Choosing a health insurance policy these days isn’t just about snagging the lowest premium. With medical costs on the rise and plans packed with features, the real trick is figuring out what you are actually getting when you purchase a policy.
From limits on room rent and benefits that get restored to how quickly claims are settled and which hospitals are in the network, every single feature can make a huge impact on your out-of-pocket expenses during a medical emergency.
To make it easier for policyholders to compare the key differences, here’s a detailed comparison of individual health insurance plans from Care, HDFC ERGO, Tata AIG, ICICI Lombard, and Niva Bupa, provided by Square Insurance Brokers Pvt. Ltd.
Comparison of different health insurance plans in India (2026)
Below is a detailed comparison of leading insurers for a 30-year-old non-smoker:
Premium and sum insured
| Parameter | Care Health
(Care Supreme) |
Niva Bupa
(ReAssure 2.0) |
TATA AIG
(MediCare Premier) |
ICICI Lombard
(iHealth) |
HDFC ERGO (Optima Secure) |
|
Annual Premium – ₹5L SI (30 yr, Individual, Non-smoker) |
~₹6,800 | ~₹7,200 | ~₹7,500 | ~₹8,000 | ~₹7,800 |
|
Annual Premium – ₹10L SI |
~₹9,500 | ~₹10,200 | ~₹10,800 | ~₹11,500 | ~₹11,000 |
|
Annual Premium – ₹1Cr SI |
~₹18,000 | ~₹19,500 | ~₹20,500 | ~₹22,000 | ~₹21,000 |
|
Sum Insured Options |
₹5L – ₹6Cr | ₹5L – ₹1Cr | ₹3L – ₹3Cr | ₹5L – ₹50L | ₹5L – ₹2Cr |
Source: Square Insurance Brokers Pvt. Ltd.
Premium rises with age
Health insurance premiums rise with age as the risks of medical conditions and hospitalization increase over time.
According to Square Insurance Brokers, for a 40-year-old non-smoking individual, the annual premium for a ₹5 lakh sum insured starts at around ₹9,500 for Care Health, ₹11,500 for ICICI Lombard, and ₹11,200 for HDFC ERGO.
For a ₹10 lakh sum insured, the annual premium is approximately ₹13,500 for Care Health, ₹14,800 for Niva Bupa, ₹15,500 for Tata AIG, ₹16,000 for ICICI Lombard, and ₹15,800 for HDFC ERGO.
Coverage and benefits of various health insurance plans
Comparing insurance policies based only on premiums is not enough. While a lower premium may seem attractive initially, the true value of a policy depends on the coverage and benefits it provides during a medical emergency.
A comprehensive health insurance policy today goes beyond basic hospitalisation cover. Features such as no-room-rent limit, maternity benefits, OPD cover, restoration benefits, and no-claim bonus can significantly impact the final claim experience and reduce out-of-pocket expenses.
Here’s a look at the coverage and benefits offered by different health plans.
| Parameter | Care Health
(Care Supreme) |
Niva Bupa
(ReAssure 2.0) |
TATA AIG
(MediCare Premier) |
ICICI Lombard
(iHealth) |
HDFC ERGO (Optima Secure) |
|
Room Rent Limit |
No limit (SI ≥ 5L) | No limit | Single A/C room | Single A/C room | No limit |
|
Maternity Cover (Rider) |
Optional rider | Yes (2 yr wait) | Optional rider | Not available | Optional rider |
|
OPD Cover |
Optional | Yes (ReAssure+) | Optional | No | Optional |
|
Newborn Baby Cover |
Yes (maternity add-on) | Yes (Day 1) | Yes (maternity add-on) | No | Yes (maternity add-on) |
All the plans cover pre-hospitalisation expenses for 60 days and post-hospitalisation expenses for 180 days, except for Tata AIG and ICICI Lombard health plans, which cover post-hospitalisation expenses for 60 days.
All the plans also provide mental health coverage. Additionally, they cover day-care procedures, while the Tata AIG plan specifically covers over 540 procedures.
For AYUSH treatment, Care Health, Niva Bupa, Tata AIG, and HDFC ERGO provide coverage up to the sum insured, whereas ICICI Lombard covers AYUSH treatment expenses up to 25% of the sum insured.
What is a restoration benefit in health insurance policy?
A restoration benefit, also known as a refill benefit, restores your sum insured after it is exhausted due to a settled claim within the same policy year.
According to the Square Insurance Brokers, in terms of sum insured restoration benefits, Care Health offers unlimited restore, Niva Bupa provides ReAssure unlimited benefits, Tata AIG allows auto restore once, and HDFC ERGO offers restore benefits once every year, while ICICI Lombard does not provide a restore benefit.
How does No Claim Bonus (NCB) work in health insurance?
A No Claim Bonus (NCB) in health insurance is a reward for not filing a claim during a policy year. It increases the sum insured of a health insurance policy without increasing the premium, or alternatively offers a discount on the renewal premium.
According to the Square Insurance Brokers, for No-Claim Bonus (NCB), Care Health, Niva Bupa, and HDFC ERGO offer a 50% increase per year up to 100% of the sum insured, Tata AIG offers a 25% increase per year up to 100%, while ICICI Lombard provides a 20% increase per year.
What’s the waiting period for a health insurance policy?
The waiting period is a key detail that many people miss when they are looking at different health insurance options.
In health insurance, the waiting period is the time after you purchase a policy during which certain benefits and coverages are not available. During this time, the insurer does not cover specified illnesses, treatments, or pre-existing diseases.
Here, all the health insurance plans have an initial waiting period of 30 days and for pre-existing diseases (PED), Care Health, Niva Bupa, ICICI Lombard, and HDFC ERGO have a waiting period of three years, while Tata AIG has a waiting period of four years.
Additionally, for specific diseases, all five health insurance plans have a waiting period of two years.
Network and claim settlement ratio of health insurance plans
Besides the features of the policy, the operational strength of the insurer also matters significantly.
A larger hospital network generally improves cashless treatment access, while a stronger claim settlement ratio reflects the insurer’s ability to settle claims efficiently.
| Parameter | Care Health (Care Supreme) | Niva Bupa (ReAssure 2.0) | TATA AIG (MediCare Premier) | ICICI Lombard (iHealth) |
HDFC ERGO (Optima Secure) |
|
Network Hospitals |
22,000+ | 10,000+ | 10,000+ | 8,500+ | 13,000+ |
|
% of claims paid in less than 3 months during 2024-25 |
99.95 | 100 | 94.14 | 98.45 | 98.85 |
What are the exclusions and limitations of these health insurance policies?
Like all health insurance policies, these plans also come with exclusions.
According to the Square Insurance Brokers, cosmetic and dental treatments are excluded under all five health insurance plans. Similarly, obesity and weight-loss treatments are also excluded across all the plans.
For adventure sports injuries, Care Health, Niva Bupa, and HDFC ERGO offer optional coverage, whereas Tata AIG and ICICI Lombard exclude such coverage.
Additional Features
According to the Square Insurance Brokers, Care Health, Niva Bupa, and HDFC ERGO offer unlimited telehealth/e-consultation services, while Tata AIG and ICICI Lombard provide limited access.
For annual health check-ups, while Niva Bupa and HDFC ERGO offer the benefit every year, Care Health provides it after one year. Tata AIG and ICICI Lombard offer it after every two years.
Global emergency cover is available as an optional rider under Care Health, Tata AIG, and HDFC ERGO plans, whereas Niva Bupa and ICICI Lombard do not offer this benefit.
Different policies may suit different types of buyers depending on age, family size, medical history and budget.
