Care Insurance Care Freedom Plan

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Care Insurance Care Freedom is a health insurance plan from Care Health Insurance Company. It is designed to shield you from unexpected medical costs, focusing on pre-existing conditions like diabetes, hypertension, and high BMI that often get overlooked in other plans. This means you can relax, knowing that you and your family are covered for necessary medical care without the stress of unexpected bills.

What Are The Age Requirements To Be Eligible For The Plan?

Minimum Age Of Entry: To join the policy, adults must be at least 18 years old. For individual policies, dependent children need to be at least 5 years old, and for family floater policies, they should be at least 90 days old. It's important to note that if you want coverage exceeding Rs. 5 Lakhs, the oldest insured person must be at least 46 years old.
Maximum Age Of Entry: There is no upper limit for adults. However, for individual policies, dependent children should be at least 17 years old.

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Benefits And Limits Of The Care Insurance Care Freedom Plan

The Care Insurance Care Freedom Plan includes coverage for your inpatient hospitalisation expenses involving hospital stay exceeding 24 hours. This includes covering room and boarding, nursing charges, the cost of prescribed medicines and drugs, medical practitioner's fees, ICU charges, and other related expenses. Here's a quick overview of some of the other expenses covered by the plan –

Pre & Post-Hospitalisation Expenses
Expenses before your admission and after your discharge, known as pre-hospitalization and post-hospitalization expenses, are taken care of for a reasonable duration - 30 days before and after hospitalisation. The coverage extends up to a specified amount depending on the sum insured you choose. The Care Insurance Care Freedom Plan covers these costs only if they are related to the medical condition/disease for which you are hospitalised, and the claim is approved as part of the inpatient hospitalisation coverage.
Here’s what the plan covers based on the sum insured you choose for your plan -

Sum Insured(in Rs)	Pre-hospitalisation And Post-hospitalisation Expenses Limits
3 Lakhs	Up to 7.5% of payable hospitalisation expenses
5 / 7 / 10 Lakhs	Up to 10% of payable hospitalisation expenses

Daycare Treatment Coverage
Daycare treatments refer to medical procedures or surgeries that used to need a long hospital stay but can now be completed within 24 hours, with the help of medical advancements. The Care Insurance Care Freedom Plan covers 541 such procedures without any limit and all expenses are covered up to the limit of the chosen sum insured.
Domiciliary Treatment Coverage
Domiciliary treatment are medical treatments for illnesses or injuries needing urgent medical attention that would typically be given in a hospital, but can be administered at home when the patient is too unwell to travel safely to a hospital or when no nearby hospital beds are available. With the Care Insurance Care Freedom Plan, you get coverage for domiciliary treatment costs, up to 10% of the sum insured.
Modern Treatment Coverage
Healthcare is developing fast with new technologies, bringing us treatments that were once thought impossible. The Care Insurance Care Freedom Plan stays up-to-date with these changes, covering the costs of these modern treatments up to your chosen sum insured.
Consumable Allowance (Non-Medical Expenses)
The Care Insurance Care Freedom Plan covers both medical and non-medical costs. Non-medical expenses include the costs related to consumables like gloves, oxygen masks, nebulization kits, and other necessary items used for treatment. These items can get pricey, accumulate and cause financial strain. The plan covers these costs up to a set amount based on your chosen sum insured. However, it covers consumable expenses for a maximum of 7 consecutive days per hospitalisation, starting from the 3rd day of hospitalisation.

Sum Insured (in Rs)	Maximum Limit
3 Lakhs	Up to Rs. 750 per day
5 Lakhs / 7 Lakhs / 10 Lakhs	Up to Rs. 1000 per day

Recharge Of Sum Insured (Restoration Benefit)
This feature replenishes your coverage when it gets exhausted within a policy year. Under the Care Freedom Plan, it activates when your base sum insured is fully used up in a policy year, and is available for subsequent claims. You can use this benefit once every year for as long as you renew your policy, and it applies only to unrelated illnesses.
Room Rent Limit
This limit is the maximum amount your health insurance policy will cover for your hospital room. If you opt for a room within the limit in your plan, you will not have any extra expenses. But if you go for a fancier room beyond your limit, you will need to pay a share of the total bill, not just the difference in rent. In the Care Freedom, your room rent limit depends on the sum insured you choose, as per the following -

