Compare TATA AIG vs HDFC ERGO Health Insurance Plans
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| Medicare Protect | Medicare | Medicare Premier | Easy Health | Optima Restore | Arogya Sanjeevani |
| BUY NOW | BUY NOW | BUY NOW | BUY NOW | BUY NOW | BUY NOW |
| In-patient Treatment | |||||
| Covers hospitalisation expenses due to an disease/illness/injury | Covers hospitalisation expenses due to an disease/illness/injury | Covers hospitalisation expenses due to an disease/illness/injury | Covered up to sum insured | Covered | Covered |
| Room Rent | |||||
| Shared Accommodation / 10% co pay for higher Room category | Shared Accommodation (with 10% co-pay)/ Single Private A/c Room | NIL Room Rent restrictions | Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day |
| ICU Charges | |||||
| Covered | Covered | Covered | Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day |
| Pre-hospitalization | |||||
| 30 days before the date of admission to the hospital | 60 days before the date of admission to the hospital | 60 days before the date of admission to the hospital | Covered up to 60 Days | Covered up to 60 Days | 30 days before the date of admission to the hospital |
| Post-hospitalization | |||||
| 60 days after discharge from the hospital | 90 days after discharge from the hospital | 90 days after discharge from the hospital | Covered up to 90 Days | Covered up to 180 Days | 60 days after discharge from the hospital |
| Day Care Procedures | |||||
| 540+ listed Day Care Treatment covered | 540+ listed Day Care Treatment covered | 540+ listed Day Care Treatment covered | All day care treatments covered | All day care treatments covered | 142 day care expenses covered |
| Domiciliary Treatment | |||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | Covered upto sum insured | Not Covered |
| Emergency Ambulance | |||||
| Up to Rs.1,000 per hospitalisation | Up to Rs.3,000 per hospitalisation | Up to Rs.5,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation |
| Dental Treatment | |||||
| Not covered | Covers expenses incurred towards hospitalization for dental treatment under anesthesia necessitated due to an accident/ injury/illness | 10,000 (OPD Dental) | Individual - Standard & Exclusive: Not Covered Platinum (4 lakhs to 10 lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000 Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.7,500 Family - Standard & Exclusive: Not Covered Platinum (4 to 10 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000 Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.10,000 (waiting period: 3 years) |
Not Covered | Dental treatment, necessitated due to disease or injury |
| Bariatric Surgery | |||||
| Not Covered | Covered | Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | |||||
| Covered up to Sum Isured | Covered up to Sum Insured | Covered up to Sum Insured | Standard: Up to Rs.20,000 Exclusive & Platinum (3 to 10 Lakhs): Up to Rs.25,000 Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.50,000 |
Not Covered | Covered |
| Maternity Benefits | |||||
| Not Covered | Not Covered | Up to Rs.50,000 (Rs.60,000 in case of girl child) per policy (Waiting period 4 years) |
Standard: Not Covered Exclusive & Platinum (3 to 10 Lakhs): Normal Delivery Rs.15,000, Caesarean Delivery Rs.25,000 Exclusive & Platinum (15 to 50 Lakhs): Normal Delivery Rs.30,000, Caesarean Delivery Rs.50,000 (Waiting Period: 4 Years) |
Not Covered | Not Covered |
| New Born baby cover | |||||
| Not Covered | Not Covered | If a claim is admitted under the maternity benefit, then the company covers for medical expenses incurred on the treatment of new born baby up to Rs.10,000 for complications related to delivery |
Standard: Not Covered Exclusive & Platinum: Additional Benefit on payment of additional premium |
Not Covered | Not Covered |
| Vaccination of the new born baby | |||||
| Not Covered | Not Covered | Up to Rs.10,000 (Rs.15,000 in case of girl child) up to one year after the birth of the child |
Not Covered | Not Covered | Not Covered |
| Organ Donor Expenses | |||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | Covered up to sum insured | Not Covered |
| Vaccination (In case of post bite treatment) | |||||
| Not Covered | Covered | Covered | Not Covered | Not Covered | Not Covered |
| Health Check-up | |||||
| Up to 1% of previous sum insured subject to a maximum of Rs.10,000 per policy | Up to 1% of previous sum insured per policy | Up to 1% of sum insured subject to a maximum of Rs.10,000 per policy | Standard: Every 4 years 1% of sum insured, up to Rs.5,000, irrespective of claim Exclusive: Every 3 years 1% of sum insured, up to Rs.5,000, irrespective of claim Platinum: Every 2 years 1% of sum insured, up to Rs.5,000, irrespective of claim |
