How to select the best health insurance plan from Care Health insurance?
There is no best health insurance plan which fits for all. Each person has different requirements and the health insurance plan has to be chosen as per the requirements. The health insurance plans available from CARE HEALTH INSURANCE Company provide many options to customers which can sometimes lead to confusion. In that case below factors are to be considered before deciding on the best health insurance plan:-
- Sum Insured: Sum insured in a health insurance is also known as the coverage available under the health insurance plan. Higher the coverage, higher would be the premium charged by the insurance company. The basic premium starts at Rs.50k in Care health insurance company and can go up to 1 Crore depending on the requirements of the customers. The sum insured or coverage should be ideally decided by the customer keeping in mind different factors such as Age of the customer, family members in the policy, rising inflation costs, cost of treatments, affordability/premium paying capacity. Now-a-days insurance companies are providing EMI options to pay their health insurance premiums which provide a great relief to customer to select the higher sum insured plans.
- Individual/ Floater: It is important to decide whether the health insurance policy would be taken for an individual or for family. There are many options in a health insurance policy which cannot be utilised by an individual alone and availing these options would be of no use and the customer would end up paying high premium for the options he wouldn’t be using. The sum insured can be opted separately for each individual in the health insurance policy or everyone in the policy can use a single sum insured. Most of the health insurance plans include individual and floater sum insured options for the customer to select from.
- Need for health insurance: First of all, the need for health insurance should be identified by the customer before proceeding to the health insurance policy purchase. As there are different types of policies for different requirements, it is important to analyse the need for health insurance before taking one. For instance there are Covid health insurance plans, Maternity plans, senior citizen plans, Plans for customers with pre-existing diseases such as Heart attack, Hypertension etc., Cancer Mediclaim plans, Arogya Sanjeevani plans etc. For example, a customer with pre existing disease should better opt for Care Heart plan instead of Care Freedom where the pre existing disease waiting period is higher.
- Add-on/ Rider: Add-on or Rider is the extra coverage that is available under the health insurance premium on payment of additional premium. The base coverage can be extended with the help of add-ons on payment of additional premium. There are almost 12 add-ons available with the Care health insurance company with different health insurance plans. Careful analysis should be made before deciding an add-on as the riders are charged by the insurance company. Customer should identify the add-on which is necessary as including all the add-ons will only increase the premium with less scope for utilization of all the add-ons.
Exclusive features of Care Health insurance :
Care Health insurance (formerly known as Religare Health Insurance Company) offers comprehensive health insurance plans which make the best choice for you and your family. Some of the exclusive features offered by Care health insurance company are:-
- Care health insurance offers health insurance plans for families up to 6 members (4 Adults and 2 children). This is very convenient for families to include their parents or parents-in-law.
- The pre and post hospitalization limits are 30 days and 60 days which are considered best in the health insurance market.
- Organ donor cover is provided up to Rs.3 L of sum insured for plans with higher sum insured.
- Ambulance charges of Rs.3000 per hospitalization which is the highest amount in the insurance industry.
- Air ambulance is offered to customers availing higher sum insured options.
- Up to 150% of Sum insured is given as No claim bonus for each claim free year to the customers.
- Global treatment option is available in which the customers can get treatment from anywhere in the World with cashless or reimbursement option.
- Lifelong renewability option to the customers who wants to continue their coverage for a long period of time.
- Under Room rent category a Single Private AC room is provided to the patients.
- 15500+ health care providers serve Cashless Medical Services across the Globe with which the Care Health insurance company has a tie-up.
- Free health check up options to customers in a policy year.
What is included in Care Health Insurance?
Different health insurance plans from Care health insurance have different inclusions. Some of the common inclusions are mentioned below:-
- In-patient hospitalization: Care health insurance covers the hospitalization expenses of insured including Room rent, boarding charges, ICU charges, Doctor Charges etc., up to the sum insured mentioned under the policy. The in-patient hospitalization requires insured to get admitted in the hospital for treatment for more than 24 hours. The in-patient hospitalization charges cover a big chunk of treatment cost of the insured customer.
- Pre hospitalization expenses: The cost of treatment incurred by the customer before getting admitted to a hospital as in-patient treatment for treatment is known as pre hospitalization expense. Pre hospitalization expenses for up to 30 days would be paid by Care health insurance company to the customers in case there is an inpatient claim admissible under the policy.
