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How do co-payment clauses impact health insurance premiums and claim settlements?

Co-payment means you share a part of the claim cost. Opting for co-pay lowers your premium but increases your out-of-pocket expenses.

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Health Insurance

Compare Health Insurance Plans

Heart Vs Cardiac Care Platinum

Insurance Plans Comparison

Care Heart vs Star Cardiac Care Platinum

Make an informed decision with our detailed side-by-side comparison of top health insurance policies. Compare coverage, benefits, and premiums to find the perfect plan for your needs.

Make an informed decision with our detailed side-by-side comparison of top health insurance policies. Compare...

Heart

Specialised Cardiac Health Insurance with 2-Year Cardiac PED Waiting Period

What Makes It Special:

Care Heart Health Insurance is a specialized policy designed for people with existing heart conditions or cardiac risks. It provides comprehensive coverage for hospitalization, surgeries, and treatments related to heart ailments, including pre and post-hospitalization expenses. The plan also covers annual health check-ups, ambulance charges, and optional add-ons for enhanced...

Best For:

Focused Protection for Cardiac Patients
Covers Pre and Post Hospitalization
Annual Health Check-Up Included
Lifelong Policy Renewability Option

VS

Cardiac Care Platinum

Health cover for heart patients with cardiac cover from day 31, plus non-cardiac, OPD and health check-up benefits.

What Makes It Special:

A specialised health plan for people who have already had heart treatment, including cardiac surgery or a procedure. It covers heart-related hospitalisation after 30 days, as well as non-cardiac illness and accident cover, OPD expenses and an annual health check-up.

Best For:

Patients who may need cardiac devices such as pacemakers or AICD.
People who want heart and non-heart hospitalisation in one plan.
People wanting cardiac cover after a 30-day waiting period.
Heart patients who find it hard to get a regular health policy.
People aged 7 to 70 who have had cardiac surgery or a procedure, such as angioplasty or bypass.

Insurance Plans Comparison

Get Personalized Advice

Our insurance experts are here to help you make the right choice. Get personalized recommendations based on your specific needs and budget.

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Your Enquiry

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Quick Decision Guide

Care Heart

You have a past history of heart disease
You need coverage for cardiac-related hospitalization expenses
You want insurance despite pre-existing heart conditions
You seek affordable premiums for heart-focused care
You prefer lifelong renewability with cardiac protection

Star Cardiac Care Platinum

Things to Consider: Maternity is not covered, and the premium is higher than a standard health plan.
Things to Consider: Sublimits apply to cataract, cardiac devices, angiogram, rehabilitation and modern treatments.
Things to Consider: Restoration does not apply to cardiac claims or modern treatments.
Things to Consider: Sum Insured is capped at ₹15 lakh.
Things to Consider: Non-cardiac pre-existing diseases have a 36-month waiting period.
Reasons to Consider: Cardiac devices up to 50% of SI, heart transplantation and coronary angiogram are specifically covered.
Reasons to Consider: OPD expenses and an annual health check-up are paid in addition to the Sum Insured.
Reasons to Consider: Hospitalisation includes a single private AC room.
Reasons to Consider: No pre-policy medical tests are required, but past medical records must be submitted.
Reasons to Consider: Cardiac ailments, including pre-existing heart conditions, are covered after only 30 days.

Insurance Plans Comparison

Detailed Features Comparison

Compare the key features of different health insurance plans

Heart

Health Insurance Plan

Brochure

Policy Wording

VS

Cardiac Care Platinum

Health Insurance Plan

Brochure

Room Rent
Heart Up to ₹3 L sum insured – 1% of Sum Insured per day Above ₹3 L sum insured – Single Private Room	Cardiac Care Platinum Single Private A/C Room; proportionate deduction applies for a higher room category, except where the hospital does not use differential billing.

ICU Charges
Heart Up to ₹3 L sum insured – 2% of Sum Insured per day Above ₹3 L sum insured – No Limit	Cardiac Care Platinum Covered as part of hospitalisation expenses up to Sum Insured in Sections 1 and 2; no separate ICU cap stated.

Co-payment
Heart In-built co-payment: 20% if entry age ≤ 70 years, 30% if entry age > 70 years.	Cardiac Care Platinum No co-payment clause found in the policy documents.