Individual - 3 Lakhs: Not Covered 5 Lakhs: Up to Rs.1,500 10 Lakhs: Up to Rs.2,000 15 Lakhs: Up to Rs.4,000 20 to 50 Lakhs: Up to Rs.5,000 Family - 3 Lakhs: Not covered 5 Lakhs: Up to Rs.2,500 10 Lakhs: Up to Rs.5,000 15 Lakhs: Up to Rs.8,000 20 to 50 Lakhs : Up to Rs.10,000 |
Covered |
| Hospital daily allowance | |||||
| Not covered | If the insured is hospitalized in shared accommodation in a network hospital for more than 24 hours. Then the company pays 0.25% of base sum insured and maximum of Rs.2,000 per day |
If the insured is hospitalized in shared accommodation in a network hospital for more than 24 hours. Then the company pays 0.25% of base sum insured and maximum of Rs.2,000 per day |
Standard: Rs.500 per day, maximum Rs.3,000 Exclusive & Platinum (3 to 5 Lakhs): Rs.500 per day, maximum Rs.3,000 Exclusive & Platinum (7.5 to 10 Lakhs): Rs.800 per day, maximum Rs.4,800 Exclusive & Platinum (15 to 50 Lakhs): Rs.1,000 per day, maximum Rs.6,000 (Choosing shared accommodation) |
3 to 15 Lakhs: Rs.800 per day, maximum Rs.4,800 20 to 50 Lakhs: Rs.1,000 per day, maximum Rs.6,000 (Choosing shared accommodation) |
Not Covered |
| Co-pay | |||||
| No co-pay | No co-pay | No co-pay | NIL Co-pay under this plan | NIL Co-pay under this plan | 5% Co-pay applicable on all claims |
| Pre-existing diseases coverage | |||||
| Pre-existing diseases covered after 4 years of continuous coverage | Pre-existing diseases covered after 3 years of continuous coverage | Pre-existing diseases covered after 2 years of continuous coverage | Covered after a waiting period of 3 years | Covered after a waiting period of 3 years | Covered after a waiting period of 4 years |
| Restore Benefit | |||||
| 100% of base sum insured for you and your family members | 100% of base sum insured for you and your family members | 100% of base sum insured for you and your family members | NIL Restoration Benefit under this plan | Up to 100% of Base Sum Insured per year | NIL Restoration benefit |
| General waiting period | |||||
| 30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
| Renewal Benefit / Cumulative Bonus | |||||
| 10% on base sum insured for every claim free year and up to 100% | 50% on base sum insured for every claim free year and up to 100%. Reduced by 50% and up to 100% in case of claim | 50% on base sum insured for every claim free year and up to 100%. Reduced by 50% and up to 100% in case of claim | 10% on base sum insured for every claim free year and up to 100% | 50% for every claim free year up to 100% of basic sum insured | 5% for every claim free year up to 50% of sum insured |
| Emergency Air Ambulance | |||||
| Not covered | Not covered | covered | Standard: Not Covered Exclusive & Platinum (3 to 10 lakhs): Not Covered Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.2.5 lakhs per hopsitalisation |
3 to 5 Lakhs: Not Covered 10 to 50 Lakhs: Covered up to Rs.2.5 lakhs per hospitalization and maximum up to sum insured in an year |
Not Covered |
| Available sum insured options | |||||
| Rs.2 to 5 Lakhs | Rs.3 to 20 Lakhs | Rs.5 to 50 Lakhs | Individual - Standard Plan: Rs.1 to 15 Lakhs Exclusive Plan: Rs.3 to 50 Lakhs Platinum Plan: Rs.4 to 50 Lakhs Family - Standard Plan: Rs.2 to 15 Lakhs Exclusive Plan: Rs.3 to 50 Lakhs Platinum Plan: Rs.4 to 50 Lakhs |
Individual: Rs.50,000 to 10 Lakhs Floater: Rs.2 to 10 Lakhs |
Rs.1 to 5 Lakhs |
| Policy can be purchased for | |||||
| 1 /2/3 years | 1 /2/3 years | 1 /2/3 years | 1/2 years | 1/2 years | 1 year |
| Eligibility criteria | |||||
| 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | Adults from 18 to 65 years (dependents 91 days to 17 years) |
| Renewability | |||||
| Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life |
| Daily Cash for Accompanying an Insured Child | |||||
| Not covered | If an insured child aged 12 years or less is hospitalized. The company pays 0.25% of base sum insured and maximum of Rs.2,000 per day for one accompanying adult for 24 hours |
If an insured child aged 12 years or less is hospitalized. The company pays 0.25% of base sum insured and maximum of Rs.2,000 per day for one accompanying adult for 24 hours |
Standard: Not Covered Exclusive & Platinum (3 to 5 Lakhs): Rs.300 per day, maximum Rs.9,000 Exclusive & Platinum (7.5 to 10 Lakhs): Rs.500 per day, maximum Rs.15,000 Exclusive & Platinum (15 to 50 Lakhs): Rs.800 per day, maximum Rs.24,000 |
Not Covered | Not Covered |
| Claims loading | |||||
| No Loading | No Loading | No Loading | Loading | Loading | No Loading |
| Portablity(At the time of renewal) | |||||
| Yes | Yes | Yes | Yes | Yes | Yes |
| Tax Benefits Limit | |||||
| Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D |
| Tata AIG | HDFC ERGO Health | |
|---|---|---|
| Claims Settlement Ratio** | 80.61% | 89.50% |
| Number of Lives Covered* | 22,48,000 | 51,16,000 |
| Network Hospitals | 4,000 + | 10,000 + |
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