Care by Care

Star
Optima Comprehensiv Ind-
Restore Niva Bupa e Suraksha 5,7,10,15,20,25,
Ind- Reassure Ind- 5, 7.5,10, Energy Platinum 30,40, 50, 60, Suraksha
5,10,15,20,25,5 3L / 4L / 5L / 15, 20, 25, 50, Silver / Gold Suraksha Suraksha 75 Care Advantage Care Freedom Platinum Suraksha Suraksha Care Advantage
0 Care Plus 7.5L / 10L / 75, 1cr Ind- Gold Silver FF- Ind-(3,5),7,10 Care by Care Gold Silver Energy Health Premia Health Premia Health Premia
FF- (Youth) 12.5L / 15L / FF- 5, 7.5,10, Ind- 20,25,50,75 Ind- 7.5,10,15 Ind- ,5 5,7,10,15,20,25, Ind- 25,50,1cr FF- (3,5),7,10 Ind- 20,25,50,75 Ind- 7.5,10,15 Ind- ,5 Gold Ind- 25,50,1cr Silver Gold Platinum Star Cardiac CareCare Heart
5,10,15,20,25,5 Ind- 3,5,7,10,25 20L / 25L / 50L 15, 20, 25, 50, 2,3,5,10,15,20,2 FF- 20,25,50,75 FF- 7.5,10,15 FF- 5 30,40, 50, 60, FF- 25,50,1cr Ind-3,4,5,7,10,15,20,25,30,40,
FF- 20,25,50,75
50, 60,
FF-75
7.5,10,15 FF- 5 FF- 25,50,1cr Ind- 5, 7.5 Ind- 10,15, 20,30,Ind-1cr,2cr,3cr
50 HeartBeat HeratBeat Star Cancer Care
Features 0 FF- 3,5,7,10,25 / 75L / 1 Cr 75, 1cr 5,50 75 (Under 46 can only
FF-3,4,5,7,10,15,20,25,30,40,
have SI 3 or 5) 50, 60, 75 Ind- 2,3,5,10,15,20,25,50 FF- 5, 7.5 FF- 10,15, 20,30, FF-
50 1cr,2cr,3cr Ind- 5L, 7.5L, 10L,Ind-
15L3L, 5L,7L,10LSilver Gold Star's Young Star Ind- 3L, 5L
Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure
Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure Brochure
Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings
For a Cover Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings
amount of Network Network Network Network Network Network Network Network Network Network
10Lakhs Hospitals Hospitals Hospitals Hospitals Hospitals Hospitals Hospitals Hospitals Hospitals Hospitals Network HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork HospitalsNetwork Hospitals
Ind- 18Y to Ind- 18Y to Ind- 18Y to Ind- 5Y to Ind- 5Y to
Ind- 18Y to 65Y Ind- 5Y to 35Y Ind- 18Y to 65Y Ind- 18Y to 65Y Lifetime Lifetime Lifetime Lifetime Lifetime
Entry Ages FF(Dep)- 91D FF(Dep)- 91D FF(Dep)- 91D FF(Dep)- 91D FF(Dep)- 91D FF(Dep)- 91D FF(Dep)- 91D FF(Dep)- 91D FF(Dep)- 91D Ind- 18Y (P1) & 46Y(P2)
Ind- 5Y to
to Lifetime
LifetimeInd- 18Y to Lifetime
Ind- 18Y to Lifetime
Ind- 18Y to Lifetime Ind- 5Y to LifetimeInd- 18Y to 65Y Ind- 18Y to 65Y Ind- 18Y to 65Y Individual- 5 months- 65 years
1 Conditions to 25Y to 25Y to 30Y to 25Y Ind- 18Y to 65Y to 25Y to 25Y to 25Y to 25Y to 25Y FF (Dep)- 90D to FF(Dep)-
24 Y 91D to 24Y
FF(Dep)- 91D to 25YFF(Dep)- 91D to 25YFF(Dep)- 91D to 25YInd- 18Y to 65Y FF(Dep)- 91D to 24YFF(Dep)- 1D to 25Y
FF(Dep)- 1D to 25Y
FF(Dep)- 1D to 25Y
Ind- 7Y to 70Y Ind- 18Y to Lifetime No Family Floater
Exit Age for
Kids 25Y 25Y 30Y 25Y
1% of SI (3L-
4L)
1% of SI Single Pvt (5L-
(SI<5L) 10L) Shared Room ( SI1% = 3L/5L)
of SI (3L-4L)
Room Single Pvt AC Single Pvt, level Single Pvt (SI = 7L/10L)
Single Pvt (5L-10L) Up to SI Up to SI Up to SI Single Pvt ( SI>3L) Restriction-
2 Rent/Category No limit (SI>=5L) No limit Single Pvt AC No limit No limit No limit No limit up (15L-75L) No limit Single Pvt, level up
No(15L-75L)
limit No limit No limit No limit No limit (Except suite and (Except
above) suite and (Except
above) suite and Single
above)Pvt AC 1% of SI (SI=3L) Single Private room
15% / 25% 15% / 25% 10% / 20%
(Optional) (Optional) (Optional) 20%, Age<70
20% Zonal Co- 20% Zonal Co- 20% Zonal Co- 30%, Age>70
20% Co- payments (1a, payments (1a, payments (1a, (Even if you bought plan before 70)15% / 25% 15% / 25% 10% / 20% 20%, Age<70
20%, Age>=61 10%, Age>=61 Payment 1b,ROI- 1b,ROI- 1b,ROI- 20%, Age>=61 20%, Age>=61 (Mandatory) 20%, Age>=61 (Optional) (Optional) (Optional) 20% Co-Payment20%, Age>=61 Zonal Copayments
Zonal
(20%)
Copayments
Zonal
(20%)
Copayments (20%) 30%, Age>70 Mandatory Co-payment-
3 Co-payments NA (Optional) NA (Mandatory) (Optional) Mandatory) Mandatory) Mandatory) (Optional) (Optional) 20% Zonal Co-payments
20% Zonal
(1a,1b,ROI-
Co-payments
20%Mandatory)
Zonal
(1a,1b,ROI-
Co-payments
(Optional)
Mandatory)
(1a,1b,ROI-
(Optional)
Mandatory) (Zone 1 & 2) (Zone 1 & 2) (Zone 1 & 2) NA (Mandatory) 10% (applicable for 61 years & above at the time of entry)
Inpatient Up to SI Up to SI
4 Treatments Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI (Has Disease wise
Upsub-limits)
to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI (Has Disease wise sub-limits) Covered upto sum Insured
Up to 7.5% of hospitalization Exp (3L)
Up to 10% of hospitalization Exp
Pre & Post 60 &180 60 & 90 60 &180 60 & 90 30 & 60 60 & 180 60 & 180 60 & 180 30 & 60 30 & 60 (IP, DC) 30 & 60 60 & 180 60 & 180 60 & 180 30 & 60 30 & 60 90 & 180 90 & 180 90 & 180 30 & 60 30 & 60
5 Hospitalistaion (IP, Dom,DC) (IP, DC, Adv) (IP, Dom,DC) (IP) (IP,DC) (IP,DC,HC) (IP,DC,HC) (IP,DC,HC) (IP,DC,Adv) (IP,DC,Adv) (IP,DC,Adv) (IP,DC,HC) (IP,DC,HC) (IP,DC,HC) (IP,DC) (IP,DC,Adv) (IP,DC,Dom,Adv) (IP,DC,Dom,Adv) (IP,DC,Dom,Adv) (IP) 30 & 60, Up to 5% of SI (IP)
Day Care Up to SI Up to SI Up to SI Up to SI
6 Procedures Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI (Has Disease wise
Upsub-limits)
to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI (Has Disease wise sub-limits) Up to SI
Domiciliary
Treatments
>For more than
3 days

>Reimburseme Upto SI Upto SI

7 nt mostly Up to SI Up to SI NA Up to SI Up to SI Up to SI Up to 10% of SI NA Up to 10% of SI Up to 10% of SI Up to SI Up to SI Up to SI NA NA Up to SI Up to SI Up to SI NA Up to SI Not Covered
