Prime Advantage with 20K OPD vs Women Care Health Insurance Plan
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| PLAN DETAILS |
 Prime Advantage with 20K OPD |
 Women Care |
| Premium Including GST | ||
| Sum Assured | 5L, 7.5L, 10L, 12.5L, 15L, 20L, 25L, 30L, 40L, 50L & 1Cr | 5, 10, 15, 20, 25, 50 Lacs & 1Cr |
| Product Type | Individual and Family Floater | Reimbursement Hospitalization and Cashless |
| Key Features (Key features of the plan) |
OPD upto INR 20000 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 |
Covers In Utero Fetal Surgery/Repair Ante-Natal Care Assisted Reproduction (ART) Voluntary Sterilization Metabolic Screening Bariatric Surgery Pediatrician Consultations & miscarriage due to Accident; Unlimited Gynecologist Consultation through Star tele health app is available |
| OPD Details (In some policies, OPD (Out patient department) expenses are also covered.) |
Upto Rs 20K/- | Only available for Female Insured Person Upto Rs. 2500/- |
| EMI Option | yes | no |
| Pre-acceptance Medical Check Up (Whether a pre-acceptance check up is required or not to buy the policy) |
Required | Not Applicable |
|
Room Rent (A limit of room rent cover during hospitalization if any) |
Single Private AC room | Rs 10000/-per day |
| Domicillary Hospitalization (It is the expenses incurred on treatment of the patient at home) |
Up to Rs 100000 | Not Available |
| 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 | Covered upto 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 | All day care treatment Covered upto 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 | Covered up to SI, Add’l 100% SI is available for the Donor in case of Redo Surgery / ICU admission |
|
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 Available |
| Pre-existing Coverage (If the insured is having some existing diseases, that would be covered after particular time period) |
24 Months | After 2 years |
| 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 | Rs 2L of the Sum Insured 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) | 100% |
| Ambulance Charges (Expenses incurred on ambulance charges) |
Upto 1000000 | Yes |
| 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) | Rs 50000/- |
| 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) | Rs 250000/- |
| Health Checkup (An added benefit of one time full health checkup of policy holder.) |
Annually from 1st Year onwards | Available every policy year (irrespective of claim) from Rs. 1000-5000/ per insured person |
| Non-allopathic Details (Expenses incurred on non-allopathic treatment) |
yes | yes |
| Vaccination (Cover againts any medical expenses occurred in Vaccinations for certain diseases) |
Not Available | Yes |
| 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 | Not Applicable |
| Co-pay (Mentioned %, if any is to be borne by Insured and rest will be borne by insurer) |
No Co-Pay | You pay 0% 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.