- Post hospitalization expenses: The cost of treatment incurred by the customer after getting treatment as an inpatient is known as post hospitalization expense. The cost of treatment including medicines, diagnostic tests, etc. after getting discharged from the hospital is paid up for a certain number of days. The post hospitalization expenses are paid up to 60 days from the date of discharge from hospital.
- Room rent & ICU Charges: Care health insurance plans cover the room rent and ICU charges as a part of inpatient hospitalization cover. There are certain sub limits for which these charges are provided by the insurance company.
- Day Care Treatments: Day care treatments are those treatments which can require less than 24 hours. Due to the advancement of technology there are many diseases or illnesses which are treated within a few hours and these are covered under the day care treatment section. The maximum coverage under the day care treatment section would be the sum insured or actual whichever is less.
- Daily Allowance: Daily allowance is an amount given to the customer if the hospitalization exceeds a certain number of days. The daily allowance is given op to 5 days per hospitalization. The daily hospitalization amount is different from that of the inpatient charges paid to the customer.
- Health check-up facility: Care health insurance provides health check-up facility to the members covered in the health insurance policy. The number of health check-ups and the sub limits are specified in the policy terms and conditions.
- Domiciliary hospitalization: Domiciliary hospitalization is the expenses incurred by the customer for getting the treatment at home on the advice of a doctor. The cost of treatment incurred for treatment at home is covered by Care Health Insurance Company under their health insurance plans.
- Alternative Treatments: Alternative treatments are medical treatments such as Ayurvedic, Siddha, Homeopathy, Unani and Yoga which are recognised by the Government of India as alternative treatment for diseases. The sum insured covered under this section is mentioned in the policy terms and conditions.
- Organ Donor Cover: Organ donor cover includes the cost of operating expenses to carry out organ replacement activity. The cost of harvesting and transplanting the organ to the insured customer is covered by Care Health Insurance Company in their health insurance plans. It also pays the organ donor costs as well in addition to the cost of insured.
- No Claim Bonus: No claim bonus of up to 150% on the sum insured is provided to the customer for each claim free year which is one of the highest percentages in the insurance industry. The no claim bonus super provides up to 100% No claim bonus for each claim free year in addition to the base NCB cover.
- Recharge of Sum Insured: Sum insured would be recharged or reinstated if the base sum insured is exhausted in a policy year. This option can be availed once in a policy year and the recharged sum insured can be utilised to treat different diseases or illnesses. With Unlimited recharge option you can get your sum insured recharged unlimited number of times as there would be no limit on the number of times the sum insured can be reinstated.
- Maternity & Baby Cover: Maternity and New born baby cover are available under the Care health insurance plans which cover the cost of delivery and other costs related to new born baby. These are available as base covers as well as add-ons depending on the health insurance plan selected by the customer.
- Second Opinion: The insured customer can go for a second option from any doctor in the World related to the treatment and the cost of that would be borne by the insurance company.
- Sum Insured Range: There are different sum insured options available to the customers. The sum insured ranges from Rs.50K to Rs.1 Cr depending on the type of health insurance plan. Higher the sum insured, higher would be the premium to be paid by the customer.
What is Excluded in Care Health insurance?
Exclusions in a health insurance policy mean the charges for diseases or illness which are not covered even after satisfying the waiting period mentioned in the policy. There are certain exclusions in Care health insurance plans which are mentioned below common to all the types of plans:-
- Any diagnosis or disease related treatment within the first 30 days of policy inception date is not covered.
- Expenses incurred due to Self-inflicted injury resulting from suicide or attempted suicide.
- Expenses arising out of or attributable to alcohol or drug misuse/ abuse.
- Expenses incurred on treatment for pregnancy or child birth, miscarriage, abortion etc.
- Diseases present from birth- Congenital diseases.
- Expenses incurred on treatment of infertility.
- War, Riot, Strike, Nuclear weapons induced hospitalization.
- Charges incurred in connection with cost of routine eye and ear examinations, dentures, artificial teeth, and all other similar external appliances in certain types of health insurance plans.
Claim Process of Care Health Insurance:
Care Health Insurance Cashless Claim Process:
Care Health Insurance Company (Formerly known as Religare Health Insurance Company) provides cashless treatment to its customers in more than 15,500 network hospitals all over the World. These hospitals are tied-up to offer comprehensive cashless services to the Care health insurance company customers. The procedure to claim cashless treatment from the network hospitals is listed below:-
In case of planned cashless treatment intimate the insurance company on their toll-free number 1800-102-4488 and register the treatment for which the cashless service would be availed. In case of emergency hospitalization, it is required to intimate the insurance company before the treatment starts. The insurance company would provide the go-ahead to the hospital and the claim would be settled on a cashless basis.