Modern
Treatments
>Can have Covered upto
sub-limits SI, few robotic Sub-limits
> Can be Covered surgeries based on Up to SI Up to SI Up to SI
8 expensive (IP,Dom,DC) Up to SI covered upto 1L treatment Upto SI Upto SI Upto SI Upto SI Up to SI Up to SI NA Up to SI NA NA NA NA Up to SI (Robotic Surgery (Robotic
Sub limit Surgery
1L) (Robotic
Sub limit Surgery
1L) Sub-limits
Sub limit 1L)
based on
Uptreatment
to SI Covered with sublimits
AYUSH/
Alternative
Treatments
>Govt certified
center

>Reimburseme
nt mostly
>In-Patient Upto SI 15k (SI 5L to
9 cover NA Up to 10% of SI 15L) NA Up to SI Up to SI Up to SI Up to 20K NA NA Up to 20K Up to SI Up to SI Up to SI NA NA Up to SI Up to SI Up to SI NA Up to 25% of SI Not Covered
Maternity
>2 years
waiting period ( Up to 1L
Ditto) 15000 (SI<=5L) Normal=30k, C- Up to 1L, WP- 2
>Child cover 25000 (SI>5L) section=50k years NA NA NA
from day 1 (Optional (SI=10L, WP=2 NA NA NA (Only for SI Up to 1L, WP- 2 years
Maternity, OPD, Infertility,
Maternity, NN
OPD, Infertility,
Maternity, NN
OPD, Infertility, NN Up to 60T Up to 1L Up to 2L,
10 >2 Deliveries NA Benefit) NA Years) NA 50L, 60L, 75L) NA NA (Only for SI 50L, 60L,
(Optional,
75L) WP-4Y)(Optional, WP-4Y)(Optional, WP-4Y)NA NA 2 terminations covered
2 terminations covered
2 terminations covered
NA NA Not Covered
100% once,
100% unlimited, 100% once, partial 100% once,
100% once, partial 100% unlimited, 100% once, partial utilization, partial 100% once, 100% once,
partial utilization, partial complete 100% once, utilization, Same illness utilization, partial partial 100% once,
utilization, same illness utilization, utilization, same partial (Chemo and (Chemo and (Chemo and utilization, utilization, 100% once, partial utilization, 100% once,
same illness cover same illness illness utilization, Dialysis once/ Dialysis once/ Dialysis once/ Diff illness same illness 100% once, partial partial
utilization,
utilization, (Chemo and Dialysis partial
once/
utilization, 100% once, 100% once,
Restoration cover (45 days cover - Automatic same illness policy lifetime) policy lifetime) policy lifetime) cover cover (after 45 100% once, complete
Diff illness
utilization,
coverdifferent
(Chemo illness
and Dialysis
policy
once/
lifetime)
policy lifetime)
(Chemo and Dialysis partial
once/
utilization,
policy lifetime)
partial utilization, 100% once, Partial
100%
exhaustion,
once, Partial
same
100%
exhaustion,
illness
once, Partial
same100%
exhaustion,
illness
once, complete
same
100%
illness
utilization,
once, complete
different
utilization,
illness different illness
11 Benefits -Restore Benefit cooling period) -Restore Benefit Restoration cover -SI Rebound -SI Rebound -SI Rebound days) (Unlimited- Optional) -SI Rebound -SI Rebound -SI Rebound same illness coversame illness cover-Refill benefit -Refill benefit -Refill benefit (Cannot be utilized-Automatic
for Heart Conditions)
Recharge NA
100% per year
up to 100% (If 10% per year,
50% per year 50% per year cover is 7.5L or 25% per year, 10% per year, 10% per year, up to 50%
upto 100% 50% per year, upto 100% Above) 10% per year up to 200% up to 100% up to 100% (Clawback) 25% per year, 10% per year, 10% per year, Loyalty Benefit Loyalty Benefit Loyalty Benefit
-Multiplier upto 200% -Multiplier (Clawback) (IP), (Claw back) (Clawback) (Clawback) (50% 10% per year, 10% per year, up up
to 50%
to 200% up to 100% up to 100% 10% per year (IP), 10% per year, up 10%
to 100%
per year, up 10%
to 100%
per year, up to 100% 10% per year, up to 50%
Benefit (Clawback Benefit -Cumulative Up to 100% -Cummulative -Cummulative -Cummulative upto100%, upto 50% (Clawback) (Claw back) (Clawback) (Clawback) Up to 100% 10% per year, upto
(No
50%
Clawback) (No Clawback) (No Clawback) 10% per year up to (Clawback)
100%
12 No Claim Bonus (Clawback) >=25% SI) (Clawback) Bonus (Clawback) Bonus Bonus Bonus optional) (Clawback) NA (50% upto100%, optional)
-Cummulative Bonus
-Cummulative Bonus
-Cummulative Bonus
(Clawback) (Clawback) Add on EnhancedAddLoyalty
on Enhanced
(20%) Add Loyalty
on Enhanced
(20%) (Clawback)
Loyalty (20%) - No Claim Bonus 5% up to 50%
No WP- Initial- 30 Days Initial- 30 Days Initial- 30 Days
Diabates & Covid- 30 Days Covid- 30 Days Covid- 30 Days
Initial- 30 Days Hypertenision No WP- Diabates & Hypertenision SD- 1 Year SD- 1 Year SD- 1 Year Initial- 30 Days Initial- 30 Days 30 days - Initial
Initial- 30 Days Initial- 30 Days Initial- 30 Days Covid- 30 Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days PED- 2 Years PED- 2 Years PED- 2 Years Covid- 30 Days Covid- 30 Days 30 days - Covid
Covid- 30 Days Covid- 30 Days Covid- 30 Days Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days (Laser & weight loss
(Laserweight-lossoss
surgeries, (Laser
surgeries,
& weight loss
SD-surgeries,
2 Years SD- 2 Years 4 Years- PED (except Cancer)
SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years Mental treatment-Mental
3 yearstreatment-Mental
3 yearstreatment-PED-
3 years4 Years PED- 2 Years 2 years- Specific
13 Waiting Periods PED- 3 Years PED- 3 Years PED- 3 Years PED- 3 Years PED- 2 Years PED- 3 Years PED- 3 Years PED- 3 Years PED- 4 Years PED- 4 Years PED- 2 Years PED- 4 Years PED- 3 Years PED- 3 Years PED- 3 Years PED- 2 Years PED- 4 Years HIV/AIDS- 4 years,HIV/AIDS-
Sub-limits)
4 years,
HIV/AIDS-
Sub-limits)
4 years,
Cardiac-
Sub-limits)
30 Days Cardiac- 2 Years Lump sum payment- 30 months (recurrence, metastasis, or second malignancy
