HDFC Ergo last year created a flutter when it launched Optima Secure last year. The health insurance plan promises 4X returns but this comes at an extra cost. The Reassure from Niva Bupa on the other hand has been one of most searched plans online because it been feature rich. A detailed comparison between the two plans therefore will be of help to many. Below is HDFC Ergo Optima Secure Vs Niva Bupa Reassure in a easy to understand tabular form.
| Particulars | Niva Bupa ReAssure | HDFC Ergo Optima Secure |
|---|---|---|
| About | A comprehensive health policy offering plans from 3 Lacs to 1 cr with Unlimited ReAssure benefit | A base health policy that offers 2X the sum insured from Day 1. Offers cover from 5 Lac to 2 Cr. The plan promises 4x or 5x cover of the sum insured |
| How the plan works? | The plan works like any other insurance plan. A policy holder chooses a sum insured. He/she is given cumulative bonus of 50% if there is no claim in the year. | The Plan adds additional sum insured equal to your sum insured chosed from Day one. Making the cover 2 times (2X) from Day one. The plan thereafter offers 50% as bonus in first two years as Plus Benefit. This bonus is still offered even if claim is made. Therefore at the end of year one the cover would be 2.5 times and at the end of second year the cover would be 3 times. Restore benefit will be offered additionally making the coverage 4 times or 4X. |
| Eligibility | Entry Age 91 days – 65 yrs. A child can be upto the age of 30 yrs. Lifetime renewal. | Entry Age 91 days – 65 yrs. A dependent Child can be upto the age of 25 yrs. Lifetime renewal. |
| Variants | NA | (a) Optima Secure. (b) Optima Super Secure. Optima Secure offer 2X cover from day one. Optima Super Secure offers 3X cover from day one. Super Secure available for SI 10 Lacs – 2Cr when policy term selected is 3 yrs at time of inception. |
| Key Plan Benefits | Re-instatement of Sum Insured unlimited times & Homecare benefit. | High SI from Day one. No reduction in no-claim bonus even if claim is made. Consumable Cover in-built. HomeCare on Cashless basis. |
| Coverage | Over 24 hrs hospitalisation in in-patient department | Over 24 hrs hospitalisation in in- patient department |
| Cashless / Reimbursement | Cashless in network. Reimbursement in non-network hospital. | Cashless in network. Reimbursement in non-network hospital. |
| Day Care Procedures | Covered | Covered |
| Type of Room | Any Type of Room (Except Suite) | Any Type of Single Private Room |
| Pre & Post Hospitalisation Expenses | Upto 60 & 180 days | Upto 60 & 180 days |
| Cumulative Bonus or No Claim Bonus | 50% of SI for every claim free year max. upto 100% of SI. Plus Benefit offered with the plan adds the bonus even if the claim is made. | 50% of SI for every claim free year max upto 100% of SI. Incase of claim there is a reduction in the same proportion in subsequent year. |
| Sub-Limits | Specific Robotic Surgeries have a max limit of Rs 1 Lac | None |
| Co-payment | None | None. However Option to choose deductible of ₹25000/- or ₹50,000/- or ₹100000/- |
| AYUSH Benefit (Ayurveda, Unani, Siddha & Homepathy) | Covered upto Sum Insured in a Govt recognised hospital | Covered upto Sum Insured in a Govt recognised hospital |
| Organ Donor Expenses – For harvesting the organ from donor’s body | Covered upto Sum Insured | Covered upto Sum Insured |
| Domiciliary Treatment | Covered incase the condition of patient is such when he/she can not be transported to a Hospital or no bed is available. Coverage only if treatment is done for minimum 3 consecutive days. Some diseases have exclusion. | Covered incase the condition of patient is such when he/she can not be transported to a Hospital or no bed is available. Some diseases have exclusion |
| ReAssure/ Restore (Often sold as 10+10 cover) | Available from 2nd claim in a year. A single claim will not exceed base SI. Sequence – base SI, SI Safeguard (if opted), Cumulative Bonus, Reassure Benefit. Unlimited number of times in a year upto 100% of SI. | Upto 100% of SI can be Restored once in a policy year. Active from 2nd claim onwards. Valid for same person same illness. Will be available only once in a yr. Single claim amount will never exceed basic sum insured of the policy. |
| Ambulance Cover | Upto Rs 2000 per hospitalisation | Upto Sum Insured |
| Other Benefits | a) Home Care Treatment for Chemotherapy & Dialysis in specific cities. Pre & Post treatment medical expenses not payable. b) Shared Room Benefit of ₹ 800 / ₹1000 for maximun of 6 days depending on SI selected. c) Air Ambulance cover of upto SI on Cashless basis or ₹ 2.5 lacs per on reimbursement). d) Second Medical Opinion available only once. Claim for the disease or treatment is already approved by insurer. | a) Homecare benefit on cashless basis only. It has to be pre-approved by the insurance company. b) Protect Benefit pays for cost towards consumables. c) Shared Room Benefit of Rs 800 for maximum of 6 days provided. Not valid incase of ICU. Minimum 48 of hospitalisation is required. d) Air Ambulance cover of upto 5 lacs per e) E-Opinion incase of listed 51 critical illness. Offered only once |
| Renewal Condition | Change in Health Condition at time of Renewal needs to be disclosed at time of renewal | NA |
| Waiting Periods | ||
| Basic | 30 days | 30 days |
| Specific Diseases & Treatments | 2 years (Chronic Kidney disease not covered in initial two years) | 2 years |
| Pre Existing Conditions | 3 years | 3 years |
| Annual Health Check-up | Once in a year. ₹500 per Lac. Maximum ₹5000 for individual & ₹10000 for Floater Plan. Infloater plan validity is only for adult members. | Annually as per SI – Individual Policy ₹ 1500-₹8000. Floater Policy ₹2500-₹15000. |
| Discounts | ||
| Long Term Policy Discount | 7.5% discount on 2nd yr premium if 2 yr premium is paid in advance. For a 3 yr policy 7.5% discount on 2nd yr premium, 15% discount on 3rd yr premium | 7.5% discount if 2 yr premium is paid in advance. 10% discount if 3yr premium is paid in advance |
| Loyalty Discount | NA | 2.5% discount if one holds any other reatil policy above ₹ 2000/- from HDFC Ergo |
| Renewal Discount | 2.5% discount at time of Renewal if ECS or Auto Debit is selected | NA |
| Medical Practitioner Discount | 5% discount for Doctors | |
| Deductible Discount | NA | Discount varies from 25%- 50% depening on SI & Deductible. Deductible Amount – ₹ 25K or 50K or 1 Lac. To be slected at inception of policy only. |
| Good Health/ Wellness Discount | Renewal premium discount of up to 30% basis the heath points collected by you on Max Bupa Health App | NA |
| Riders/ Add-ons Available (after paying additional premium) | ||
| Hospital Cash | Rider allows one to receive cash on basis of per day hospitalisation. Max 30 days in a year. Min 48 hrs hospitalisation required. Rs 2000/- per day | NA |
| Inflation and Consumable Add-on | Provides three benefits a) Claim Safeguard: Non-payable items paid up to Sum Insured b) Booster Benefit Safeguard: No impact on Booster benefit if claim in a policy year is less than Rs. 50,000 c) Sum Insured Safeguard: CPI linked increase in Base Sum Insured | NA |
The above detailed comparison will be able you in-depth knowledge on the the two products. One major difference lies in the price of the two products. HDFC Ergo Optima Secure as it offers 2X cover from day one is expensive when compared with Niva Bupa Reassure. Incase your preference of the plan is Optima Secure one could choose a deductible amount to bring down the premium.
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