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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.

Which health insurance plan offers the best coverage for critical illnesses and pre-existing diseases?

Plans with comprehensive coverage, minimal waiting periods, and optional critical illness riders are ideal. OneAssure helps identify policies that best meet these requirements.

Can I compare waiting periods and sub-limits for hospitalisation expenses on OneAssure?

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What are room rent limits in health insurance, and how do they affect claims?

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Myhealth Medisure Super Top Up Vs Complete Health Insurance Health Shield

Insurance Plans Comparison

HDFC ERGO myHealth Medisure Super Top-up vs ICICI Lombard Complete Health Insurance Health Shield

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...

myHealth Medisure Super Top-up

A super top-up that pays eligible hospitalisation costs only after your aggregate deductible is met, with no sub-limit on room rent or ICU and cover for day care procedures.

What Makes It Special:

my:health Koti Suraksha delivers a ₹1 crore sum insured at a lower premium by accepting three restrictions in the base cover — a room category capped at a Single Standard AC Room, a ₹75,000 sub-limit on eight common procedures, and a mandatory 20% co-payment for lives with a pre-existing disease...

Best For:

Buyers prepared to pay for the waiver covers so a ₹1 crore cover works without room, procedure or co-payment restrictions
Buyers who already hold a base policy and can take the aggregate deductible to reduce premium further
Buyers in Tier 2 cities where a Single Standard AC Room is likely to fall within or close to the plan's room entitlement
Families wanting a wide relationship list on one individual sum insured policy, extending to siblings, in-laws, grandparents, nieces and nephews
Buyers who want a very high sum insured for catastrophic illness and are willing to accept caps on routine, lower-cost procedures

Complete Health Insurance Health Shield

Add 10% to the sum insured after every claim-free year, up to 50%, and cover organ-donor expenses up to ₹10 lakh, with domiciliary hospitalisation and air ambulance paid over and above the sum insured.

What Makes It Special:

Health Shield is a variant listed under ICICI Lombard Complete Health Insurance. Its benefits include inpatient hospitalisation, eligible daycare procedures, inpatient AYUSH treatment, pre- and post-hospitalisation expenses, and a reset benefit that can replenish eligible cover after previous claims. The policy also lists a cumulative bonus and wellness services. Coverage...

Best For:

Customers who may use the policy's wellness services and preventive health-check-up facilities.
Buyers who want eligible daycare and inpatient AYUSH treatment covered.
Customers who value a cumulative bonus for claim-free years.
Individuals or families comparing different base sum insured options.
Buyers looking for hospitalisation cover with a reset benefit for subsequent eligible claims.

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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Quick Decision Guide

HDFC ERGO myHealth Medisure Super Top-up

The room entitlement is a Single Standard AC Room rather than a percentage of sum insured, so check what that category means at the hospitals you would use, since exceeding it can trigger deductions.
Opting for the aggregate deductible removes both the Cumulative Bonus and the Sum Insured Rebound, so weigh the premium saved against losing those two benefits.
If anyone insured is entering above age 60 or has a declared pre-existing disease, a 20% co-payment applies, so check whether the Waiver of Co-Payment costs less than the share you would otherwise bear.
The ₹75,000 sub-limit covers eight of the most commonly claimed procedures, including cataract, hernia and hysterectomy, so if these are a realistic prospect for anyone insured, the Waiver of Disease Capping is likely to matter more than the sum insured.
Price all three waiver covers — room rent, disease capping and co-payment — before comparing this plan against a conventional ₹1 crore policy, because the headline premium reflects the restrictions, not the unrestricted cover.

ICICI Lombard Complete Health Insurance Health Shield

Verify that the Health Shield variant is still available and that the quoted UIN matches the policy document before purchase.
Compare the cataract sub-limit with your expected needs, especially if selecting a lower sum insured.
Check the 24-month PED and specified-disease waiting periods against your medical history.
Review the reset rules carefully, including the restrictions on using reset cover for the same illness.
Confirm the available sum insured and room-rent limit in the policy schedule before choosing the plan.