Application Post RT PCR
14 COVID 30 Days 30 Days 30 days Negative 30 days 30 days 30 days 30 days 30 Days 30 Days 30 Days 30 Days 45 Days 45 Days 45 Days 45 Days 30 Days 30 Days 30 Days 30 Days RT PCR Negative30 Days RT PCR negative report
Up to 2.5k (SI= Up to 2100 (SI
10L-25L) =10L)
Limit 350/ 300/
15 OPD Benefits NA Consultation NA Consultation NA NA NA NA NA (Add on) NA NA NA (Add on) NA NA NA NA NA NA NA 50K/ Year Up to 3500 (SI= 10L)
NA NA
Loading Applicable Applicable Applicable
Charges Applicable Applicable Applicable (Max-35% to (Max-35% to (Max-35% to Applicable Applicable Applicable
(Ditto-10% to (Max 100% to (Max 100% to (Max of 100% 100%) 100%) 100%) (Max-35% to 100%)
(Max-35% to 100%)
(Max-35% to 100%)
Applicable Applicable Applicable Applicable Applicable
16 40%) 150%) NA 150%) NA to 150%) NA NA NA NA (Max of 100% to 150%)
NA (Max up to 250%)(Max up to 250%)(Max up to 250%)NA (Max up to 50%) NA
Covered Covered
Up to a Up to a
Covered up to Covered Covered up to specified specified
SI Up to SI SI Covered Covered Covered Covered amount amount
Donor's medical (No Pre & Post Donor's medical Up to SI Donor's medical Donor's medical Donor's medical Donor's medical (No Pre & Post (No Pre & Post
and Surgical hospitalization and Surgical (No Pre & post and Surgical and Surgical and Surgical and Surgical hospitalization hospitalization
expenses cover for expenses hospitalization expenses expenses expenses expenses cover for cover for Covered Covered Covered Covered Covered Covered Up to SI Up to SI Up to SI NA
No Pre & post insured and No Pre & post cover for the No Pre & Post No Pre & Post No Pre & Post No Pre & Post insured and insured and Up to a specified amount
Donor's medical and
Donor's
Surgical
medical
expenses
and
Donor's
Surgical
medical
expenses
and
Donor's
Surgical
medical
expenses
and
Up to
Surgical
a specified
expenses
amount
(No Pre & post hospitalization
(No Pre & post hospitalization
(No Pre & post hospitalization
(Heart Transplantation
17 Organ Donor hospitalization donor) hospitalization donor) hospitalization hospitalization hospitalization hospitalization donor) donor) NA (No Pre & Post hospitalization
No Pre & Postcover
hospitalization
NoforPre
insured
& Post
and
hospitalization
donor)
No Pre & Post hospitalization
No Pre & Post hospitalization
(No Pre & Post hospitalization
cover for the cover
donor)
cover
for insured
for the and
donor)
donor)
cover for the donor)
cover up to 200%NAof SI) NA
3500/
Hospitalization Upto 2000 /
15000/ Hospitalization Up to SI Up to SI Up to SI
Road Upto 2000 / Upto 2000 / Upto 2000 / Up to 2000 / Hospitalization 3500/ 2000/ (1500 to 3000 Up to 1000 / Hospitalization
Upto 2000 / Hospitalization
3500/ Hospitalization (Non-Network- Up(Non-Network-
to 2000/ Up(Non-Network-
to 2000/ Up to 2000/ Up to 2K (SI= 3L/5L) Covered
18 Ambulance Hospitalization Hospitalization Hospitalization No limit Hospitalization (SI>50l) Hospitalization Hospitalization as per SI) Up to SI (1500 to 3000 as 15000/
per SI) Hospitalization
3500/(SI>50l)
Hospitalization
2000/ Hospitalization
Up to 2000 / Hospitalization
Up to SI Hospitalization) Hospitalization) Hospitalization) No limit Up to 3K (SI= 7L/10L) Up to Rs. 1500 per hospitalisation and Rs 2000 per policy period
Actual or 2.5L/ up to Rs. 2.5 Up to 2.5L/
Hosp L/Hospitalizatio Hospitalization
up to SI (SI 10L Upto SI, max of n. Max. up to Max up to 5L/ NA (Add on) NA (Add on)
19 Air Ambulance or Above) 5L/year sum insured Year NA Upto 5L Upto 2L NA NA (Add on) NA Upto 5L Upto 2L NA NA NA (Add on) Up to SI Up to SI Up to SI NA NA
E-Opinion/
Second Opinion
>For Major EO- Unlimited S.O. - Once a EO- Unlimited NA
20 illnesses mostly EO- Once/ year SO- Once/ Year year SO- No Limit NA EO- Once/ Year EO- Once/ Year EO- Once/ Year SO- Once/ Year NA NA SO- Once/ Year EO- Once/ Year EO- Once/ Year EO- Once/ Year NA NA EO- Unlimited EO- Unlimited SO- Once/ Specified
EO-illness
Covered (International SO- Add on)
NA
(HbA1c tests Covered for
are reimbursed Adults,
up to 750 cashless, the
Once @ Covered for twice/year) list of tests
Renewal Adults, Once/ Year Once/ Year Once/ Year covered varies
Free Health Ind- Upto 2000 Cashless, the Full Body check within 60 days within 60 days within 60 days as per SI Cashless,
Checkups FF- Upto 5000 list of tests Rs 500/Lakh Up to 3000/ up and wellness of renewal of renewal of renewal Covered for 2 test series/year Covered Tests worth up to 2500/ person Once/ year
( Cannot carry (Reimbursemen covered varies Ind. - 5000 Max Year program - In (1% of the SI / (1% of the SI / (1% of the SI / Children (Care Covered for Adults,Covered
once/ year,
for Adults,
Once/
cashless,
Year within
the list
Once/
60ofdays
tests
Year
of
covered
renewal
withinOnce/
60
varies
daysYear
asofper
renewal
within
SI Free
60 days
at Network
of renewal
Hospitals (cashless)
Cashless, (SI=10L) Cashless or Reimbursement,
Up to 3000/ Year Cardiac Health Check-up
21 forward) t) as per SI FF - 10000 Max (SI=10L) gold Max 5000) Max 5000) Max 5000) 1) NA (Add on) Cashless, list of tests
Covered
provided
for Children
(List(Care
of tests
1) provided)
(List of tests provided)
(List of tests provided)
Up to 2000 reimbursement
NA (Add on)
at Non-network
Tests worth
Hospitals
up to Up
1875/
to 7500
person
(as perTests
SI) worth up to (SI=10L)
10000/ person
Covered Covered Covered Covered Covered Covered Covered Covered Covered Covered