Sum Insured(in Rs)	Room Rent Limit
3 Lakhs	Up to Twin Sharing Room, subject to a maximum of 1% of sum insured per day
5 Lakhs	Up to Twin Sharing Room
7 / 10 Lakhs	Up to Single Private AC Room

Standout Features of The Care Insurance Care Freedom Plan

Dialysis Cover
Dialysis is a crucial treatment that steps in when your kidneys are not working properly. If your kidneys struggle to clean and purify your blood, dialysis steps in temporarily, acting like a substitute until your kidneys recover and function independently. The Care Insurance Care Freedom plan helps ease the financial strain of these medical sessions, covering costs up to Rs. 1,000 per session. This support is available for two policy years and is subject to certain conditions for coverage.
Home Care
Care Insurance Care Freedom Plan understands the importance of recovering in the comfort of your own space and offers an optional benefit designed to meet your needs during this period. This feature provides financial assistance for hiring a qualified nurse, as recommended by your doctor, covering up to Rs. 1,000 per day. This support makes it easier for a seamless transition from the hospital to the familiarity of your home. The actual goal is to improve your quality of life by ensuring you can carry out essential daily activities. By choosing this add-on, you and your family can rest easy, knowing professional medical support is right at home. However, you should remember that there are some terms and conditions to consider before choosing this benefit.
Annual Health Check-Up: Every year, the Care Insurance Care Freedom Plan covers a set of medical tests, even if you have not made any claims. These tests are essential health checks like complete blood count with ESR, lipid profile, kidney function test, ECG, etc. This benefit is applicable to everyone who is covered under the policy if they are 18 years or older. If you are interested, you can opt for extra health checkups focusing on diabetes and heart conditions by paying an extra premium.

Understanding Waiting Periods

When you buy a health insurance policy, there is a certain period during which specific medical conditions or illnesses won't be covered. This duration is referred to as the waiting period. Once this waiting period concludes, you can start claiming for those health conditions. Waiting periods come in various types and they include –

Initial Waiting Period
For the first 30 days after getting your health insurance, all medical conditions are not covered except accidents. During this period, you cannot claim for hospitalisation unless it is due to an accident.
Waiting Period For Pre-Existing Diseases
Such diseases are medical conditions you had in the 48 months before getting your health insurance. With the Care Freedom Plan, there is a 24-month waiting period for pre-existing diseases. This means that for the first 24 months, the policy will not provide coverage for expenses related to your pre-existing conditions.
Waiting Period For Specific Diseases
Aside from your pre-existing conditions, there is a waiting period for certain diseases or medical conditions that are listed by insurers. It does not matter if you had these diseases before or not; the waiting period is set by the insurer. And, it is not based on your current health. Under the Care Insurance Care Freedom Plan, there is an applicable 24-month waiting period for specific diseases.

What The Plan Doesn’t Cover?

Exclusions refer to situations not covered by your health insurance policy. These include –