Insurance Plans Comparison

Detailed Features Comparison

Compare the key features of different health insurance plans

myHealth Medisure Super Top-up

Health Insurance Plan

Brochure

Complete Health Insurance Health Shield

Health Insurance Plan

Brochure

Room Rent
myHealth Medisure Super Top-up Normal: Single A/C private room ICU: no limit, expenses incurred will be covered by the insurance	Complete Health Insurance Health Shield Normal: Health Shield offers room rent and ICU coverage without sub-limits, ensuring full financial support for hospitalization, including intensive care expenses.

ICU Charges
myHealth Medisure Super Top-up Covered within medical expenses; no separate ICU limit stated	Complete Health Insurance Health Shield Covered under eligible inpatient hospitalisation, subject to policy terms.

Advanced Treatments
myHealth Medisure Super Top-up Robotic surgeries for precise, minimally invasive procedures. Bariatric surgery for obesity management (as per policy terms). Modern cancer treatments like immunotherapy and targeted therapy. Stem cell therapy (for approved conditions). Proton beam therapy for advanced cancer care. Advanced cardiac procedures including transplants and minimally invasive heart surgeries.	Complete Health Insurance Health Shield Covers advanced treatments, including robotic surgeries, stem cell therapy, immunotherapy, and modern cancer treatments

Advanced Treatments

myHealth Medisure Super Top-up

Robotic surgeries for precise, minimally invasive procedures.
Bariatric surgery for obesity management (as per policy terms).
Modern cancer treatments like immunotherapy and targeted therapy.
Stem cell therapy (for approved conditions).
Proton beam therapy for advanced cancer care.
Advanced cardiac procedures including transplants and minimally invasive heart surgeries.

Complete Health Insurance Health Shield

Covers advanced treatments, including robotic surgeries, stem cell therapy, immunotherapy, and modern cancer treatments

Co-payment
myHealth Medisure Super Top-up The HDFC My: Health Medisure Super Top-Up Plan has a co-payment clause of 10% for individuals aged 61 years and above at the time of policy purchase.	Complete Health Insurance Health Shield 10% of copay will be applied to every admissible claim.

Disease-wise sublimits
myHealth Medisure Super Top-up Yes — a ₹75,000 sub-limit applies to each of cataract; surgery for benign tumours, cysts, nodules or polyps; stone in the urinary system; hernia-related procedures; appendectomy; hysterectomy; fissures, piles and fistulas; and cellulitis or abscess. Optional Waiver of Disease Capping deletes these sub-limits	Complete Health Insurance Health Shield Cataract: ₹20,000 per eye per policy year for sum insured up to ₹5 lakh; ₹1 lakh per eye per policy year for sum insured above ₹5 lakh.

Cashless Healthcare Providers
myHealth Medisure Super Top-up 16,000+ Healthcare providers.	Complete Health Insurance Health Shield 10,896+ hospitals across India.

Restoration Benefit
myHealth Medisure Super Top-up Optional — Sum Insured Rebound adds an amount equal to the claim paid under the basic sum insured, up to a maximum of the basic sum insured, on subsequent hospitalisation in a policy year. A single claim cannot exceed the basic sum insured plus cumulative bonus earned; for chemotherapy and dialysis it applies only once in the policy lifetime; unused amounts do not carry forward; not available if aggregate deductible is opted	Complete Health Insurance Health Shield Unlimited Reset Benefit is listed; reset does not trigger on the first claim and remains subject to illness, insured-person and other policy conditions.

Restoration Benefit

myHealth Medisure Super Top-up

Optional — Sum Insured Rebound adds an amount equal to the claim paid under the basic sum insured, up to a maximum of the basic sum insured, on subsequent hospitalisation in a policy year. A single claim cannot exceed the basic sum insured plus cumulative bonus earned; for chemotherapy and dialysis it applies only once in the policy lifetime; unused amounts do not carry forward; not available if aggregate deductible is opted

Complete Health Insurance Health Shield

Unlimited Reset Benefit is listed; reset does not trigger on the first claim and remains subject to illness, insured-person and other policy conditions.