Mental Health (IRDAI (IRDAI (IRDAI (IRDAI (IRDAI (On prescribed (On prescribed (On prescribed (IRDAI (IRDAI Covered Covered Covered Covered Covered Covered Covered Up to SI Up to SI Up to SI Covered Covered
22 Cover Guidelines) Guidelines) Guidelines) Guidelines) Guidelines) hospitalization) hospitalization) hospitalization) Guidelines) Guidelines) (IRDAI Guidelines)
(IRDAI Guidelines)
(On prescribed hospitalization)
(On prescribed hospitalization)
(On prescribed hospitalization)
(IRDAI Guidelines)
(IRDAI Guidelines)
(Sub limit 50k on few
(Subcases)
limit 50k on few
(Subcases)
limit 1L on few
(IRDAI
cases)
Guidelines)
(IRDAI Guidelines)
Add on Add on
(Protector (Safeguard Add on Add on From 3rd day up to
Add
7 days
on (1k/Day) Covered Add on Add on
23 Consumables Rider) NA Rider) NA NA NA NA NA (Care Shield) (Care Shield) & Add on (Care Shield)
(Care Shield) NA NA NA (No Add-on required)
(Care Shield) NA NA NA NA (Care Shield)
Unlimited
Protector rider Safeguard rider Recharge
(Inflation, NCB (Inflation, NCB Reduction in
Protection Protection PED NCB Super
(50k), (50k), Care Shield Care Shield Personal AccidentPersonal
Cover AccidentPersonal
Cover Accident Cover
Consumables) Consumables) Buyback PED (Inflation, NCB (Inflation, NCB Unlimited RechargeNA NA NA Critical Illness Critical Illness Critical Illness
Riders at check Unlimited Unlimited WP= 3 Years to NA NA NA safeguard, safeguard, Reduction in PEDCritical Illness Critical Illness Critical Illness NCB Super Hospital Cash (3k)Hospital Cash (5k)Hospital Cash (7.5k) Home Care (Qualified Nurse) 50% Lumpsum payment
24 out restoration rider Maternity restoration rider 1 year NA consumables) consumables) Care Shield(Inflation,
CareNCB
Shield
safeguard,
(Inflation,
Hospital
consumables)
NCBCash(
safeguard,
3k,Hospital
5k,consumables)
7.5k)Cash( 3k,Hospital
5k) Cash( 1k,NA
2k) Care Shield(Inflation,
Enhanced
NCB safeguard,
LoyaltyEnhanced
(20%)
consumables)
LoyaltyEnhanced
(20%) LoyaltyNA
(20%) Care Shield(Inflation, NCB safeguard, consumables) Rider (For contracting new cancer)
Network
25 Hospitals 13000+ 8500+ 8000+ 10000+ 13000+ 13000+ 13000+ 13000+ 8350+ 8350+ 8350+ 8350+ 13000+ 13000+ 13000+ 13000+ 8350+ 7600+ 7600+ 7600+ 8000+ 8350+ 8000+
CSR (Claim
Settlemenst
26 Ratio) 97% 95.20% 92.00% 83.64% 97% 97% 97% 97% 95.20% 95.20% 95.20% 95.20% 97% 97% 97% 97% 95.20% 90.69% 90.69% 90.69% 83.64% 95.20% 84%
ICR (Incurred
27 Claims Ratio) 79.00% 55.15% 56.00% 94.44% 73.69% 73.69% 73.69% 73.69% 55.15% 55.15% 55.15% 55.15% 73.69% 73.69% 73.69% 73.69% 55.15% 56.09% 56.09% 56.09% 94.44% 55.15% 94.44%
Upto 25000, Upto 25000, Upto 25000, Upto 25000, Upto 25000,
Unlimted <60 <60 <60 <60 <60
Restoration Upto 50000, Upto 25000, <60 Upto 50000, Upto 50000, Upto 50000, Upto 50000, Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60
Offer >60 Upto 50000, >60 >60 >60 >60 >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60
Covers cardiac ailments
from 30 days We haven't seen any loading charges in Ditto's experience
If the treatment is Covers
done incardiac ailments
past 7 years after 2 years
If the treatment has taken more than 7 years back, then they will put a permanent exclusion.
 HDFC ERGO Optima Restore Care Plus Niva Bupa Reassure Star Comprehensive
Cover amt 5,10,15,20,25,50 3,5,7,10,25 3,4,5,7.5,10, 12.5,15,20,25,50,75,1 Cr 5, 7.5,10, 15, 20, 25, 50, 75, 1cr
Age barrier 18-65 5-100 (Youth for under 35) 18-65 18-65
Loading Usually between 18-40% No Usually between 20-40% No
Copayment No No No 10% mandatory after 61y
Single Private AC room for 5L+
Room rent restrictions No under 5L, 1% of SI No Single Private AC room
Pre and post hosp 60d and 180d, upto SI 60d and 90d, upto SI 60d and 180d, upto SI 60d and 90d
Day care treatments Yes Yes Yes Yes
for 5L to 15L - 15k, 20L to 25L -
AYUSH No Yes, upto 10% SI Upto SI 20k, 50L+ - 30k
Upto SI, but excludes some Upto SI, but excludes some
Domiciliary treatment Yes, upto SI. diseases Upto SI diseases
Home Care treatment No No Yes No
PED waiting period 3 years 3 years 3 years 3 years
50% upto 200%, clawback at upto 5L- 50% upto 100% ,
50% upto 100% , clawback at 50%, no clawback if claim amt is clawback at 50%, for 7.5L and
NCB 50% less than 25% of SI 50% upto 100% , clawback at 50% above- directly 100%
100%, one time, partial 100%, unlimited, partial
exhaustion, can be used for any exhaustion, can be used for any 100%, unlimited, partial exhaustion, can 100%, one time, full exhaustion,
Restoration illness illness be used for any illness can be used for same illness
Disease wise sublimits No No No No
Can avail checkups once a year, Ind- 5L- 2k, 7.5L- 2.5k, 10L-3k,
Ind- 5L- 1.5k, 10L- 2k, 15L- 4k, covers certain lists of tests Lists of tests, limit of 500 for every 1L 15L-4k, 20L- 4.5k, 25L- 4.5k,
Free health checkups 20-50L - 5k depending on cover amt (Max 5k for individual and 10k for FF) 50L+ - 5k
Covered with limits for every 3
Dental treatments Only if hospitalization mandated Covered with limits Only if hospitalization mandated years of holding the policy
Covered with limits for every 3
Ophthalmic treatments No Covered with limits No years of holding the policy
OPD No Yes, under 350 per consultation No Yes, 300 / consultation
Other Specialties No upto 30% on walking x number of steps
No No
ADD ON in care plus youth : 10L
cover, 25k limit. For 5L cover, 15k
limit, with 2 years waiting period, Delivery and new born cover with