Disease-wise sublimits
Heart Yes	Cardiac Care Platinum Cataract: ₹30,000 per eye (maximum ₹40,000 per year) for SI ₹5L; ₹40,000 per eye (maximum ₹60,000 per year) for higher SI. Cardiac devices up to 50% of SI; conventional coronary angiogram ₹20,000 for SI up to ₹7.5L or ₹25,000 above; rehabilitation and pain management up to 10% of SI; modern treatment sublimits apply; coronary stents are subject to DPCO/NPPA caps.

Disease-wise sublimits

Heart

Yes

Cardiac Care Platinum

Cataract: ₹30,000 per eye (maximum ₹40,000 per year) for SI ₹5L; ₹40,000 per eye (maximum ₹60,000 per year) for higher SI. Cardiac devices up to 50% of SI; conventional coronary angiogram ₹20,000 for SI up to ₹7.5L or ₹25,000 above; rehabilitation and pain management up to 10% of SI; modern treatment sublimits apply; coronary stents are subject to DPCO/NPPA caps.

Cashless Healthcare Providers
Heart 21700+ Healthcare Providers	Cardiac Care Platinum Cashless treatment is available at Star Health network hospitals for Sections 1 and 2. Reimbursement is available at non-network hospitals; network hospital count requires verification.

Restoration Benefit
Heart Provides 1 restoration of the base cover upon exhaustion, applicable for unrelated illnesses only	Cardiac Care Platinum Automatic restoration of 100% of Basic Sum Insured once per policy period under Section 1 only, for unrelated illness; not available for cardiac ailments or modern treatments.

Daycare Treatment
Heart Covers medical expenses for treatments not requiring 24-hour hospitalization, up to your annual sum insured	Cardiac Care Platinum All Day care procedures are covered.

Cumulative Bonus
Heart Your sum insured increases by 10% each policy year as a No-Claim Bonus, up to 50% of the sum insured. The bonus reduces by 10% for every claim paid	Cardiac Care Platinum 10% of the Basic Sum Insured for each claim-free year, up to 100%; not applicable to Section 3 OPD.

AYUSH Treatment
Heart Covers AYUSH treatment expenses up to your annual sum insured during the policy period	Cardiac Care Platinum In-patient AYUSH treatment is covered up to the Sum Insured under Sections 1 and 2. Yoga and Naturopathy require prior approval.

Consumable Cover
Heart No. However available as an add-on.	Cardiac Care Platinum Not mentioned as a separate benefit in the policy documents.

Initial Waiting Period
Heart 30 days	Cardiac Care Platinum 30 days for illness under Section 1; accidents are covered from day 1. Section 2 cardiac cover also has a 30-day waiting period.

Specific Waiting Period
Heart 2 years	Cardiac Care Platinum 24 months for listed diseases and procedures in Section 1; 24 months for heart transplantation.

PED Waiting Period
Heart 2 years	Cardiac Care Platinum 36 months for non-cardiac pre-existing diseases in Section 1; 30 days for cardiac pre-existing diseases in Section 2.

Modern Treatment
Heart Hospital expenses for listed advanced treatments are covered up to your full sum insured during the policy period	Cardiac Care Platinum Covered under Sections 1 and 2, subject to treatment-wise sublimits by Sum Insured. Examples: robotic surgery ₹2.5L–₹4L; oral chemotherapy ₹1.25L–₹2.5L; immunotherapy ₹2.5L–₹5L. Bronchial thermoplasty, prostate vaporisation and IONM are covered up to the Sum Insured. These benefits are part of the Sum Insured.

Annual Health Checkup
Heart Health check-up is available from the first policy year	Cardiac Care Platinum Covered every policy year irrespective of claims at network facilities: ₹2,000 for SI ₹5L and ₹7.5L, ₹3,000 for ₹10L, and ₹4,000 for ₹15L; in addition to the Sum Insured.

Pre-Hospitalisation
Heart You get cover for medical tests and doctor visits up to 30 days before hospitalisation, if your main claim is approved	Cardiac Care Platinum Up to 30 days before admission.

Post-Hospitalisation
Heart You get cover for medical bills up to 60 days after discharge, including physiotherapy if your doctor prescribes it.	Cardiac Care Platinum Up to 60 days after discharge.

Outpatient Department Cover (OPD Expense)
Heart OPD expense is not included	Cardiac Care Platinum Covered at network facilities, including vaccination, on a reimbursement basis: ₹2,500 / ₹3,000 / ₹3,500 / ₹5,000 per policy period for SI ₹5L / ₹7.5L / ₹10L / ₹15L. In addition to the Sum Insured. Cardiac treatment is payable under Section 2, not under OPD.

