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Health Insurance (Care Plus vs HDFC Optima Restore vs HDFC myhealth Suraksha

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19 Sep, 2021 by  Vipul Wakkar

Hello Team,


I am 26 years old from Mumbai and looking to buy a health insurance (in addition to company health insurance of 5 lakhs from company). I am a little confused between Care plus, HDFC Optima Restore and HDFC myhealth Suraksha plan.


I am looking for around 6-10 lakhs of cover. Can you please guide? Also Care plus has unlimited restoration of Sum insured on Same and unrelated illness. So does this mean that there is no requirement of buying Super Top up as unlimited restorations are there?

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19 Sep, 2021
Avinash Sonee

Hi Vipul,

  1. Do you have any PEDs?
    • If you have PED, then you may have to decide the plan based on the PED waiting period and conditions.
  2. How long will you work in a corporate (which provides health insurance coverage)?
    • If it's for long, then you may opt for a plan which has a deductible option (like HDFC Optima Secure) which will cut down the premiums drastically.
  3. Does your present company insurance have any limitations?
    • Based on the limitations, you will have to choose a complimentary plan. For eg., if your company insurance doesn't provide coverage for AYUSH treatment, then you may buy a plan which has this.
  4. Are you planning to get married in a couple of years?
    • If yes, then you have to compare the benefits of the floater plan as well before deciding.

There are other things to consider as well, like pre and post-hospitalization duration, ambulance limit, health check-ups, etc.

Also, Care plus offers unlimited restoration of SI which covers for same illnesses as well but one catch is that the restoration is triggered only on complete exhaustion of your base SI + NCB. And another catch with restoration is any policy of any company is that, for anyone claim, the maximum payable cannot exceed your SI + NCB

You can ping me or any advisor here for more guidance. Or you can post your questions on the forum and we'll be happy to help.

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20 Sep, 2021
Vipul Wakkar
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19 Sep, 2021

Hi Vipul,


Very relevant questions.


How should you decide on your cover? Let me give you a framework with 3 criteria. Apply these and you should be able to arrive at decision faster. Don't worry about any other factors as they contribute to negligible advantage.

  1. No room rent capping - Please check which plan out of these has no room rent limit or room category restriction. Prefer plan which has none.
  2. No claim bonus - Check which plan is allowing you to aggerate no claim bonus upto 100% or more. For the years when you're not making a claim, use those years to earn extra cover without paying anything additional.
  3. TPA - Does the insurer outsource claims to a 3rd party vendor (called TPA or Thirty Party Administrator) or does it handle claims in-house. Prefer companies that do it internally. Both Care and HDFC run in-house claim ops.


Basis these 3 you should be able to decide. Rest of the factors have negligible consequence.


Anuj

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20 Sep, 2021
Vipul Wakkar
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19 Sep, 2021
Rohit Dhingra

Hey Vipul,


It would be very difficult for anyone to recommend a product out of the options you have shortlisted.


Avinash & Anuj have given a framework that will help you in your selection. None of us would be aware of your current health conditions nor are we aware if you have any budgetary constraints.


It would be best if you meet some good adviser in your town/city and understand pros & cons of each product and then take a informed decision.


Hope it helps.


Thanks

Rohit Dhingra

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20 Sep, 2021
Vipul Wakkar
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