Maternity benefits No allows mid term inclusion No limits
International treatments No No No No
Zonal copayments No No No No
Mumbai and delhi priced Mumbai and delhi priced differently, rest
Zonal pricing differently, rest of india differently No of india differently NA
upto 8% on walking x number of Tiny discount for fitness related
steps activities 8% on walking x number of steps -
Care plus youth offers discount family discount: if multiple individuals buy upto 10% discount for being
of 10% on renewal every year the same policy individually, then 10% healthy under star wellness
2 pay 7.5% discount on total sum after the ageof 40 -early bird discount on all premiums every year programme
discount
family discount: if multiple
Discounts
individuals buy the same policy Multi year policy discount: 2 year - Multi year policy discount: 2 year - 7.5%
individually, then 10% discount on 7.5% on second year, 3 years - on second year, 3 years - 7.5% on
all premiums every year 7.5% on second and 10% on third second and 15% on third -
- - 5% on being a medical practitioner -
2.5% for asking bank to autodebit
- - premiums every year -
Family floater only for spouse and kids only for spouse and kids only for spouse and kids only for spouse and kids
max 4 kids, upto 25 years max 4 kids, upto 25 years max 4 kids, upto 30 years max 3 kids, upto 25 years
Network hospitals 13500+ 8350+ 7600+ 10000+
CSR 97% 95% 91% 83.64%
ICR 79% 55% 56% 94.44%
Covered upto SI, few robotic surgeries
Modern treatments covered covered upto SI covered upto 1L Covered with sub limits
Covered upto SI, donor's medical Covered, upto SI, (No Pre & Post
and surgical expenses, no pre hospitalization cover for insured Covered upto SI, donor's medical and Covered, upto SI, (No Pre & Post
Organ donor and post and donor) surgical expenses, no pre and post hospitalization cover for donor)
Road ambulance upto 2000 per hospitalization upto 2000 per hospitalization upto 2000 per hospitalization Covered, no limits
upto 2.5L per hospitalization, max upto 2.5L per hospitalizations, not
Air ambulance for 10L+ 2.5L per hospitalization upto SI or max 5L/year SI execeeding 5L per policy period
Inflation Shield, Consumable
cover, NCB shield for under 50k, Inflation Shield, Consumable cover, NCB
Safeguard Rider Unlimited restoration rider - shield for under 50k -
Consumables Protected under add on NA Protected under add on NA
Hospital Cash: 3k or 6k on you
choice,cash paid everyday during Hospital Cash: For 5L, 1k everyday for
your stay in the hosp for 30 days max 30 d. For 7.5-15L, 2k everyday, for PED buyback - reduction of
to deal with loss of income. On 15L+, 4k everyday. Min hosp 48 hrs. waiting periods to 1 year from 3
reimbursement basis Paid on reimbursement basis years
Other ADD ONs Maternity
Other ADD ONs
Personal Accidental Insurance:
On the death of primary insured,
get 5 times base cover upto 1cr.
Also eligible for part of cover in
lumpsum in case of disability
Maternity
Personal Accidental Insurance: On the
death of primary insured, get 5 times
base cover upto 1cr. Also eligible for part
of cover in lumpsum in case of disability
 HDFC Energy Silver/ Gold HDFC Suraksha Platinum / Gold / Silver Care Care Care Advantage
Ind and FF -
Cover amt Ind- 2,3,5,10,15,20,25,50 Ind and FF- Silver 5L, Gold 7.5-15L, Platinum 20-75L 5,7,10,15,20,25,30,40, 50, 60, 75 Ind and FF- 25,50 1cr
Age barrier 18-65 18- Lifetime 5y- Lifetime 5y- Lifetime
Might impose in rare cases for BP
and diabetes. Depends on
severity for other conditions,
Loading usually 20-40% Usually upto 20-40% NA NA
Copayment Optional 20% Optional. Silver 10%/20% Gold 15%/25% Platinum 15%/25% 20% for 61 and above 20% for 61 and above
Room rent restrictions No No Single Private Room No
Pre and post hosp 30d and 60d, upto SI 60d and 180d, upto SI 30d and 60d, upto SI 30d and 60d, upto SI
Day care treatments Yes Yes Yes Yes
AYUSH No upto SI Yes, upto 20k No
Domiciliary treatment No Upto SI, with some exclusions 10% of SI No
Home Care treatment No Upto SI No Np
2 years for all, except BP and
PED waiting period diabetes 3 years 4 years, can reduce by 2 years 4 years, can reduce to 2 years
NCB 10% upto 100% 10% upto 200%, In Platinum, 25% upto 200 10% upto 50% 10% upto 50%
100%, once, partial exhaustion, 100%, once, partial exhaustion, for any illness. Once restored, can 100%, once, partial exhaustion, 100%, once, partial exhaustion,
Restoration for any illness avail for chemo and dialysis only once in the lifetime for different illness only for any illness
Disease wise sublimits No No No No
Standard test once / year. Only in
Free health checkups Hba1c upto 750 every year cashless partner facility Optional
Dental treatments Only if it mandates hospitalization Only if it mandates hospitalization Only if it mandates hospitalization Only if it mandates hospitalization
Ophthalmic treatments No No No no
OPD No No Add on no
No waiting period for people with
Other Specialties diabetes and High BP NA NA Large cover for very low premium
Maternity benefits No No 1L cover (SI 50L+) WP 2 years No
International treatments No No No No
20% if you seek treatment in higher tiered city after buying in lower
Zonal copayments No tiered city No no
Zonal pricing No Yes No no
25% on renewal if BP/sugar/BMI/
cholestrol stays within certain limit Upto 10% for walking x number of steps Multi year discount Multi year discount
25% of premiums can be
Discounts reimbursed if you prove that you
