Insurance Plans Comparison
ManipalCigna ProHealth Accumulate vs Niva Bupa Health Premia Gold
Make an informed decision with our detailed side-by-side comparison of top health insurance policies. Compare...
Read moreProHealth Accumulate
ProHealth Accumulate
What Makes It Special:
ProHealth is designed for those who want comprehensive coverage without restrictions. It offers extensive coverage for modern treatments and innovative features.
Best For:
- Not available
VS
Health Premia Gold
Health Premia Gold offers ₹10-50 Lakh cover with 100% refill, 10% yearly loyalty additions, maternity cover and in-built single-trip travel insurance.
What Makes It Special:
Health Premia Gold is the mid-tier plan of Niva Bupa's Health Premia product. Along with hospitalisation up to Sum Insured (any room except suite), 90/180 days pre/post-hospitalisation and AYUSH cover, it adds LASER surgery cover and an in-built international cover of up to ₹30 Lakh for one trip of up...
Best For:
Extended families (Family First) wanting up to 19 relationships in one policy
Buyers who want a 100% refill plus 10% yearly loyalty additions regardless of claims
People who want LASER surgery and mental health cover included
Frequent-ish travellers who value in-built overseas emergency cover for one trip a year
Families wanting ₹10-50 Lakh cover with maternity and newborn benefits
Insurance Plans Comparison
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Quick Decision Guide
Not available
Things to Consider: Domestic OPD cover and Second Medical Opinion are not included in Gold.
Things to Consider: Robotic surgery, some mental disorders and HIV/AIDS have sub-limits; mental illness has a 36-month waiting period.
Things to Consider: Non-payable items (consumables like gloves) need the paid Safeguard add-on.
Things to Consider: Choosing Zone 2 pricing means a 20% co-payment for treatment in Mumbai, Delhi NCR, Kolkata and Gujarat.
Things to Consider: Maternity cover is only for Family Floater / Family First policies and needs 24 months of continuous cover.
Reasons to Consider: In-built international cover (₹30 Lakh, one trip) and LASER surgery cover are included.
Reasons to Consider: PED waiting period is 24 months and specific disease waiting period is just 12 months.
Reasons to Consider: Pre and post-hospitalisation are covered for 90 and 180 days.
Reasons to Consider: A 100% Re-fill of Base Sum Insured is available once a year for any illness.
Reasons to Consider: Loyalty Additions grow your cover by 10% of Base Sum Insured every year (up to 100%), even if you make a claim.
Insurance Plans Comparison
Detailed Features Comparison
Compare the key features of different health insurance plans
![]() ProHealth Accumulate Health Insurance Plan VS VS |
Health Premia Gold Health Insurance Plan |
| Room Rent |
|---|
ProHealth Accumulate Normal: Single Private AC Room ICU: Up to Sum Insured |
VS VS |
Health Premia Gold Covered up to Sum Insured, any room except Suite or above (all Gold variants incl. Family First). Proportionate deduction applies if a higher room than eligible is taken |
| Advanced Treatments |
|---|
ProHealth Accumulate Sum Insured below ₹5 Lakh: Covered up to 50% of Sum Insured Sum Insured ₹5 Lakh and above: Covered up to Sum Insured |
VS VS |
Health Premia Gold Information Unavailable |
| ICU Charges |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Covered up to Sum Insured as part of In-patient Care; no separate ICU cap stated |
| Co-payment |
|---|
ProHealth Accumulate Not mentioned |
VS VS |
Health Premia Gold No mandatory co-payment with Zone 1 pricing. With Zone 2 pricing, 20% co-pay applies to treatment in Mumbai (incl. Navi Mumbai & Thane), Delhi NCR, Kolkata and Gujarat. OPD claims under International Coverage have 20% co-pay |
| Disease-wise sublimits |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold No sublimits on common conditions like cataract or joint replacement. Sublimits apply to: robotic surgeries (₹1 Lakh, with exceptions), specified mental disorders (₹50,000), HIV/AIDS (₹50,000 per year), LASER surgery (up to ₹50,000), non-network road ambulance (₹2,000 per event) |
| Waiting Period |
|---|
ProHealth Accumulate Initial Waiting Period: 30 Days Pre-existing Disease Waiting Period: Sum Insured up to ₹5 Lakh: 36 Months Sum Insured ₹7.5 Lakh and above: 24 Months Specific Disease/Procedure Waiting Period: 24 Months Bariatric Surgery Waiting Period: 36 Months Maternity & Infertility Waiting Period: 36 Months |
VS VS |
Health Premia Gold Information Unavailable |
| Cashless Healthcare Providers |
|---|
ProHealth Accumulate Not mentioned |
