How does OneAssure help me compare health insurance policies and choose the best plan?

OneAssure allows you to compare multiple health insurance policies side by side, analyzing coverage, premiums, hospital networks, and benefits to choose the most suitable plan for your needs.

What is the difference between cashless and reimbursement claims in health insurance policies?

Cashless claims let you get treatment at network hospitals without paying upfront, while reimbursement claims require you to pay first and get refunded later.

Does OneAssure provide expert guidance while selecting health insurance with maternity or newborn coverage?

Yes, OneAssure’s insurance experts guide you in selecting plans with maternity benefits, newborn cover, and short waiting periods for family planning needs.

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?

Yes, OneAssure’s comparison tool highlights waiting periods, sub-limits, and exclusions so you can choose a policy that maximizes benefits and minimizes restrictions.

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

Room rent limits cap the daily room cost covered by your insurer. Choosing a plan without strict limits ensures higher claim payouts.

Does OneAssure assist with health insurance claims and renewals after I purchase a policy?

Absolutely. OneAssure provides end-to-end support for claims, renewals, and queries, ensuring a hassle-free experience throughout your policy tenure.

How can I check if a health insurance plan covers daycare procedures and modern treatments?

OneAssure’s policy comparison clearly lists daycare and advanced treatment coverage, helping you pick a plan aligned with your healthcare needs.

What documents are needed to buy and claim a health insurance policy online via OneAssure?

To buy a policy, you need ID proof, address proof, and medical details. For claims, hospital bills, prescriptions, and discharge summaries are required.

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Compare Health Insurance Plans

Family Health Optima Vs Health Premia Gold

Insurance Plans Comparison

Star Family Health Optima vs Niva Bupa Health Premia Gold

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...

Family Health Optima

Family Floater Health Insurance with Hospitalisation Benefits

What Makes It Special:

Family Health Insurance

Best For:

Customers comparing restoration and loyalty bonus benefits.
Families wanting eligible AYUSH treatment and preventive health check-ups.
Customers seeking pre- and post-hospitalisation benefits.
Families looking for hospitalisation and daycare coverage.
Families seeking health insurance under a single floater Sum Insured.

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

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

Star Family Health Optima

Check the policy limits for specific treatments and benefits.
Review pre- and post-hospitalisation coverage.
Check the restoration and loyalty bonus conditions.
Understand the 24-month specific disease waiting period and 36-month pre-existing disease waiting period.
Review the 30-day initial waiting period.
Check the shared accommodation benefit and applicable limits.
Review the 20% co-payment applicable to insured persons aged 61 and above at entry.

Niva Bupa Health Premia Gold

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

Family Health Optima

Health Insurance Plan

Brochure

Policy Wording

VS

Health Premia Gold

Health Insurance Plan

Brochure

Policy Wording

Room Rent
Family Health Optima Shared accommodation is covered within the applicable policy limits.	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

ICU Charges
Family Health Optima Covered as part of eligible hospitalisation expenses, subject to policy terms.	Health Premia Gold Covered up to Sum Insured as part of In-patient Care; no separate ICU cap stated

Co-payment
Family Health Optima 20% of each claim for insured persons whose age at entry is 61 years or above.	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
Family Health Optima Sublimits apply to specified benefits and treatments, subject to policy terms.	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
Family Health Optima Cashless treatment is available at eligible network hospitals, subject to authorisation and policy conditions.	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
Family Health Optima 100% of the Sum Insured is restored up to three times in a policy year, subject to policy conditions.	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
Family Health Optima Eligible daycare procedures are covered, subject to policy terms.	Health Premia Gold All listed day care procedures (Annexure III) covered up to Sum Insured

Cumulative Bonus
Family Health Optima Loyalty Bonus is available for eligible Sum Insured options, subject to renewal conditions and policy limits.	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
Family Health Optima Eligible inpatient Ayurveda, Unani, Siddha and Homeopathy treatment is covered up to the Sum Insured, subject to policy terms.	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
Family Health Optima Not specified.	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
Family Health Optima 30 days, except for accidents.	Health Premia Gold 30 days (not for accidents or renewals)

