Insurance Plans Comparison
ICICI Lombard Health Elite vs Niva Bupa Health Premia Gold
Make an informed decision with our detailed side-by-side comparison of top health insurance policies. Compare...
Read moreHealth Elite
Include maternity after 3 years and outpatient treatment, pay hospital daily cash for a stay of at least 3 days, and add a 10% cumulative bonus each claim-free year, up to 50% of the sum insured.
What Makes It Special:
ICICI Lombard Health Elite is a comprehensive health insurance option with benefits that may include in-patient treatment, daycare procedures, pre- and post-hospitalisation expenses, outpatient treatment and maternity cover, depending on the applicable policy version and selected configuration.
Best For:
Buyers comparing sum insured options, reset benefits, waiting periods and policy-specific restrictions before choosing a plan.
Families evaluating maternity and newborn-related benefits, subject to eligibility and waiting periods.
Individuals who want to compare available outpatient treatment benefits and their applicable limits.
Buyers looking for a policy with additional healthcare benefits beyond basic hospitalisation cover.
Individuals seeking health insurance for eligible hospitalisation and daycare expenses.
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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Our insurance experts are here to help you make the right choice. Get personalized recommendations based on your specific needs and budget.
Quick Decision Guide
Match the policy UIN and schedule to the exact Health Elite version being offered, because benefits may differ between versions.
Confirm whether outpatient treatment, maternity and newborn benefits are included in your chosen configuration and check their limits.
Review waiting periods for pre-existing diseases, specified treatments and maternity benefits before relying on the policy.
Check room eligibility, hospitalisation limits and exclusions to understand the expenses the policy may leave you paying.
Choose a sum insured that reflects potential hospitalisation expenses and the number of people covered.
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
![]() Health Elite Health Insurance Plan VS VS |
Health Premia Gold Health Insurance Plan |
| Room Rent |
|---|
Health Elite Information Unavailable |
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 |
|---|
Health Elite
|
VS VS |
Health Premia Gold Information Unavailable |
| ICU Charges |
|---|
Health Elite Covered under eligible in-patient hospitalisation, subject to the applicable sum insured and policy conditions. |
VS VS |
Health Premia Gold Covered up to Sum Insured as part of In-patient Care; no separate ICU cap stated |
| Co-payment |
|---|
Health Elite Policyholders can opt for a co-payment of 10% or 20%, sharing a fixed percentage of the claim amount, which can help reduce premium costs. |
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 |
|---|
Health Elite Specific limits depend on the applicable policy wording, sum insured and benefit configuration. A complete variant-specific list has not been verified. |
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) |
| Cashless Healthcare Providers |
|---|
Health Elite Access to over 6,700 network hospitals and clinics for cashless treatments, ensuring convenient and hassle-free medical care. |
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 |
|---|
Health Elite Published Health Elite materials list an unlimited reset benefit. The precise trigger, eligible claims and conditions must be confirmed against the applicable policy wording. |
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 |
|---|
Health Elite Covers medical procedures requiring less than 24-hour hospitalization, such as cataract surgery and chemotherapy, accommodating treatments that don't necessitate extended hospital stays. |
VS VS |
Health Premia Gold All listed day care procedures (Annexure III) covered up to Sum Insured |
| Cumulative Bonus |
|---|
Health Elite Published Health Elite materials list Additional Sum Insured and a Super No Claim Bonus option. The applicable benefit percentage and conditions are not verified for this variant. |
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 |
|---|
Health Elite Expenses for alternative treatments, including Ayurveda, Yoga, Unani, Siddha, and Homeopathy, are covered when availed at government-recognized institutions, promoting holistic healthcare options. |
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 |
|---|
Health Elite Published Health Elite materials list Additional Sum Insured and a Super No Claim Bonus option. The applicable benefit percentage and conditions are not verified for this variant. |
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 |
|---|
Health Elite The insurer's general health insurance information states 30 days for illness-related hospitalisation, except accidents. Confirm the exact Health Elite policy terms. |
VS VS |
Health Premia Gold 30 days (not for accidents or renewals) |
| Specific Waiting Period |
|---|
Health Elite The exact waiting period for specified diseases and procedures is not verified for this variant. |
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 |
|---|
Health Elite The exact waiting period for specified diseases and procedures is not verified for this variant. |
VS VS |
Health Premia Gold 24 months of continuous cover |
| Modern Treatment |
|---|
Health Elite Listed as a covered category in the older Complete Health Insurance policy information, subject to the applicable policy terms and limits. |
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 |
|---|
Health Elite Health check-up is listed in published Health Elite materials. Eligibility, frequency and monetary limits are not verified for this exact variant. |
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 |
|---|
Health Elite Up to 30 days according to the published Health Elite product comparison, subject to policy terms. |
VS VS |
Health Premia Gold Up to 90 days before admission, covered up to Sum Insured |
| Post-Hospitalisation |
|---|
Health Elite Up to 60 days according to the published Health Elite product comparison, subject to policy terms. |
VS VS |
Health Premia Gold Up to 180 days after discharge, covered up to Sum Insured |
| Outpatient Department Cover (OPD Expense) |
|---|
Health Elite Outpatient Treatment Cover is listed in published Health Elite materials. The limit depends on the applicable sum insured and policy configuration. |
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 |
|---|
Health Elite A voluntary deductible may be available under applicable ICICI Lombard health products, but its availability for this Health Elite variant is not verified. |
VS VS |
Health Premia Gold Not available (the policy wording has no deductible option for Health Premia) |
| Coverage Options |
|---|
Health Elite 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 |
|---|
Health Elite FY 24-25: ~84% |
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 |
|---|
Health Elite Published materials list multiple sum insured options, including ₹5 lakh, ₹7 lakh, ₹10 lakh, ₹15 lakh, ₹20 lakh, ₹25 lakh and ₹50 lakh. Availability varies by policy version. |
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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