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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. Optima Super Secure is sold by HDFC Ergo and Senior Citizen Plan is sold by United India. 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. Optima Super Secure is quite comprehensive. It offers considerable protection and it doesn’t impose as many restrictions. However, Senior Citizen Plan 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.


Let’s start with Optima Super Secure. The product comes from HDFC Ergo’s stable:

Founded in the year 2002, the company is a joint venture between India’s HDFC and Germany’s ERGO International AG. It offers policies across motor, travel, health and other sectors. And it also happens to be one of the largest insurers in the country.

More importantly, HDFC Ergo boasts a claim settlement ratio of 98%, with a network of 11,500+ hospitals

All in all, an impressive resume.


Senior Citizen Plan meanwhile 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.

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Insurance Parameters

Recommended
Not Recommended
Network hospitals
11,500+
3,043
Claim settlement ratio

(avg. of last 3 years)

98%
94%
Co-payment

No

No

Room rent

Any Room

Any Room

(up to 1% of sum insured)

Disease sub-limit

No

Yes

Pre existing diseases waiting

3 years

4 years

Pre/Post hospitalization

60/180 days

30/60 days

No claim bonus

50% per year

(up to 100%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(once for any illness)

Health check-up
Once every year
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, Optima Super Secure doesn’t impose a co-payment clause. And neither does Senior Citizen Plan.

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, however, you can pick any room you want with Optima Super Secure but Senior Citizen Plan only lets you stay in a room whose rent doesn’t exceed 1% of the total sum insured.

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, Optima Super Secure doesn’t impose a disease wise sub-limit whereas Senior Citizen Plan imposes disease-wise sub-limits on Heart diseases, Major surgeries.

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. In this case, Optima Super Secure imposes a waiting period of 3 years on pre-existing diseases while Senior Citizen Plan extends a waiting period of 4 years on existing conditions.

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, Optima Super Secure covers expenses incurred 60 days before hospitalization and expenses incurred 180 days post-hospitalization. Meanwhile, Senior Citizen Plan 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, Optima Super Secure offers a no-claim bonus whereas Senior Citizen Plan doesn’t offer a no-claim bonus.

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, Optima Super Secure offers domiciliary cover. And Senior Citizen Plan 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, Optima Super Secure covers Ayush procedures and Senior Citizen Plan also extends 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 Optima Super Secure offers maternity cover nor does Senior Citizen Plan.

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 Optima Super Secure extends coverage for outpatient consultations, nor does Senior Citizen Plan.

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 Optima Super Secure. However, if you are specifically looking to buy a policy for senior citizens, then you may want to consider Senior Citizen Plan.

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