Specific Waiting Period
Family Health Optima 24 months for specified diseases and procedures.	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
Family Health Optima 36 months for pre-existing diseases.	Health Premia Gold 24 months of continuous cover

Modern Treatment
Family Health Optima Specified modern treatments are covered, subject to policy limits.	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
Family Health Optima Preventive health check-up at network providers, according to the applicable Sum Insured and package.	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
Family Health Optima Covered for up to 60 days before hospital admission.	Health Premia Gold Up to 90 days before admission, covered up to Sum Insured

Post-Hospitalisation
Family Health Optima Covered for up to 90 days after discharge.	Health Premia Gold Up to 180 days after discharge, covered up to Sum Insured

Outpatient Department Cover (OPD Expense)
Family Health Optima Not specified.	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
Family Health Optima Not specified.	Health Premia Gold Not available (the policy wording has no deductible option for Health Premia)

Coverage Options
Family Health Optima Family Floater.	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

Coverage Options

Family Health Optima

Family Floater.

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
Family Health Optima Insurer-level metric, not a policy benefit.	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
Family Health Optima Not specified.	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

Detailed Features Comparison

Compare the key features of different health insurance plans

Family Health Optima

Health Insurance Plan

Brochure

Policy Wording

VS

Health Premia Gold

Health Insurance Plan

Brochure

Policy Wording

Room Rent
Family Health Optima Shared accommodation is covered within the applicable policy limits.
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

ICU Charges
Family Health Optima Covered as part of eligible hospitalisation expenses, subject to policy terms.
VS VS
Health Premia Gold Covered up to Sum Insured as part of In-patient Care; no separate ICU cap stated

Co-payment
Family Health Optima 20% of each claim for insured persons whose age at entry is 61 years or above.
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
Family Health Optima Sublimits apply to specified benefits and treatments, subject to policy terms.
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
Family Health Optima Cashless treatment is available at eligible network hospitals, subject to authorisation and policy conditions.
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
Family Health Optima 100% of the Sum Insured is restored up to three times in a policy year, subject to policy conditions.
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
Family Health Optima Eligible daycare procedures are covered, subject to policy terms.
VS VS
Health Premia Gold All listed day care procedures (Annexure III) covered up to Sum Insured

Cumulative Bonus
Family Health Optima Loyalty Bonus is available for eligible Sum Insured options, subject to renewal conditions and policy limits.
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
Family Health Optima Eligible inpatient Ayurveda, Unani, Siddha and Homeopathy treatment is covered up to the Sum Insured, subject to policy terms.
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
Family Health Optima Not specified.
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
Family Health Optima 30 days, except for accidents.
VS VS
Health Premia Gold 30 days (not for accidents or renewals)

Specific Waiting Period
Family Health Optima 24 months for specified diseases and procedures.
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
Family Health Optima 36 months for pre-existing diseases.
VS VS
Health Premia Gold 24 months of continuous cover

Modern Treatment
Family Health Optima Specified modern treatments are covered, subject to policy 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
Family Health Optima Preventive health check-up at network providers, according to the applicable Sum Insured and package.
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
Family Health Optima Covered for up to 60 days before hospital admission.
VS VS
Health Premia Gold Up to 90 days before admission, covered up to Sum Insured

Post-Hospitalisation
Family Health Optima Covered for up to 90 days after discharge.
VS VS
Health Premia Gold Up to 180 days after discharge, covered up to Sum Insured

Outpatient Department Cover (OPD Expense)
Family Health Optima Not specified.
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
Family Health Optima Not specified.
VS VS
Health Premia Gold Not available (the policy wording has no deductible option for Health Premia)

Coverage Options
Family Health Optima Family Floater.
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
Family Health Optima Insurer-level metric, not a policy benefit.
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
Family Health Optima Not specified.
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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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

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Insurance Plans Comparison

Explore Insurance Category

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

Family Health Plan

One policy covers the entire family
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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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