary
Ayush treatments
Restoration benefit
Health check-up
Once every 3 years
Maternity
Out Patient Department
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, Individual Platinum Plan doesn’t impose a co-payment clause whereas Medicare Senior imposes a mandatory co payment of 85% if you opt for shared room and 70% if you opt for any other room.

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, Individual Platinum Plan only lets you stay in a room whose rent doesn’t exceed 1% of the sum insured whereas Medicare Senior lets you stay in a shared room and nothing fancy. In effect, both policies impose restrictions on the kind of room you can pick.

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, Individual Platinum Plan doesn’t impose a disease wise sub-limit whereas Medicare Senior imposes disease-wise sub-limits on Cataract, Joint Replacement, Hernia, Hysterectomy, Benign Prostate surgery.

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, Individual Platinum Plan imposes a 4 year waiting period on pre-existing diseases and Medicare Senior will similarly tell you to wait 4 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, Individual Platinum Plan covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Medicare Senior covers expenses incurred 30 days before hospitalization and expenses incurred 60 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, Individual Platinum Plan doesn’t offer a no-claim bonus and neither does Medicare Senior.

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, Individual Platinum Plan offers domiciliary cover. And Medicare Senior 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 Individual Platinum Plan covers Ayush treatments whereas Medicare Senior doesn’t extend 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, neither Individual Platinum Plan offers maternity cover nor does Medicare Senior.

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, neither Individual Platinum Plan extends coverage for outpatient consultations, nor does Medicare Senior.

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 affordable, you could go for Individual Platinum Plan. However, if you are specifically looking to buy a policy for null, then it’s a no brainer, Medicare Senior is your go-to option.

talk to us

Select the best plan with our help!

Get in touch to find out what plan works best for you. Zero fuss. Zero spam. Zero charges. Book a call now. Limited slots available!