Prime Advantage with 50K OPD vs Senior Citizen Plan Health Insurance Plan
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| PLAN DETAILS |
 Prime Advantage with 50K OPD |
 Senior Citizen Plan |
| Premium Including GST | ||
| Sum Assured | 5L, 7.5L, 10L, 12.5L, 15L, 20L, 25L, 30L, 40L, 50L & 1Cr | 3L, 4L, 5L, 7.5L, 10L, 15L, 20L & 25L |
| Product Type | Individual and Family Floater | Reimbursement Hospitalization and Cashless |
| Key Features (Key features of the plan) |
OPD upto INR 50000 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 |
No Pre medical test required Pre Existing disease coverd after 12 month Renewal gauranteed for lifetime |
| OPD Details (In some policies, OPD (Out patient department) expenses are also covered.) |
Upto Rs 50K/- | Rs 200 per consultation upto Rs 1400 |
| EMI Option | yes | no |
| Pre-acceptance Medical Check Up (Whether a pre-acceptance check up is required or not to buy the policy) |
Required | no |
|
Room Rent (A limit of room rent cover during hospitalization if any) |
Single Private AC room | Upto Rs 6000 |
| Domicillary Hospitalization (It is the expenses incurred on treatment of the patient at home) |
Up to Rs 100000 | Not Applicable |
| Pre-hospitalization (Expenses before the insured is hospitalized) |
60 Days | Pre hospitalization medical expenses incurred for a period not exceeding 30 days prior to the date of hospitalisation as per the policy |
| Post-hospitalization (Expenses after discharge from the hospital) |
180 Days | Post-Hosp. - 7% of the hospitalization expenses comprising of Nursing Charges, Surgeon / Consultant fees, Diagnostic charges,Medicines and drugs expenses, subject to a max of Rs.7000/- per occurrence |
| Non-allopathic (Expenses incurred on non-allopathic treatment) |
Upto Rs 1000000 | Not Covered |
| 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 10L & All Day Care Treatment Covered |
| Hospital_network (Number of Hospital Network in city) |
||
| Organ Donor Expenses (Expenses incurred on organ donor in case of organ transplants) |
Upto Rs 1000000 | Not Applicable |
|
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) | Not Applicable |
| Pre-existing Coverage (If the insured is having some existing diseases, that would be covered after particular time period) |
24 Months | After 1 year |
| 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 | Not Applicable |
| 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) | Not Applicable |
| Ambulance Charges (Expenses incurred on ambulance charges) |
Upto 1000000 | Rs 1000/- per hospitalization up to max of 2000/- ppp |
| Worldwide Emergency (The emergency medical assistance and cover against medical expenses while the customer is abroad) |
NA | Not Applicable |
|
Maternity Benefits (All Hospitalization cost covered at the time of pregnancy.) |
Optional (Can be opted through enhance plus rider) | Not Covered |
| 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) | No |
| Health Checkup (An added benefit of one time full health checkup of policy holder.) |
Annually from 1st Year onwards | Rs 2000/- per person |
| 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 Applicable |
| Animal Bite (Cover againts any medical expenses occurred due to any Animal Bite) |
Not Applicable | Not Applicable |
|
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 | 30% For any Claims |
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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.