spent it on OPD, medicines or
other health checkups Multi year discount: 2y - 7.5% and 3y- 12.5% - -
- Family discount- all individuals get 10% discount on premiums - -
Family floater No only for spouse and kids only for spouse and kids only for spouse and kids
- max 4 kids, till 25 max 4 kids, till 25 max 4 kids, till 24
Network hospitals 13500+ 13500+ 8350+ 8350+
CSR 97% 97% 95.20% 95.20%
ICR 79% 79% 55.15% 55.15%
Modern treatments Upto SI Upto SI upto SI upto SI
Covered Covered
Covered upto SI, donor's medical Up to a specified amount Up to a specified amount
and surgical expenses, no pre Covered upto SI, donor's medical and surgical expenses, no pre and (No Pre & Post hospitalization (No Pre & Post hospitalization
Organ donor and post post cover for insured and donor) cover for insured and donor)
Silver SI 5L- 2000/hospitalization. Gold SI 7.5L - 15L - 3.5k / Upto 2000 / Hospitalization
Road ambulance 2000/ hospitalization hospitalization. Platinum SI 20L- 50L - 3.5k, 50L+ - 15k (1500 to 3000 as per SI) upto SI
NA (Add on) NA (Add on)
Air ambulance No Silver NA, Gold- upto 2L, Platinum- upto 5L
Unlimited Recharge
Reduction in PED
NCB Super
Care Shield (Inflation, NCB
Care Shield(Inflation, NCB
safeguard, consumables), NCB
safeguard, consumables)
Safeguard Rider NA NA Super, OPD
Consumables NA NA
NA NA
Other ADD ONs
Features Care Freedom Plan Niva Bupa Health Premia
Freedom 1 Freedom 2 Star Cardiac Care Care Heart Silver Gold Platinum
Ind- 18y to lifetime / Floater available only Ind- 18Y to 65Y
Age barrier 18 - lifetime (ff- 91d to 24y) 46 - lifetime Ind- 7y to 70y for self and spouse FF(Dep)- 1D to 25Y
Ind and FF- 3L and 5L (under Ind and FF 10,15, 20,30,
Cover 46 can only have this) Ind and FF- 7L and 10L 5L / 7.5L / 10L / 15L 3L / 5L / 7L/ 10L Ind and FF 5, 7.5 50 Ind and FF- 1cr,2cr,3cr
Zonal Copayments (20%)
Copayment Yes: for under 70y - 20% and above 30% No Yes: for under 70y - 20% and above 30% (Zone 1 & 2) (optional, cx has option to choose pan india plan)
1% of SI (3L), Twin Sharing 1% of SI (3L), Single Pvt room (5L / 7L Covered up to Sum Insured (except for Suite or above room
Room Rent room Single private room Single Pvt AC room /10L) category) upto SI
Disease wise sub-limit Yes Yes Yes HIV AIDS covered only upto 50k
No claim bonus None 10% of SI, upto 100% 10% of SI, upto 50% 10% upto 100% NO CLAWBACK
100%, once, different illness, full
exhaustion. (Cannot use for cardiac
ailments, modern treatments and for 100%, once, full exhaustion, different
Restoration 100%, once, full exhaustion, different illness the same illness) illness 100%, once, partial exhaustion, same and diff illness
Pre/Post 60 days / payable upto 30 days beyond renewal 30/60d 30/60d (max upto 5% of SI) 90/180D , upto SI
Upto 7.5% of hosp expenses (3L) Upto 10% payable (5L
and above)
Day Care upto SI, with sub limits upto SI upto SI upto SI
Optional (1k/ day for 3L and 5L and 2k/day
Home care Optional, 1000/day not covered for 7L and 10L) not covered
Domiciliary 10% of SI not covered upto 100% of SI upto SI
AYUSH/ Alternate treatments NA not covered upto 25% of SI upto SI
Up to SI
(Robotic Surgery copay
50%), (Bariatric upto 1L) (Robotic surgery copay 20%)
Modern Treatments NA Covered with sub limits not covered NA (LASIK (upto 50k) (Bariatric 1.5L) (LASIK 1L)
2y, (Laser & weight loss surgeries,
Mental treatment- 3 years
PED waiting periods 2y 4y (except for cardiac ailments 30d) 2y even for cardiac HIV/AIDS- 4 years, Sub-limits)
Initial Witing Period 30d 30d 30d 30d
Specific Illness waiting period 2y 2y 2y 1y
OPD NA Covered with limits depending on SI optional NA NA Upto 50k
Up to 60T Up to 1L Up to 2L,
Maternity not covered not covered not covered 2 terminations covered 2 terminations covered 2 terminations covered
New Born Vaccination not covered not covered until new born completes 1 yr, vaccinations as per pre defined list
NA Up to SI
(Heart Transplantation (No Pre & post hospitalization
Organ Donor NA cover up to 200% of SI) not covered cover for the donor)
Cashless,
Tests worth up to 2500/
Once/ year person Cashless or Reimbursement,
Annual, basic (optional diabetes and cardiac), covered for Cardiac Health Check-up Cashless, (SI=10L) Tests worth up to 10000/
Health Check up adults, cashless, lists of tests SI 5L / 7L (2k), 10L (3k), 15L (4k) Tests worth up to 1875/ person Up to 7500 (as per SI) person
Road Ambulance upto 1000/hospitalization No limit upto 2k (3k for 7L and above) network hosp, upto SI, non network hosp upto 2000/event
Air ambulance not covered not covered not covered upto SI
From 3rd day up to 7 days (1k/Day)
Consumables & Add on (Care Shield) NA Add on Care Shield covered
Network hospital 8350+ 8000+ 8350+ 7900+
CSR 95.20% 83.64% 95.20% 91%
ICR 55.15% 94.44% 55.15% 56%
Personal Accident Cover Personal Accident Cover Personal Accident Cover
Home Care (Qualified Nurse) Critical Illness Critical Illness Critical Illness
Care Shield(Inflation, NCB safeguard, Hospital Cash (3k) Hospital Cash (5k) Hospital Cash (7.5k)
Riders at check out Care Shield(Inflation, NCB safeguard, consumables) NA consumables) Enhanced Loyalty (20%) Enhanced Loyalty (20%) Enhanced Loyalty (20%)

Covers cardiac ailments We haven't seen any loading charges in

from 30 days Ditto's experience
If the treatment is done in Covers cardiac ailments
past 7 years after 2 years
If the treatment has taken more than 7
years back, then they will put a permanent
exclusion.