Cumulative Bonus
myHealth Medisure Super Top-up 10% of basic sum insured on each continuous renewal irrespective of claims, up to a maximum of 100%; not applicable if aggregate deductible is opted. Optional Cumulative Bonus Booster increases this to 50% per renewal, maximum 100%	Complete Health Insurance Health Shield 10% of annual sum insured per claim-free year, up to 50%; accumulated bonus reduces by 10% of annual sum insured following a claim, as specified in the policy.

Daycare Treatment
myHealth Medisure Super Top-up Covered by the policy.	Complete Health Insurance Health Shield Covered under the policy.

Consumable Cover
myHealth Medisure Super Top-up Optional — Non-Medical Expenses Cover pays non-medical expenses up to 5% of the admissible claim amount under the hospitalisation section	Complete Health Insurance Health Shield

AYUSH Treatment
myHealth Medisure Super Top-up Covered in the policy.	Complete Health Insurance Health Shield Covered under this policy

Initial Waiting Period
myHealth Medisure Super Top-up 30 days, except claims arising from an accident	Complete Health Insurance Health Shield 30 days for illnesses; injury-related hospitalisation is excepted.

Specific Waiting Period
myHealth Medisure Super Top-up 24 months for specified illnesses and surgical procedures	Complete Health Insurance Health Shield 24 months for specified illnesses and treatments.

PED Waiting Period
myHealth Medisure Super Top-up 36 months; optional Waiting Period Modification reduces it to 24 months	Complete Health Insurance Health Shield 24 months for declared and accepted pre-existing diseases.

Modern Treatment
myHealth Medisure Super Top-up Not specified	Complete Health Insurance Health Shield Not verified as a separately defined benefit in the reviewed Health Shield document.

Annual Health Checkup
myHealth Medisure Super Top-up Preventive health check-up after completion of each policy year or at renewal at a network provider, covering a listed panel including chest X-ray, 2D echo or stress test, PSA for males, PAP smear for females, medical examination report, complete blood count, urine routine, fasting blood sugar, lipid profile and ECG. The benefit is not carried forward if not used within 60 days of the policy anniversary	Complete Health Insurance Health Shield Health-check-up coupon each policy year, up to 2 coupons per year for floater policies.

Annual Health Checkup

myHealth Medisure Super Top-up

Preventive health check-up after completion of each policy year or at renewal at a network provider, covering a listed panel including chest X-ray, 2D echo or stress test, PSA for males, PAP smear for females, medical examination report, complete blood count, urine routine, fasting blood sugar, lipid profile and ECG. The benefit is not carried forward if not used within 60 days of the policy anniversary

Complete Health Insurance Health Shield

Health-check-up coupon each policy year, up to 2 coupons per year for floater policies.

Pre-Hospitalisation
myHealth Medisure Super Top-up Information Unavailable	Complete Health Insurance Health Shield Up to 30 days.

Post-Hospitalisation
myHealth Medisure Super Top-up 180 days after discharge	Complete Health Insurance Health Shield Up to 60 days.

Outpatient Department Cover (OPD Expense)
myHealth Medisure Super Top-up Not covered. Wellness services include discounts on OPD, pharmaceuticals, pharmacy and diagnostic centres, which are discounts rather than cover	Complete Health Insurance Health Shield Wellness points may be redeemable for eligible outpatient expenses; a fixed comprehensive OPD limit was not verified.

Deductible Option
myHealth Medisure Super Top-up Optional — Aggregate Deductible. The insured bears the opted amount across all admissible claims in a policy year before the insurer's liability begins. Opting for it removes the Cumulative Bonus and the Sum Insured Rebound	Complete Health Insurance Health Shield Not verified in the reviewed Health Shield document.