The second step is to fill and submit the Claim intimation form / pre-authorization form available with the hospital. The E-card or the insurance policy copy should also be submitted along with the pre-authorization form to enable the insurance company to process the claim.
The next step is to submit the cashless claim form along with all the other documents as required to process the claim.
The form and the other documents submitted would be verified by the insurance company and if found satisfactory, a go-ahead will be given by the insurance company for a cashless claim.
Once the treatment is done and the cashless request is accepted by the insurance company, Care Health Insurance Company would transfer the claim amount directly to the hospital without any involvement of the insured customer.
Documents required for Claim Processing
There are certain documents required by the Care health insurance company to process the claims other than cashless. Any treatment taken in the non-network hospital would be settled on a reimbursement basis as the process involves the customer paying the bill and then claiming for the reimbursement after submitting all the necessary documents. The process of claim settlement under reimbursement basis would be as below:
The first step under the reimbursement claim process is to intimate the insurance company within 24 hours of admission to the hospital. For pre-planned treatment, intimation can be given even 48 hours prior to admission to the hospital.
The next step is to duly fill the claim intimation form and sign it. There are certain documents that are to be submitted to the insurance company along with the claim intimation form which is mentioned below:-
- Details of the hospital in which the insured has undergone treatment which includes the details of the patient, the treatment underwent, etc.
- Policy copy or the Health card of the insurance company to prove the validity and the coverage.
- Date of admission and date of discharge.
- Discharge Summary.
- Estimated claim amount for the treatment undergone at the hospital.
- Authorization from doctor advising hospitalization/ diagnostic tests/ consultation.
- Original hospital bills and the discharge summary.
- Pathological reports and any other reports were taken as a part of the treatment.
- Police FIR and Post mortem report (for death claims)
- Any other documents as requested by the insurance company.
- Canceled cheque leaf of the insured customer.
The last step is where the insurance company would settle the bill after thorough enquiry and the quantum of claim would be decided by the insurance company subject to the terms and conditions mentioned under the policy. The insurance company would transfer the claim amount to the bank details submitted by the customer and any other bank details other than that of customer’s would not be accepted by the insurance for claim settlement.
FAQs of Care Health Insurance:
Do I need health insurance if everyone in my family is healthy?
Health insurance covers the hospitalization and other costs related to the treatment in case the insured or family members are admitted in a hospital. The claim paid by the insurance company would not exceed the sum insured mentioned under the policy terms and conditions. Health insurance should be considered as a mandatory requirement by every person as the diseases or illness cannot be anticipated in advance.
For instance no one can firmly say that they would not be contracted with any illness for a particular period of time. Hence, health insurance should be taken even if everyone in the family is healthy. If we consider Covid-19 pandemic, there have been many cases where people who haven’t had even a common cold were admitted to hospital with Covid-19 and underwent treatment for the same.
Is health insurance mandatory?
Unlike motor insurance, there is no law in India making health insurance mandatory. Health insurance should be mandatorily taken by each and every individual to safeguard themselves and their families from unnecessary financial hiccups at the time of hospitalization. Having a health insurance can save a lot of your money at the time of hospitalization as the rising health care costs can burn a big hole in the savings of customers.
Does care health insurance have health insurance for diabetic patients?
Yes. Care health insurance covers pre existing conditions such as diabetes, hypertension etc. Care freedom plan from Care Health Insurance Company provides health insurance to diabetic customers without any pre-policy medical check-up. The pre existing conditions are covered after a waiting period of 24 months from the date of first policy start date with the coverage being continuous.
Is there a health insurance plan for Cancer coverage?
Yes. Care health insurance has introduced health insurance plan to cover the customers treated for Cancer. Care Cancer insurance provides treatments costs in case the insured is diagnosed with Cancer and needs to undergo chemotherapy and other treatments as a process. The cancer cover is available lifelong with sum insured options ranging from Rs.10 L to Rs.2 Cr.
What is the tax exemption under Care health insurance plans?