Deductible Option
Heart Not available	Cardiac Care Platinum Not available or mentioned in the policy documents.

Coverage Options
Heart Available coverage options: ₹3L, ₹5L, ₹7L and ₹10L	Cardiac Care Platinum Sum Insured ₹5L, ₹7.5L, ₹10L, or ₹15L. Entry age 7–70 years with a past cardiac ailment treated by surgical intervention or procedure. Policy term 1, 2, or 3 years; lifelong renewal.

Claim Settlement Ratio
Heart 96%	Cardiac Care Platinum 92.16% of claims settled by number in FY 2025–26.

Maternity Cover
Heart Not available	Cardiac Care Platinum Not covered; maternity is excluded under Code Excl 18.

Insurance Plans Comparison

Detailed Features Comparison

Compare the key features of different health insurance plans

Heart

Health Insurance Plan

Brochure

Policy Wording

VS

Cardiac Care Platinum

Health Insurance Plan

Brochure

Room Rent
Heart Up to ₹3 L sum insured – 1% of Sum Insured per day Above ₹3 L sum insured – Single Private Room
VS VS
Cardiac Care Platinum Single Private A/C Room; proportionate deduction applies for a higher room category, except where the hospital does not use differential billing.

ICU Charges
Heart Up to ₹3 L sum insured – 2% of Sum Insured per day Above ₹3 L sum insured – No Limit
VS VS
Cardiac Care Platinum Covered as part of hospitalisation expenses up to Sum Insured in Sections 1 and 2; no separate ICU cap stated.

Co-payment
Heart In-built co-payment: 20% if entry age ≤ 70 years, 30% if entry age > 70 years.
VS VS
Cardiac Care Platinum No co-payment clause found in the policy documents.

Disease-wise sublimits
Heart Yes
VS VS
Cardiac Care Platinum Cataract: ₹30,000 per eye (maximum ₹40,000 per year) for SI ₹5L; ₹40,000 per eye (maximum ₹60,000 per year) for higher SI. Cardiac devices up to 50% of SI; conventional coronary angiogram ₹20,000 for SI up to ₹7.5L or ₹25,000 above; rehabilitation and pain management up to 10% of SI; modern treatment sublimits apply; coronary stents are subject to DPCO/NPPA caps.

Cashless Healthcare Providers
Heart 21700+ Healthcare Providers
VS VS
Cardiac Care Platinum Cashless treatment is available at Star Health network hospitals for Sections 1 and 2. Reimbursement is available at non-network hospitals; network hospital count requires verification.

Restoration Benefit
Heart Provides 1 restoration of the base cover upon exhaustion, applicable for unrelated illnesses only
VS VS
Cardiac Care Platinum Automatic restoration of 100% of Basic Sum Insured once per policy period under Section 1 only, for unrelated illness; not available for cardiac ailments or modern treatments.

Daycare Treatment
Heart Covers medical expenses for treatments not requiring 24-hour hospitalization, up to your annual sum insured
VS VS
Cardiac Care Platinum All Day care procedures are covered.

Cumulative Bonus
Heart Your sum insured increases by 10% each policy year as a No-Claim Bonus, up to 50% of the sum insured. The bonus reduces by 10% for every claim paid
VS VS
Cardiac Care Platinum 10% of the Basic Sum Insured for each claim-free year, up to 100%; not applicable to Section 3 OPD.

AYUSH Treatment
Heart Covers AYUSH treatment expenses up to your annual sum insured during the policy period
VS VS
Cardiac Care Platinum In-patient AYUSH treatment is covered up to the Sum Insured under Sections 1 and 2. Yoga and Naturopathy require prior approval.

Consumable Cover
Heart No. However available as an add-on.
VS VS
Cardiac Care Platinum Not mentioned as a separate benefit in the policy documents.

Initial Waiting Period
Heart 30 days
VS VS
Cardiac Care Platinum 30 days for illness under Section 1; accidents are covered from day 1. Section 2 cardiac cover also has a 30-day waiting period.

Specific Waiting Period
Heart 2 years
VS VS
Cardiac Care Platinum 24 months for listed diseases and procedures in Section 1; 24 months for heart transplantation.

PED Waiting Period
Heart 2 years
VS VS
Cardiac Care Platinum 36 months for non-cardiac pre-existing diseases in Section 1; 30 days for cardiac pre-existing diseases in Section 2.