VS VS |
Health Premia Gold Cashless treatment at Niva Bupa network hospitals across India; 10,000+ network hospitals (approximate, per Platinum brochure and Annual Report FY 2024-25; subject to change). Pre-authorisation target of 30 minutes |
| Restoration Benefit |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Re-fill Benefit: up to 100% of Base Sum Insured once per policy year, for the same or a different illness, after the Sum Insured is partly or fully used. Not available under the Family First variant |
| Daycare Treatment |
|---|
ProHealth Accumulate Covered up to Sum Insured |
VS VS |
Health Premia Gold All listed day care procedures (Annexure III) covered up to Sum Insured |
| Cumulative Bonus |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Loyalty Additions of 10% of expiring Base Sum Insured every policy year, up to 100%, even if you claim. Optional Enhanced Loyalty Addition: 20% per year, up to 200% |
| AYUSH Treatment |
|---|
ProHealth Accumulate Covered up to Sum Insured |
VS VS |
Health Premia Gold In-patient Ayurveda, Unani, Siddha and Homeopathy treatment in an AYUSH hospital covered up to Sum Insured, with 90/180 days pre/post-hospitalisation |
| Consumable Cover |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Allowable consumables paid within hospital bills; IRDAI non-payable items are not covered in the base plan. Covered with the optional Safeguard (List I) or Safeguard+ (Lists I-IV) add-on (Add-on UIN NBHHLIA24109V022324) |
| Initial Waiting Period |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold 30 days (not for accidents or renewals) |
| Specific Waiting Period |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold 12 months for listed conditions (e.g. cataract, hernia, joint/spine disorders, piles). Accidents covered from day 1; cancer after the 30-day wait. Mental illness and LASER surgery: 36 months. HIV/AIDS: 48 months |
| PED Waiting Period |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold 24 months of continuous cover |
| Modern Treatment |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Covered up to Sum Insured (12 listed procedures, e.g. robotic surgery, oral chemotherapy, immunotherapy, stem cell therapy). Robotic surgeries capped at ₹1 Lakh, except robotic radical prostatectomy, cardiac, partial nephrectomy and cancer surgeries |
| Annual Health Checkup |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Annual from Day 1: tests up to ₹2,500 per insured (₹10-20L SI), ₹5,000 (₹30L), ₹7,500 (₹50L). Family First Gold: ₹2,500 |
| Pre-Hospitalisation |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Up to 90 days before admission, covered up to Sum Insured |
| Post-Hospitalisation |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Up to 180 days after discharge, covered up to Sum Insured |
| Outpatient Department Cover (OPD Expense) |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Domestic OPD: Not available under Gold. (OPD abroad is covered only within the in-built International Coverage, with 20% co-pay). Unlimited e-consultations included in all plans |
| Deductible Option |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Not available (the policy wording has no deductible option for Health Premia) |
| Coverage Options |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Individual / Family Floater: ₹10, 15, 20, 30 or 50 Lakh Base Sum Insured. Family First variant: Base Individual SI ₹5-10 Lakh per person with a shared floater layer on top. Policy types: Individual, Family Floater (up to 6 members, max 4 children) and Family First (up to 19 relationships). Entry age: adults 18-65, children 91 days-30 years. 1, 2 or 3-year terms; lifelong renewal |
| Claim Settlement Ratio |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold 93.5% of claims settled (by number) for Health Premia in FY 2025-26. Source: Niva Bupa Public Disclosures FY2025-26 (Form NL-47), https://transactions.nivabupa.com/pages/doc/pub-dis/quarterly-reports/Website-Public-Disclosures-Mar-2026.pdf. Company-level: 94.4% (Niva Bupa Annual Report FY 2025-26) |
| Maternity Cover |
|---|
ProHealth Accumulate Information Unavailable |
VS VS |
Health Premia Gold Covered only under Family Floater / Family First (not Individual), after 24 months continuous cover, up to 2 pregnancies/terminations: ₹70,000 (₹10L), ₹75,000 (₹15L), ₹80,000 (₹20L), ₹1,00,000 (₹30L/₹50L); Family First Gold ₹50,000. New born covered up to SI till end of policy year; newborn vaccination in first year |
Insurance Plans Comparison
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