Star Health
Family Health Optima Insurance Plan
Premium depends on your profile
Health Insurance · head to head
Family Health Optima Insurance Plan vs MediCare
Tata AIG
MediCare
Premium depends on your profile
Specifications side by side
Spec
Family Health Optima Insurance Plan
MediCare
Cover
Plan type
Family floater
Individual and family floater
Sum insured options
5 lakh, 10 lakh, 15 lakh, 20 lakh, 25 lakh
3 lakh, 4 lakh, 5 lakh, 7.5 lakh, 10 lakh, 15 lakh, 20 lakh
Highest sum insured
25 lakh
20 lakh
Entry age
18 years (adults); 16 days (dependent children) to 65 years
91 days to 65 years
Room rent
Single Private A/C Room
No room rent sub-limit stated (In-patient Treatment up to Sum Insured; room category as per Policy Schedule)
Co-payment
20% of each and every claim for Insured Persons whose age at entry is 61 years and above
None (10% if admitted to a room category higher than the eligible category)
Waiting periods
Initial waiting period
30 days
30 days
Pre-existing disease waiting
36 months
36 months
Specific illness waiting
24 months
24 months
Benefits
Pre-hospitalisation
60 days
60 days
Post-hospitalisation
90 days
90 days
Day-care treatment
Yes
Yes
AYUSH treatment
Yes
Yes
Restore benefit
Automatically restored 3 times in a Policy Year by 100% each time upon exhaustion; usable only for illness unrelated to earlier claims (not for Modern Treatment)
Additional amount equivalent to base Sum Insured, restored once during the policy period
No-claim bonus
Loyalty Bonus 10% of expiring Sum Insured per year (irrespective of claims), up to maximum 100% of Sum Insured
Cumulative Bonus 50% of base SI per claim-free year, max 100% (50% decrease after a claim) OR 1% discount in renewal premium
Maternity
—
Not covered
OPD
Not covered (unlimited tele-consultation only)
Not covered
Insurer
Health incurred claim ratio (insurer)
70.3%
76.24%
Claims figures for
FY 2024-25: health incurred claim ratio including personal accident, IRDAI Annual Report (Statement 10)
FY 2024-25: health incurred claim ratio including personal accident, IRDAI Annual Report (Statement 10)
Network hospitals (insurer)
16,000+
13,000+
IRDAI UIN
SHAHLIP26046V092526
TATHLIP26053V042526
A tick marks the better value where the category rules say higher (or lower) is better. Text values are shown without a winner. Ties have no winner.
Pros and cons
Family Health Optima Insurance Plan
- Con: Co-payment: 20% of each and every claim for Insured Persons whose age at entry is 61 years and above
MediCare
- Pro: No co-payment on claims
- Pro: No room-rent cap
- Con: Lower maximum sum insured than 82% of the 52 health insurance plans on Comparezi that state it (₹20 lakh)