 Care by Care

Suraksha Ind-
Platinum Suraksha Suraksha 5,7,10,15,20,25,30,40, 50, Care Advantage
Energy Gold Silver 60, 75
Silver / Gold Ind- 20,25,50,75 Ind- 7.5,10,15 Ind- ,5 FF- Ind- 25,50,1cr
FF- 20,25,50,75 FF- 7.5,10,15 FF- 5 5,7,10,15,20,25,30,40, 50, FF- 25,50,1cr
Features Ind- 2,3,5,10,15,20,25,50 60, 75
Brochure Brochure Brochure Brochure Brochure Brochure

For a Cover Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings
amount of
10Lakhs Network Hospitals Network Hospitals Network Hospitals Network Hospitals Network Hospitals Network Hospitals
Entry Ages Ind- 18Y to Lifetime Ind- 18Y to Lifetime Ind- 18Y to Lifetime Ind- 5Y to Lifetime Ind- 5Y to Lifetime
1 Conditions Ind- 18Y to 65Y FF(Dep)- 91D to 25Y FF(Dep)- 91D to 25Y FF(Dep)- 91D to 25Y FF(Dep)- 91D to 24Y FF(Dep)- 91D to 24Y
Exit Age for
Kids NA 26Y 26Y 26Y 25Y 25Y
1% of SI (3L-4L)
Single Pvt (5L-10L)
Room Single Pvt, level up (15L-
2 Rent/Category No limit No limit No limit No limit 75L) No limit
20% Co-Payment 20%, Age>=61 20%, Age>=61
3 Co-payments (Optional) 20% Zonal Co-payment 20% Zonal Co-payment 20% Zonal Co-payment
Pre & Post 30 & 60 60 & 180 60 & 180 60 & 180 30 & 60 30 & 60
5 Hospitalistaion (IP,DC) (IP,DC,HC) (IP,DC,HC) (IP,DC,HC) (IP,DC,Adv) (IP,DC,Adv)
Day Care
6 Procedures Up to SI Up to SI Up to SI Up to SI Up to SI Up to SI
Domiciliary
Treatments
>For more than
3 days

>Reimburseme
7 nt mostly NA Up to SI Up to SI Up to SI Up to 10% of SI NA
Modern
Treatments
>Can have
sub-limits
> Can be
8 expensive Upto SI Upto SI Upto SI Upto SI Up to SI Up to SI
AYUSH/
Alternative
Treatments
>Govt certified
center

>Reimburseme
nt mostly
>In-Patient
9 cover NA Up to SI Up to SI Up to SI Up to 20K NA
Maternity
>2 years
waiting period (
Ditto)
>Child cover Up to 1L, WP- 2 years
from day 1 NA NA NA (Only for SI 50L, 60L,
10 >2 Deliveries NA 75L) NA
100% once,
partial utilization, Same
100% once, illness 100% once,
partial utilization, (Chemo and Dialysis partial utilization, 100% once, partial 100% once,
100% once, (Chemo and Dialysis once/ once/ (Chemo and Dialysis once/ utilization, partial utilization,
Restoration partial utilization, policy lifetime) policy lifetime) policy lifetime) Diff illness cover same illness cover (after 45
11 Benefits same illness cover -SI Rebound -SI Rebound -SI Rebound days)
25% per year, 10% per year, 10% per year,
10% per year (IP), up to 200% up to 100% up to 100% 10% per year, up to 50%
Up to 100% (Claw back) (Clawback) (Clawback) (Clawback) 10% per year, upto 50%
12 No Claim Bonus (Clawback) -Cummulative Bonus -Cummulative Bonus -Cummulative Bonus (50% upto100%, optional) (Clawback)
No WP- Diabates &
Hypertenision
Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days Initial- 30 Days
Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days Covid- 30 Days
SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years SD- 2 Years
13 Waiting Periods PED- 2 Years PED- 3 Years PED- 3 Years PED- 3 Years PED- 4 Years PED- 4 Years
Application Post
14 COVID 30 days 30 days 30 days 30 days 30 Days 30 Days
15 OPD Benefits NA NA NA NA NA (Add on) NA
Loading
Charges Applicable Applicable Applicable
(Ditto-10% to Applicable (Max-35% to 100%) (Max-35% to 100%) (Max-35% to 100%)
16 40%) (Max of 100% to 150%) NA NA
Covered Covered Covered
Donor's medical and Covered Donor's medical and Covered Up to a specified amount Covered
Surgical expenses Donor's medical and Surgical Surgical expenses Donor's medical and Surgical (No Pre & Post Up to a specified amount
No Pre & Post expenses No Pre & Post expenses hospitalization cover for (No Pre & Post hospitalization
17 Organ Donor hospitalization No Pre & Post hospitalization hospitalization No Pre & Post hospitalization insured and donor) cover for insured and donor)
3500/ Hospitalization Upto 2000 /
Road 15000/ Hospitalization Hospitalization
18 Ambulance Up to 2000 / Hospitalization (SI>50l) 3500/ Hospitalization 2000/ Hospitalization (1500 to 3000 as per SI) Up to SI
NA (Add on)
19 Air Ambulance NA Upto 5L Upto 2L NA NA (Add on)
E-Opinion/
Second Opinion
>For Major
20 illnesses mostly NA EO- Once/ Year EO- Once/ Year EO- Once/ Year SO- Once/ Year NA
 Care by Care

Suraksha Ind-
Platinum Suraksha Suraksha 5,7,10,15,20,25,30,40, 50, Care Advantage
Energy Gold Silver 60, 75
Silver / Gold Ind- 20,25,50,75 Ind- 7.5,10,15 Ind- ,5 FF- Ind- 25,50,1cr
FF- 20,25,50,75 FF- 7.5,10,15 FF- 5 5,7,10,15,20,25,30,40, 50, FF- 25,50,1cr
Features Ind- 2,3,5,10,15,20,25,50 60, 75
NA
(HbA1c tests are reimbursed Covered for Adults,
Free Health up to 750 twice/year) cashless, the list of tests
Checkups Once/ Year within 60 days of Once/ Year within 60 days Once/ Year within 60 days of covered varies as per SI
( Cannot carry Full Body check up and renewal of renewal renewal Covered for Children
21 forward) wellness program - In gold (1% of the SI / Max 5000) (1% of the SI / Max 5000) (1% of the SI / Max 5000) (Care 1) NA (Add on)
Covered Covered
Mental Health Covered (On prescribed (On prescribed Covered Covered Covered
22 Cover (IRDAI Guidelines) hospitalization) hospitalization) (On prescribed hospitalization) (IRDAI Guidelines) (IRDAI Guidelines)
Add on Add on
23 Consumables NA NA NA NA (Care Shield) (Care Shield)
Unlimited Recharge
Reduction in PED
Care Shield (Inflation, NCB Super
Riders at check NA NA NA NCB safeguard, Care Shield(Inflation, NCB
24 out NA consumables) safeguard, consumables)
Network
25 Hospitals 13000+ 13000+ 13000+ 13000+ 8350+ 8350+
CSR (Claim
Settlemenst
26 Ratio) 97% 97% 97% 97% 95.20% 95.20%
ICR (Incurred
27 Claims Ratio) 73.69% 73.69% 73.69% 73.69% 55.15% 55.15%
Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60
Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60
 Care Freedom
Ind-(3,5),7,10
FF- (3,5),7,10 Health Premia Health Premia Health Premia
Silver Gold Platinum Star Cardiac Care Care Heart
(Under 46 can only have Ind- 5, 7.5 Ind- 10,15, 20,30, 50 Ind-1cr,2cr,3cr
Features SI 3 or 5) FF- 5, 7.5 FF- 10,15, 20,30, 50 FF- 1cr,2cr,3cr Ind- 5L, 7.5L, 10L, 15L Ind- 3L, 5L,7L,10L
Brochure Brochure Brochure Brochure Brochure Brochure

