Prime Advantage with 30K OPD vs Prime Senior Elite Health Insurance Plan
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| PLAN DETAILS |
 Prime Advantage with 30K OPD |
Prime Senior Elite |
| Premium Including GST | ||
| Sum Assured | 5L, 7.5L, 10L, 12.5L, 15L, 20L, 25L, 30L, 40L, 50L & 1Cr | 5L, 7.5 L, 10L, 15L, 20L, 25L & 50L |
| Product Type | Individual and Family Floater | Individual/Multi-individual and Family Floater |
| Key Features (Key features of the plan) |
OPD upto INR 30000 Guaranteed Bonus Unlimited Tele-Consultation Unlimited Restoration of 10 L No Co-Pay Health Check-up from 1st Year Waives off one year renewal Policy Premium upon occurrence of Accidental Death or diagnosis of any of the listed Critical Illnesses |
Modern and Advanced Treatments/HIV/ AIDS & STD / Mental Illness Cover are covered upto SI Unlimited Restoration of Sum Insured for unrelated/ related illnesses Unlimited Tele-consultation in a policy year including specialists Discount on Pharmacy - Diagnostics - Medical Devices - Health Supplements and other services offered by the network providers of MCHI Waives off next one year renewal Policy Premium upon occurrence of Accidental Death or diagnosis of any of the listed Critical Illnesses Reduction in PED Waiting period to 90 Days (Optional) |
| OPD Details (In some policies, OPD (Out patient department) expenses are also covered.) |
Upto 30K/- | Not Available |
| EMI Option | yes | yes |
| Pre-acceptance Medical Check Up (Whether a pre-acceptance check up is required or not to buy the policy) |
Required | Not required |
|
Room Rent (A limit of room rent cover during hospitalization if any) |
Single Private AC room | Single Private AC room |
| Domicillary Hospitalization (It is the expenses incurred on treatment of the patient at home) |
Up to Rs 100000 | Up to Rs 10L |
| Pre-hospitalization (Expenses before the insured is hospitalized) |
60 Days | 60 Days |
| Post-hospitalization (Expenses after discharge from the hospital) |
180 Days | 90 Days |
| Non-allopathic (Expenses incurred on non-allopathic treatment) |
Upto Rs 1000000 | Upto Rs. 10L |
| Day Care Treatment Covered (Day care treatments refers to the treatments that do not necessarily require 24hrs of hospitalization like MRI.) |
Upto Rs 1000000 | Upto Rs. 10L |
| Hospital_network (Number of Hospital Network in city) |
||
| Organ Donor Expenses (Expenses incurred on organ donor in case of organ transplants) |
Upto Rs 1000000 | Upto Rs. 10L |
|
Hospital Daily Allowance (Some plans offer daily allowance to take care of expenses like food, etc) |
800/- day and Max 5,600 (These are only available on shared accomodation) | INR 800 per day up to maximum of INR 5600 per hospitalization (On Shared Accomodation) |
| Pre-existing Coverage (If the insured is having some existing diseases, that would be covered after particular time period) |
24 Months | Covers after 24 Months |
| Cumulative Bonus (The amount by which your sum assured gets increased, if there is no claim.) |
(Guaranteed) Rs 2.5L per year upto Rs 20L | Guaranteed Bonus of Rs 1L Or max Upto Rs 10L |
| Restoration Details (Increase of Sum Insured for non-related illness if the original sum insured is exhausted) |
Unlimited (on related and unrelated illness & on partial exhaution) | Unlimited Restoration of Sum Insured for unrelated/ related illnesses |
| Ambulance Charges (Expenses incurred on ambulance charges) |
Upto 1000000 | Upto Rs. 10L |
| Worldwide Emergency (The emergency medical assistance and cover against medical expenses while the customer is abroad) |
NA | Not Available |
|
Maternity Benefits (All Hospitalization cost covered at the time of pregnancy.) |
Optional (Can be opted through enhance plus rider) | Not Available |
| New Born Baby Covered (Newborn babies can be covered under the insurance plan after a certain period) |
Optional (Can be opted through enhance plus rider) | Not Available |
| Health Checkup (An added benefit of one time full health checkup of policy holder.) |
Annually from 1st Year onwards | Annually from 1st year onwards. Limits basis opted Sum Insured |
| Non-allopathic Details (Expenses incurred on non-allopathic treatment) |
yes | no |
| Vaccination (Cover againts any medical expenses occurred in Vaccinations for certain diseases) |
Not Available | Not Available |
| Animal Bite (Cover againts any medical expenses occurred due to any Animal Bite) |
Not Applicable | Not Available |
|
Sub Limit (Sub-limit is a monetary capping that applies on specific diseases like cataract) |
Applicable | Applicable |
| Co-pay (Mentioned %, if any is to be borne by Insured and rest will be borne by insurer) |
No Co-Pay | You pay 20% of claim |
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Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.