Health insurance premium paid for Care health insurance plans are eligible for income tax deduction under the section 80D of the Income tax act. The limits are as mentioned below:-
||Exemption category wise
|Self & Family
|Self & Family + Parents (Not Senior Citizens)
||Rs.25,000 + Rs.25,000
|Self & Family + Parents (Senior Citizens)
||Rs.25,000 + Rs.30,000
|Self & Family(Senior Citizen) + Parents (Senior Citizens)
||Rs.30,000 + Rs.30,000
Is there cashless facility under Care health insurance policies?
Yes. Care health insurance(Religare health Insurance) has tied-up with almost 5050+ globally and all these hospitals provide cashless claim settlement service to the Care health insurance customers. The cashless facility can be availed by enquiring on the toll free number 1800-102-4499.
How many network hospitals are available with care health insurance Company?
There are more than 5050 network hospitals to provide cashless facility to the Care health insurance customers. The detailed list of tie-up hospitals can be found at Health Plan Certified Network Hospitals
Does my Care health insurance policy provide free annual check-up?
Yes, most of the health insurance policies from Care Health Insurance Company provide with free annual health check-up to all the individuals covered under the policy. The list of medical check-ups available differs from one plan to the other.
What is the eligible age to buy Care health insurance plan?
The minimum age to buy health insurance from Care Health Insurance Company is 18 years which is the legal age in India. There are certain plans where even a 91 day child can be included in the health insurance plan subject to one or both the parents already covered under the plan.
What is the pre-existing waiting period in care health insurance plans?
Any condition or illness which exists prior to taking the health insurance policy is known as pre-existing illness or disease. Every health insurance policy has a provision to cover the pre-existing diseases after a certain period of time. The pre-existing diseases waiting period in care health insurance plans range from 24 months to 48 months depending on the type of plan chosen.
Care health insurance even offers an add-on named “Reduction in pre-existing waiting period” where the pre-existing waiting period can be reduced from 48 months to 24 months on payment of additional premium. This add-on is specific to few plans of Care Health Insurance Company.
What is the specific waiting disease in my health insurance policy?
There are certain diseases or illnesses which would be covered only after a certain period of time such as Hernia, Knee replacement etc. These diseases require a certain waiting period to be satisfied and it is known as specific disease waiting period. The specific disease waiting period in Care health insurance plans is 24 months from the date of policy start date.
Can I take health insurance and claim immediately?
Health insurance plans have an initial waiting period before which no claim would be paid except for the accidental claims. Only accidental claims are payable immediately after taking the health insurance policy. The initial waiting period in Care health insurance plans is 30 days from the policy start date.
What is the maximum sum insured offered under care health insurance plans?
The maximum sum insured offered under pre underwritten Care health insurance plans is Rs.1 Cr for general health insurance plans and Rs.2 Cr for Cancer plans. Higher sum insured can also be offered to customers after satisfactory underwriting from the insurance company. Pre underwritten plans are those where the premium is fixed for any particular sum insured.
Can I take health insurance for more than 1 year?
Yes. Care health insurance offers plans ranging from 1 year to 3 years. Please contact our Care Health insurance customer care number 1800-123-4003 to have a clear understanding of the Care Health insurance plans. The time period of health insurance policy depends on the type of plan selected by the customer.
Are there are health insurance plans for Senior citizens?
Yes. Care Health Insurance Company has introduced health insurance plans specifically for senior citizens such as Care Senior. The minimum entry age for this plan is 61 years and there is no maximum entry age under this plan. There is a 24 months waiting period for Named ailments and 48 months for pre-existing diseases under this plan. This plan is designed to provide maximum benefit to senior citizens aged above 61 years.
How are senior citizen plans beneficial?
Senior citizen plans such as “Care Senior” are beneficial as these plans are designed keeping in mind the needs of senior citizens. In this plan there is a co-pay of 20% per claim for every claim made by the insured under the policy within the policy period. The need for hospitalization is high in case of senior citizens and there is a need to have a separate health insurance plan which covers all the requirements of senior citizens.
Is there are plan to cover Maternity?
Yes. Care health insurance company offers health insurance plan which specifically covers the Maternity and New born baby expenses. Care health insurance plan “JOY” is a perfect blend of hospitalization and maternity. The policy tenure is 3 years and the maternity waiting period would be 9 months from the date of policy start date. The maximum sum insured under the “JOY” health insurance plan is Rs.5 L and the claim is also paid for new born baby under this plan.
Is personal accident cover available under health insurance?