For a Cover Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings Policy Wordings
amount of
10Lakhs Network Hospitals Network Hospitals Network Hospitals Network Hospitals Network Hospitals Network Hospitals
Ind- 18Y (P1) & 46Y(P2)
Entry Ages to Lifetime Ind- 18Y to 65Y Ind- 18Y to 65Y Ind- 18Y to 65Y
1 Conditions FF (Dep)- 90D to 24 Y FF(Dep)- 1D to 25Y FF(Dep)- 1D to 25Y FF(Dep)- 1D to 25Y Ind- 7Y to 70Y Ind- 18Y to Lifetime
Exit Age for
Kids
Shared Room ( SI =
3L/5L)
Room Single Pvt (SI = 7L/10L) Up to SI Up to SI Up to SI Single Pvt ( SI>3L)
2 Rent/Category (Except suite and above) (Except suite and above) (Except suite and above) Single Pvt AC 1% of SI (SI=3L)
20%, Age<70
30%, Age>70
(Even if you bought plan
before 70) 20%, Age<70
(Mandatory) Zonal Copayments (20%) Zonal Copayments (20%) Zonal Copayments (20%) 30%, Age>70
3 Co-payments (Zone 1 & 2) (Zone 1 & 2) (Zone 1 & 2) NA (Mandatory)
Up to SI Up to SI
Inpatient (Has Disease wise sub- (Has Disease wise sub-
4 Treatments limits) Up to SI Up to SI Up to SI Up to SI limits)
Up to 7.5% of
hospitalization Exp (3L)
Up to 10% of
hospitalization Exp
Pre & Post (IP, DC) 90 & 180 90 & 180 90 & 180 30 & 60
5 Hospitalistaion (IP,DC,Dom,Adv) (IP,DC,Dom,Adv) (IP,DC,Dom,Adv) (IP) 30 & 60, Up to 5% of SI
Up to SI Up to SI
Day Care (Has Disease wise sub- (Has Disease wise sub-
6 Procedures limits) Up to SI Up to SI Up to SI Up to SI limits)
Domiciliary
Treatments
>For more than
3 days

>Reimburseme
7 nt mostly Up to 10% of SI Up to SI Up to SI Up to SI NA Up to SI
Modern
Treatments
>Can have
sub-limits Up to SI Up to SI Up to SI
> Can be (Robotic Surgery Sub limit (Robotic Surgery Sub limit (Robotic Surgery Sub limit Sub-limits based on
8 expensive NA 1L) 1L) 1L) treatment NA
AYUSH/
Alternative
Treatments
>Govt certified
center

>Reimburseme
nt mostly
>In-Patient
9 cover NA Up to SI Up to SI Up to SI NA Up to 25% of SI
Maternity
>2 years
waiting period (
Ditto)
>Child cover
from day 1 Up to 60T Up to 1L Up to 2L,
10 >2 Deliveries NA 2 terminations covered 2 terminations covered 2 terminations covered NA NA
100% once, complete
utilization, different
100% once, complete 100% once, Partial 100% once, Partial 100% once, Partial illness 100% once, complete
Restoration utilization, different illness exhaustion, same illness exhaustion, same illness exhaustion, same illness (Cannot be utilized for utilization, different illness
11 Benefits -Refill benefit -Refill benefit -Refill benefit Heart Conditions) -Automatic Recharge
Loyalty Benefit Loyalty Benefit Loyalty Benefit
10% per year, up to 100% 10% per year, up to 100% 10% per year, up to 100% 10% per year up to 10% per year, up to 50%
100% (Clawback)
12 No Claim Bonus NA (Clawback)
Initial- 30 Days Initial- 30 Days Initial- 30 Days
Covid- 30 Days Covid- 30 Days Covid- 30 Days
SD- 1 Year SD- 1 Year SD- 1 Year
PED- 2 Years PED- 2 Years PED- 2 Years
(Laser & weight loss (Laserweight-lossoss (Laser & weight loss Initial- 30 Days Initial- 30 Days
Initial- 30 Days surgeries, surgeries, surgeries, Covid- 30 Days Covid- 30 Days
Covid- 30 Days Mental treatment- 3 years Mental treatment- 3 years Mental treatment- 3 years SD- 2 Years SD- 2 Years
SD- 2 Years HIV/AIDS- 4 years, Sub- HIV/AIDS- 4 years, Sub- HIV/AIDS- 4 years, Sub- PED- 4 Years PED- 2 Years
13 Waiting Periods PED- 2 Years limits) limits) limits) Cardiac- 30 Days Cardiac- 2 Years
Application Post
14 COVID 30 Days 30 Days 30 Days 30 Days RT PCR Negative 30 Days
15 OPD Benefits NA NA NA 50K/ Year Up to 3500 (SI= 10L) NA
Loading
Charges
(Ditto-10% to Applicable Applicable Applicable
16 40%) NA (Max up to 250%) (Max up to 250%) (Max up to 250%) NA NA
 Up to SI Up to SI Up to SI
(No Pre & post (No Pre & post (No Pre & post NA
hospitalization hospitalization hospitalization (Heart Transplantation
17 Organ Donor NA cover for the donor) cover for the donor) cover for the donor) cover up to 200% of SI) NA
Up to SI
Up to 1000 / Up to SI Up to SI (Non-Network- Up to
Road Hospitalization (Non-Network- Up to 2000/ (Non-Network- Up to 2000/ 2000/ Up to 2K (SI= 3L/5L)
18 Ambulance Hospitalization) Hospitalization) Hospitalization) No limit Up to 3K (SI= 7L/10L)
19 Air Ambulance NA Up to SI Up to SI Up to SI NA NA
E-Opinion/
Second Opinion EO- Unlimited
>For Major SO- Once/ Specified NA
20 illnesses mostly NA EO- Unlimited EO- Unlimited illness EO- Covered (International SO- Add on)
Cashless,
Free Health Covered for Adults, once/ Tests worth up to 2500/ Cashless or
Checkups year, Cashless, person Reimbursement, Once/ year
( Cannot carry Cashless, list of tests Tests worth up to 1875/ (SI=10L) Tests worth up to 10000/ Up to 3000/ Year Cardiac Health Check-up
21 forward) provided person Up to 7500 (as per SI) person (SI=10L)
Up to SI Up to SI Up to SI
Mental Health Covered (Sub limit 50k on few (Sub limit 50k on few (Sub limit 1L on few Covered Covered
22 Cover (IRDAI Guidelines) cases) cases) cases) (IRDAI Guidelines) (IRDAI Guidelines)
From 3rd day up to 7 days
(1k/Day) Add on
23 Consumables & Add on (Care Shield) NA NA NA NA (Care Shield)
Personal Accident Cover Personal Accident Cover Personal Accident Cover Home Care (Qualified
Critical Illness Critical Illness Critical Illness Nurse)
Riders at check Care Shield(Inflation, NCB Hospital Cash (3k) Hospital Cash (5k) Hospital Cash (7.5k) Care Shield(Inflation, NCB
24 out safeguard, consumables) Enhanced Loyalty (20%) Enhanced Loyalty (20%) Enhanced Loyalty (20%) NA safeguard, consumables)
Network
25 Hospitals 8350+ 7600+ 7600+ 7600+ 8000+ 8350+
CSR (Claim
Settlemenst
26 Ratio) 95.20% 90.69% 90.69% 90.69% 83.64% 95.20%
ICR (Incurred
27 Claims Ratio) 55.15% 56.09% 56.09% 56.09% 94.44% 55.15%
Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60 Upto 25000, <60
Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60 Upto 50000, >60
Covers cardiac ailments We haven't seen any loading
from 30 days charges in Ditto's experience
If the treatment is done
in Covers cardiac ailments
past 7 years after 2 years
If the treatment has taken
more than 7 years back,
then they will put a
permanent exclusion.