Coverage Options
myHealth Medisure Super Top-up Individual sum insured or floater sum insured	Complete Health Insurance Health Shield Individual or family floater; listed sum insured options from ₹3 lakh to ₹50 lakh.

Claim Settlement Ratio
myHealth Medisure Super Top-up 97.43%	Complete Health Insurance Health Shield FY 2024-25: 83.65%

Maternity Cover
myHealth Medisure Super Top-up Not covered — maternity and medical treatment expenses traceable to childbirth are permanently excluded	Complete Health Insurance Health Shield Excluded under the reviewed policy wording, except for stated policy exceptions such as ectopic pregnancy.

Insurance Plans Comparison

Detailed Features Comparison

Compare the key features of different health insurance plans

myHealth Medisure Super Top-up

Health Insurance Plan

Brochure

Complete Health Insurance Health Shield

Health Insurance Plan

Brochure

Room Rent
myHealth Medisure Super Top-up Normal: Single A/C private room ICU: no limit, expenses incurred will be covered by the insurance
VS VS
Complete Health Insurance Health Shield Normal: Health Shield offers room rent and ICU coverage without sub-limits, ensuring full financial support for hospitalization, including intensive care expenses.

ICU Charges
myHealth Medisure Super Top-up Covered within medical expenses; no separate ICU limit stated
VS VS
Complete Health Insurance Health Shield Covered under eligible inpatient hospitalisation, subject to policy terms.

Advanced Treatments
myHealth Medisure Super Top-up Robotic surgeries for precise, minimally invasive procedures. Bariatric surgery for obesity management (as per policy terms). Modern cancer treatments like immunotherapy and targeted therapy. Stem cell therapy (for approved conditions). Proton beam therapy for advanced cancer care. Advanced cardiac procedures including transplants and minimally invasive heart surgeries.
VS VS
Complete Health Insurance Health Shield Covers advanced treatments, including robotic surgeries, stem cell therapy, immunotherapy, and modern cancer treatments

Co-payment
myHealth Medisure Super Top-up The HDFC My: Health Medisure Super Top-Up Plan has a co-payment clause of 10% for individuals aged 61 years and above at the time of policy purchase.
VS VS
Complete Health Insurance Health Shield 10% of copay will be applied to every admissible claim.

Disease-wise sublimits
myHealth Medisure Super Top-up Yes — a ₹75,000 sub-limit applies to each of cataract; surgery for benign tumours, cysts, nodules or polyps; stone in the urinary system; hernia-related procedures; appendectomy; hysterectomy; fissures, piles and fistulas; and cellulitis or abscess. Optional Waiver of Disease Capping deletes these sub-limits
VS VS
Complete Health Insurance Health Shield Cataract: ₹20,000 per eye per policy year for sum insured up to ₹5 lakh; ₹1 lakh per eye per policy year for sum insured above ₹5 lakh.

Cashless Healthcare Providers
myHealth Medisure Super Top-up 16,000+ Healthcare providers.
VS VS
Complete Health Insurance Health Shield 10,896+ hospitals across India.

Restoration Benefit
myHealth Medisure Super Top-up Optional — Sum Insured Rebound adds an amount equal to the claim paid under the basic sum insured, up to a maximum of the basic sum insured, on subsequent hospitalisation in a policy year. A single claim cannot exceed the basic sum insured plus cumulative bonus earned; for chemotherapy and dialysis it applies only once in the policy lifetime; unused amounts do not carry forward; not available if aggregate deductible is opted
VS VS
Complete Health Insurance Health Shield Unlimited Reset Benefit is listed; reset does not trigger on the first claim and remains subject to illness, insured-person and other policy conditions.

