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 plans?
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.
Exclusions 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.
Cashless Claim Process in Care Health Insurance Company:
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 go ahead to the hospital and the claim would be settled on 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 processing 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 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.
For any other claim related query please contact on the toll free number to get the required assistance.
Documents required for Claim processing in Care Health Insurance Company:
There are certain documents required by the Care health insurance company to process the claims other than cashless. Any treatment taken in non-network hospital would be settled on reimbursement basis as the process involves the customer to pay the bill and then claim 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 reimbursement claim process is to intimate the insurance company within 24 hours of admission in the hospital. For pre planned treatment intimation can be given even 48 hours prior to the admission in the hospital.
The next step is to duly fill the claim intimation form and sign it. There are certain documents which are to be submitted to the insurance company along with the claim intimation form which are mentioned below:-
- Details of the hospital in which the insured has undergone treatment which includes the details of patient, treatment undergone 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 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.
- Cancelled 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.
For more assistance contact our customer care number to buy the best Care health insurance policy.