Insurance Plans Comparison
TATA AIG Medicare vs Niva Bupa Health Premia Gold
Make an informed decision with our detailed side-by-side comparison of top health insurance policies. Compare...
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Tata AIG Medicare
What Makes It Special:
Tata AIG MediCare is a comprehensive health insurance plan that provides coverage for inpatient hospitalisation, Day Care Treatment, pre and post-hospitalisation expenses, domiciliary treatment and AYUSH treatment. The policy also includes benefits such as automatic restoration of the Sum Insured, Cumulative Bonus, preventive health check-ups, second medical opinion and additional...
Best For:
Customers who value additional healthcare services such as preventive health check-ups and second medical opinions.
Individuals looking for additional protection through restoration and Cumulative Bonus benefits.
Customers who want coverage for domiciliary treatment and AYUSH treatment.
Families looking for health insurance with Family Floater coverage.
Individuals looking for comprehensive hospitalisation and Day Care Treatment coverage.
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
The policy also provides additional benefits such as preventive health check-ups, second medical opinion and other healthcare support, subject to the applicable limits and conditions.
Domiciliary Treatment is covered when the treatment exceeds three days and the applicable policy conditions are satisfied.
A 50% Cumulative Bonus is added after each claim-free policy year, up to a maximum of 100% of the Sum Insured, subject to policy conditions.
The policy provides automatic restoration of the Basic Sum Insured after the Sum Insured and accrued Cumulative Bonus are exhausted, subject to applicable conditions.
Consider Tata AIG MediCare if you want coverage for inpatient hospitalisation, Day Care Treatment, pre-hospitalisation and post-hospitalisation expenses.
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
![]() Medicare Health Insurance Plan VS VS |
Health Premia Gold Health Insurance Plan |
| Room Rent |
|---|
Medicare
|
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 |
|---|
Medicare 4% of Sum Insured per day |
VS VS |
Health Premia Gold Covered up to Sum Insured as part of In-patient Care; no separate ICU cap stated |
| Co-payment |
|---|
Medicare No Specific Mandatory Co-payment 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 |
|---|
Medicare Applicable to Specified Treatments |
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 |
|---|
Medicare
|
VS VS |
Health Premia Gold Information Unavailable |
| Cashless Healthcare Providers |
|---|
Medicare 11,000+ Cashless Hospitals |
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 |
|---|
Medicare Available Once for Road Traffic Accident |
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 |
|---|
Medicare Cover expenses for listed Day Care Treatment due to disease/illness/injury during the policy period taken at a hospital or a Day Care Centre. |
VS VS |
Health Premia Gold All listed day care procedures (Annexure III) covered up to Sum Insured |
| Cumulative Bonus |
|---|
Medicare 5% of Sum Insured per claim-free year |
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 |
|---|
Medicare Cover for expenses incurred for treatment as in-patient in AYUSH Hospital. |
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 |
|---|
Medicare Not Covered as a Separate Benefit |
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 |
|---|
Medicare 30 Days |
VS VS |
Health Premia Gold 30 days (not for accidents or renewals) |
| Specific Waiting Period |
|---|
Medicare 24 Months |
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 |
|---|
Medicare 36 Months |
VS VS |
Health Premia Gold 24 months of continuous cover |
| Modern Treatment |
|---|
Medicare Covered up to 25% of Sum Insured |
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 |
|---|
Medicare Available as per Policy Terms |
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 |
|---|
Medicare Covered for Up to 30 Days |
VS VS |
Health Premia Gold Up to 90 days before admission, covered up to Sum Insured |
| Post-Hospitalisation |
|---|
Medicare Covered for Up to 60 Days |
VS VS |
Health Premia Gold Up to 180 days after discharge, covered up to Sum Insured |
| Outpatient Department Cover (OPD Expense) |
|---|
Medicare Not Covered under Base Policy |
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 |
|---|
Medicare Not Specified |
VS VS |
Health Premia Gold Not available (the policy wording has no deductible option for Health Premia) |
| Coverage Options |
|---|
Medicare ₹1 Lakh to ₹10 Lakh |
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 |
|---|
Medicare Not Specified |
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 |
|---|
Medicare Not Covered |
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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