Care Advantage Vs Optima Restore both are simple health insurance plans. Care Advantage and Optima Restore are both all-inclusive policy covers you for hospitalization expenses incurred during hospitalization exceeding 24 consecutive hours.
Let’s Understand the basic difference between both Care Advantage and HDFC Ergo Optima Restore Plans.
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Care Advantage Vs Optima Restore -Eligibilty/Who can buy?
There is no significant difference between both the plans on the level of basic eligibility conditions. The only difference is maximum entry age which is maximum 65 years in HDFC Optima restore while in case of care advantage plan it is all ages.
In addition, care advantage plan only available for high sum assured whereas HDFC Optima restore can be purchased for lower Sum Assure also.
| Feature | Care Advantage Plan | HDFC Ergo Optima Restore |
| Min. Entry Age | Individual Plan – 5 years, Floater Plan- 91 days with at least one person age 18 years or above | 91 days – children above 91 days can be insured with parents |
| Max. Entry Age | All ages | 65 years |
| Age of proposer | 18 years | 18 years |
| Sum Assured | 25 lac, 50 lac, 1 crore | 3 lac,5 lac, 10 lac,15 lac,20 lac, 25 lac,50 lac, 1crore |
| Policy Term | 1/2/3 Years | 1/2/3/ years |
| Plan Type | Individual /Floater | Individual/Floater |
| Renewability | Life Long | Life long |
Care Advantage Vs Optima Restore-Waiting Period
The only difference between Both the plans is only in pre existing disease waiting period.
PED is higher in case of Care Advantage Plan, however one can buy additional cover option and reduce the waiting period in the plan.
| Feature | Care Advantage Plan | HDFC Ergo Optima Restore |
| Initial Waiting Period | 30 days | 30 days |
| Specified disease waiting period | 2 years | 2 years |
| Pre- existing Disease Waiting Period | 4 years | 3 years |
Policy Benefits Coverage
Here, the only difference is Pre and post hospitalisation treatment days. HDFC Ergo Optima Restore scores over Care Advantage Health insurance Plan.
| Feature | Care Advantage Plan | HDFC Ergo Optima Restore |
| Room Rent | Actual | Actual |
| ICU Charges | Actual | Actual |
| Day Care | Up to Sum Assured | Up To Sum Assured |
| Pre Hospitalisation | 30 days | 60 days |
| Post Hospitalisation | 60 days | 180 days |
| Domiciliary Treatment | NA | Covered |
Other Benefits
| Feature | Care Advantage Plan | HDFC Ergo Optima restore |
| Automatic recharge/Refill | Once in policy Year for 100% Sum Assured. Single Claim Cannot be higher than basic SA | The Sum Assured is Restored automatically, in case you use partial or full Sum Assure. However single claim cannot be higher than basic SA |
| unlimited Restore Benefit | OPTIONAL | OPTIONAL |
| Ambulance Cover | Up to Sum Assured | Up to 2000 per hospitalisation |
| Organ Donor Expense | Up to Sum Assured | Up to Sum Assured |
| Air Ambulance | On additional payment only | Up to 2.5 lac ( applicable for basic Sum Assure ABOVE 5 Lac) |
| Health Check up | On additional payment only | Available – Limit is different for different Sum Assure |
| No claim Bonus | 10% of Sum assured is increased for each claim free year. Maximum Accumulation up To 50% of SA | 50% of basic SA for every claim free year, maximum Up to 100% |
| Daily Cash | NA | 800/day ( max 4800) – for SA up to 15 lakh; 1000/day ( max6000) – for SA above 15 lakh |
| E- Opinion | NA | Second Opinion By a medical Practitioner from HDFC Panel |
| Stay Active Benefit | NA | With Stay active benefit, simply walk and stay fit get up to 8% discount on your renewal premium |
| Preventive Health Check Up | NA | At renewal, for SA 5 lac ( at the end of block of 2 policy year) for SA 10 lac and above – every year |
| Alternate Treatment | NA | NA |
| Advance Technology Treatment | Uterine Artery Embolization and HIFU, Balloon Sinuplasty, Deep Brain stimulation, Oral chemotherapy, Immunotherapy- Monoclonal Antibody to be given as injection, Intra vitreal injections, Robotic surgeries, Stereotactic radio surgeries, Bronchical Thermoplasty, Vaporisation of the prostrate (Green laser treatment or holmium laser treatment), 1ONM – (Intra Operative Neuro Monitoring), Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered. |
Optional Cover on additional Payment
| Feature | Care Advantage Plan | HDFC Ergo Optima Restore |
| No Claim Bonus Super | 50% increase in Sum Assured, maximum increase up to 100% ( But Sum assured will be decreased by 50% which has been added by NCBS in case of claim) | This option is given by default in the plan |
| Reduction in PED Time | Pre existing disease cover can be reduced from 4 years to 2 years | Default period is 3 year |
| Co Payment Waiver | co payment from age 61 can be waived off on additional payment | NA |
| Smart Select | for hospitals covered under Smart select – Up to Sum Insured For other hospital – 20% copayment | NA |
HDFC Ergo Optima Restore vs Care Advantage – Premium
This is a sample calculation for different age and 25 lac Sum Assure. In comparison Care Advantage plan premium is quiet low as compared to HDFC Ergo Optima restore, but with more benefits.
Thus one can choose the plan as per the benefits required for a family or on individual level. The hospitalisation expenses and ICU charges are fully covered in both the plans. But additional features such as NCB and other benefits are better in Optima Restore as compared to Care Advantage.
| Sum Assured – ZONE 1 | Care Advantage Plan | HDFC Ergo Optima Restore |
| 25 LAC FLOATER- ( AGE 42, SPOUSE, TWO KIDS | 28550 | 43097 |
| 25 LAC INDIVIDUAL – ( AGE 26 YRS) | 8802 | 18531 |
| * Disclaimer – The Premium Might differ with zone and age |