Cumulative Bonus
myHealth Medisure Super Top-up 10% of basic sum insured on each continuous renewal irrespective of claims, up to a maximum of 100%; not applicable if aggregate deductible is opted. Optional Cumulative Bonus Booster increases this to 50% per renewal, maximum 100%
VS VS
Complete Health Insurance Health Shield 10% of annual sum insured per claim-free year, up to 50%; accumulated bonus reduces by 10% of annual sum insured following a claim, as specified in the policy.

Daycare Treatment
myHealth Medisure Super Top-up Covered by the policy.
VS VS
Complete Health Insurance Health Shield Covered under the policy.

Consumable Cover
myHealth Medisure Super Top-up Optional — Non-Medical Expenses Cover pays non-medical expenses up to 5% of the admissible claim amount under the hospitalisation section
VS VS
Complete Health Insurance Health Shield

AYUSH Treatment
myHealth Medisure Super Top-up Covered in the policy.
VS VS
Complete Health Insurance Health Shield Covered under this policy

Initial Waiting Period
myHealth Medisure Super Top-up 30 days, except claims arising from an accident
VS VS
Complete Health Insurance Health Shield 30 days for illnesses; injury-related hospitalisation is excepted.

Specific Waiting Period
myHealth Medisure Super Top-up 24 months for specified illnesses and surgical procedures
VS VS
Complete Health Insurance Health Shield 24 months for specified illnesses and treatments.

PED Waiting Period
myHealth Medisure Super Top-up 36 months; optional Waiting Period Modification reduces it to 24 months
VS VS
Complete Health Insurance Health Shield 24 months for declared and accepted pre-existing diseases.

Modern Treatment
myHealth Medisure Super Top-up Not specified
VS VS
Complete Health Insurance Health Shield Not verified as a separately defined benefit in the reviewed Health Shield document.

Annual Health Checkup
myHealth Medisure Super Top-up Preventive health check-up after completion of each policy year or at renewal at a network provider, covering a listed panel including chest X-ray, 2D echo or stress test, PSA for males, PAP smear for females, medical examination report, complete blood count, urine routine, fasting blood sugar, lipid profile and ECG. The benefit is not carried forward if not used within 60 days of the policy anniversary
VS VS
Complete Health Insurance Health Shield Health-check-up coupon each policy year, up to 2 coupons per year for floater policies.

Pre-Hospitalisation
myHealth Medisure Super Top-up Information Unavailable
VS VS
Complete Health Insurance Health Shield Up to 30 days.

Post-Hospitalisation
myHealth Medisure Super Top-up 180 days after discharge
VS VS
Complete Health Insurance Health Shield Up to 60 days.

Outpatient Department Cover (OPD Expense)
myHealth Medisure Super Top-up Not covered. Wellness services include discounts on OPD, pharmaceuticals, pharmacy and diagnostic centres, which are discounts rather than cover
VS VS
Complete Health Insurance Health Shield Wellness points may be redeemable for eligible outpatient expenses; a fixed comprehensive OPD limit was not verified.

Deductible Option
myHealth Medisure Super Top-up Optional — Aggregate Deductible. The insured bears the opted amount across all admissible claims in a policy year before the insurer's liability begins. Opting for it removes the Cumulative Bonus and the Sum Insured Rebound
VS VS
Complete Health Insurance Health Shield Not verified in the reviewed Health Shield document.

Coverage Options
myHealth Medisure Super Top-up Individual sum insured or floater sum insured
VS VS
Complete Health Insurance Health Shield Individual or family floater; listed sum insured options from ₹3 lakh to ₹50 lakh.

Claim Settlement Ratio
myHealth Medisure Super Top-up 97.43%
VS VS
Complete Health Insurance Health Shield FY 2024-25: 83.65%

Maternity Cover
myHealth Medisure Super Top-up Not covered — maternity and medical treatment expenses traceable to childbirth are permanently excluded
VS VS
Complete Health Insurance Health Shield Excluded under the reviewed policy wording, except for stated policy exceptions such as ectopic pregnancy.

Insurance Plans Comparison

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Secure against age-related medical costs
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Covers delivery, newborn care, and maternity expenses
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