Yes, personal accident cover can be availed under health insurance plan from Care Health Insurance Company. Care Plus – A Complete health insurance plan provides personal accident cover as a part of the policy with Accidental death and Permanent total disability cover.
Is it mandatory to undergo medical check-up before taking health insurance policy?
For most of the health insurance plans with Care health insurance, it is not mandatory to avail pre policy check-up. But there might be a requirement to undergo few medical checkups in case of customers with pre-existing conditions which varies on a case to case basis.
I forgot to renew my health insurance policy on time, what should I do now?
There is a concept of Grace period in every health insurance policy. If you are unable to pay the premium before the expiry date, then the insurance company would give you a grace period of maximum 30 days to pay the health insurance renewal premium.
If the premium is paid before the grace period the policy would be in force and all the conditions satisfied under the policy would remain intact. If you do not pay the renewal premium after the expiry of the grace period, the policy would lapse and all the bonuses accumulated would be expired.
What is the maximum hospital bill that would be paid by Care health insurance Company in case of hospitalization?
The maximum claim amount that would be paid in case of any hospitalization would be the claim amount or the sum insured, whichever is less. For instance, if your sum insured is Rs.4 L and your hospital bill is Rs.5 L, insurance company would pay Rs.4 L which is the maximum liability of the insurance company.
What if I get diabetes or Hypertension after taking the health insurance policy?
Few illnesses or diseases such as Diabetes or hypertension are considered as pre-existing diseases only if they are present prior to health insurance policy purchase. If these conditions are detected after taking the health insurance, the claim is paid considering these conditions as new. But for the claims to be paid in future, the health insurance policy should be renewed every year without fail.
What are pre and post hospitalization expenses?
There are certain expenses which are incurred before the hospitalization such as investigation tests, routine checkups and certain expenses which are incurred after the hospitalization such as follow-up tests. There are expenses incurred on the pre and post hospitalization tests which are covered under the Care health insurance plans. The pre and post hospitalization expenses are covered for a certain period such as 30 days and 60 days respectively.
How many day care treatments are covered under Care health insurance plans?
The number of day care treatments covered is different for different care health insurance plans. Few plans cover up to 700 day care treatments while few plans cover 120+ day care treatments. It is advisable to talk to our health insurance expert before deciding on the type of health insurance plan.
Due to the advancement in technology there are many diseases which are treated within a day and do not require in-patient hospitalization. These treatments are known as day care treatments and the maximum coverage under these plans is the sum insured mentioned in the policy.
Is there any co-payment in my health insurance plan?
Yes, most of the health insurance plans from Care Health Insurance Company have a co-pay of up to 20% of the total claim bill. In most of the plans the co-pay is applicable to people above 61 years of age. It is important to check the co-pay condition before purchasing the policy as the co-pay would be applicable to each and every claim payable under the policy.
What happens if my sum insured is expired before the policy period?
If your sum insured expires before the policy period, Care Health Insurance Company would reinstate/recharge your sum insured up to the existing limit without any premium to be paid. The reinstated sum insured can be used only for the treatment of new illness and the reinstatement is generally done only once during the policy period unless and until you opt for unlimited reinstatement option in which the sum insured would be reinstated unlimited number of times.
What happens if I’m not satisfied with my health insurance plan?
Every health insurance plan offers a cooling period or free look period of 15 days to react on the health insurance policy. If you are not satisfied with the service or the terms and conditions of the health insurance policy, you can cancel the policy by giving a notice to the insurance company within 15 days of receiving the policy copy.
This 15 days time period is known as “Free look period” or “Cooling period”. If you wish to cancel your health insurance policy after the free look period a pro rata premium would be deducted by the insurance company and the remaining premium would be paid.
What is the waiting period to avail Maternity cover?
The minimum waiting period to avail maternity cover is 9 months while the maximum maternity waiting period is 2 years under different health insurance plans available with Care Health Insurance Company. The maternity waiting period would be applicable to all the new policy holders.
What is the renewal bonus available under Care health insurance plans?
Care Health Insurance Company offers renewal bonus for customers renewing the health insurance policies. The renewal bonus is given if there is no claim in the previous year. It is also known as No claim bonus which is given at the time of renewal for every claim free year.
The maximum renewal bonus that can be offered is 200% of the basic sum insured available under the policy with a certain percentage for each claim free year. The no claim bonus differs for different health insurance plans.
For more assistance contact our customer care number to buy the best Care health insurance policy.