Modern Treatment
Heart Hospital expenses for listed advanced treatments are covered up to your full sum insured during the policy period
VS VS
Cardiac Care Platinum Covered under Sections 1 and 2, subject to treatment-wise sublimits by Sum Insured. Examples: robotic surgery ₹2.5L–₹4L; oral chemotherapy ₹1.25L–₹2.5L; immunotherapy ₹2.5L–₹5L. Bronchial thermoplasty, prostate vaporisation and IONM are covered up to the Sum Insured. These benefits are part of the Sum Insured.

Annual Health Checkup
Heart Health check-up is available from the first policy year
VS VS
Cardiac Care Platinum Covered every policy year irrespective of claims at network facilities: ₹2,000 for SI ₹5L and ₹7.5L, ₹3,000 for ₹10L, and ₹4,000 for ₹15L; in addition to the Sum Insured.

Pre-Hospitalisation
Heart You get cover for medical tests and doctor visits up to 30 days before hospitalisation, if your main claim is approved
VS VS
Cardiac Care Platinum Up to 30 days before admission.

Post-Hospitalisation
Heart You get cover for medical bills up to 60 days after discharge, including physiotherapy if your doctor prescribes it.
VS VS
Cardiac Care Platinum Up to 60 days after discharge.

Outpatient Department Cover (OPD Expense)
Heart OPD expense is not included
VS VS
Cardiac Care Platinum Covered at network facilities, including vaccination, on a reimbursement basis: ₹2,500 / ₹3,000 / ₹3,500 / ₹5,000 per policy period for SI ₹5L / ₹7.5L / ₹10L / ₹15L. In addition to the Sum Insured. Cardiac treatment is payable under Section 2, not under OPD.

Deductible Option
Heart Not available
VS VS
Cardiac Care Platinum Not available or mentioned in the policy documents.

Coverage Options
Heart Available coverage options: ₹3L, ₹5L, ₹7L and ₹10L
VS VS
Cardiac Care Platinum Sum Insured ₹5L, ₹7.5L, ₹10L, or ₹15L. Entry age 7–70 years with a past cardiac ailment treated by surgical intervention or procedure. Policy term 1, 2, or 3 years; lifelong renewal.

Claim Settlement Ratio
Heart 96%
VS VS
Cardiac Care Platinum 92.16% of claims settled by number in FY 2025–26.

Maternity Cover
Heart Not available
VS VS
Cardiac Care Platinum Not covered; maternity is excluded under Code Excl 18.

Insurance Plans Comparison

Still Confused? Get Expert Advice

Our insurance experts are here to help you make the right choice. Get personalized recommendations based on your specific needs and budget.

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Pure advice, no unwanted calls, no unnecessary push

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Talk to experienced advisors at no cost, and make confident decisions

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Get a dedicated expert managing your claim end-to-end, from hospital admission to approval, including dispute resolution and support

End-to-End Support

From choosing the right policy to managing claims, every step is handled for you

Zero Spam. Zero Hassle

Pure advice, no unwanted calls, no unnecessary push

Free Expert Consultation

Talk to experienced advisors at no cost, and make confident decisions

24/7 Claim Assistance

Get a dedicated expert managing your claim end-to-end, from hospital admission to approval, including dispute resolution and support

What Our Experts Help You With

Personalised Recommendations

Every suggestion is backed by expert analysis of your life stage, goals, and budget

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We decode the fine print—identifying risks, sub-limits, and gaps you may have missed. No surprises later

Smart, Tech-Enabled Experience

From digital onboarding to real-time claim tracking, our platform makes insurance easy, accessible, and stress-free

Insurance Plans Comparison

Explore Insurance Category

Senior Citizen Health Plan

Secure against age-related medical costs
Tailored for seniors healthcare needs

Family Health Plan

One policy covers the entire family
High sum insured with cashless care
Multiple coverage options based on your family needs

Maternity Health Plan

Covers delivery, newborn care, and maternity expenses
Reduces financial stress of childbirth costs

Senior Citizen Health Plan

Secure against age-related medical costs
Tailored for seniors healthcare needs

Family Health Plan

One policy covers the entire family
High sum insured with cashless care
Multiple coverage options based on your family needs

Maternity Health Plan

Covers delivery, newborn care, and maternity expenses
Reduces financial stress of childbirth costs

Insurance Plans Comparison

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Having questions? We've got answers. Explore our FAQs to find the information you need.

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