Standard Permanent Exclusions: The Insurance Regulatory and Development Authority of India (IRDAI) has set 'standard permanent exclusions' that all insurance companies must adhere to. Some of these include –
- Observation And Monitoring: Hospital stay for keeping an eye on your health.
- Rest, Cure, Rehabilitation, And Respite Care: Staying in a facility for rest without active treatment.
- Weight Control Or Obesity: Treatment or surgery to manage weight or deal with obesity.
- Gender Change Treatment: Treatment to change physical characteristics to the opposite sex.
- Plastic/Cosmetic Surgery: Surgery to change body characteristics or appearance.
- Hazardous Or Adventure Sports Profession: Treatment costs while participating professionally in activities like river rafting, mountaineering, scuba diving, horse racing, etc.
- Breach Of Law: Expenses for treating someone involved in a criminal act.
- Excluded Providers: Treatments from a medical practitioner or hospital not covered by the insurance company.
- Narcotics: Treatment for addictive conditions like alcohol or drug addiction.
- Establishments For Domestic Purposes: Treatment expenses in health spas, nursing homes, or similar places arranged for domestic reasons.
- Dietary Supplements Without Prescription: Costs for vitamins, minerals, etc., not prescribed by a doctor.
- Refractive Error: Costs for correcting eyesight up to 7.5 diopters.
- Unproven Treatments: Surgeries or medical procedures not proven to be effective.
- Birth Control And Infertility: Contraception, sterilisation, artificial insemination, reproductive technologies like IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc.
- Maternity Expenses: Costs for pre/post-natal care, hospitalisation during childbirth, etc.
Additional Permanent Exclusions: Apart from the standard permanent exclusions mentioned earlier, insurance companies might add more exclusions for specific situations or medical conditions. If you have diseases or severe conditions deemed too risky to cover, insurers may permanently exclude them from your policy. It is important to note that insurers can only apply permanent exclusions based on a list of illnesses set by the IRDAI.
Non-Standard Exclusions (Specific exclusions): Non-standard exclusions, also known as specific exclusions, go beyond the standard ones outlined by the IRDAI. These can differ among insurance companies and may be based on policy terms. Let's explore some key specific exclusions under the Care Insurance Care Freedom Plan –
- Conditions resulting from or linked to any sexually transmitted disease, excluding those arising from HIV.
- Screening, counselling, or treatment for external congenital anomalies, illnesses, defects, or anomalies related to external birth defects.
- Circumcision, unless necessary for illness treatment or due to an accident.
- All preventive care, vaccinations, including inoculation and immunizations (except for post-bite treatment), and tonics.
- Intellectual faculties impairment due to misuse of stimulants or depressants, unless prescribed by a medical practitioner.
- All expenses related to donor treatment, including surgery to remove organs for transplant surgery.
- Non-allopathic treatment.
- Alopecia, wigs, toupees, and all hair or hair fall treatments and products.
- Self-destruction, self-inflicted injury, attempted suicide, or suicide, whether sane or insane. Also, illnesses or injuries resulting from the consumption, use, misuse, or abuse of tobacco, intoxicating drugs, alcohol, or hallucinogens.
- Multifocal lens implantation for cataract.

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A Quick Summary

Product Benefits	Coverage Limits
Pre- Hospitalisation Expenses	Coverage for expenses incurred 30 days before hospitalisation. For sum insured of Rs 3 Lakhs - Up to 7.5% of payable hospitalisation expenses For sum insured of Rs 5 / 7 / 10 Lakhs - Up to 10% of payable hospitalisation expenses
Post Hospitalisation Expenses	Coverage for expenses incurred 30 days after discharge. For sum insured of Rs. 3 lakhs - Up to 7.5% of payable hospitalisation expenses For sum insured of Rs. 5 / 7 / 10 lakhs - Up to 10% of payable hospitalisation expenses
Daycare Treatment Coverage	A total of 541 treatments covered up to the sum insured.
Domiciliary Treatment Coverage	Covered up to 10% of the sum insured.
Modern Treatment Coverage	Covered up to the sum insured.
Consumable Allowance (Non-medical expenses)	Covered up to a specified amount of the sum insured for a maximum of 7 consecutive days per hospitalisation (after the initial 3 days). For sum insured of Rs. 3 lakhs a maximum limit of Rs. 750 per day For sum insured of Rs 5 Lakhs / 7 Lakhs / 10 lakhs a maximum limit of Rs. 1000 per day
Recharge of Sum Insured (Restoration Benefit)	Triggers on complete exhaustion of the base sum insured in a policy year and will be available for unrelated illnesses. Applicable once per policy year for a lifetime for subsequent claims.
Room Rent Limit	For sum insured of Rs. 3 lakhs – Up to twin sharing room, up to a maximum of 1% of the total sum insured per day. For sum insured of Rs. 5 lakhs – Up to twin sharing room. For sum insured of Rs. 7/10 lakhs – Up to single private AC room.
Pre-Existing Diseases	Covered after a 24-month waiting period
Specific Diseases	Covered after a 24-month waiting period

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FAQs

Under the Care Freedom Plan, what is the maximum health cover you can opt for?
The Care Insurance Care Freedom Plan provides health coverage up to Rs. 5 Lakhs for individuals below 46 years and Rs. 10 Lakhs for those aged 46 years and above.
Does the Care Freedom Plan cover domiciliary treatments?
Yes, the plan covers expenses related to domiciliary treatment, which refers to treatment taken at home. This coverage extends up to 10% of the sum insured.
Does the Care Insurance Care Freedom plan have room rent restrictions?
Yes, the Care Insurance Care Freedom Plan has specific room limits based on your chosen sum insured –
- For a sum insured of Rs. 3 lakhs: twin sharing room, max up to 1% of the sum insured per day.
- For a sum insured of Rs. 5 lakhs: twin sharing room.
- For a sum insured of Rs. 7 / 10 lakhs: single private AC room.
Does the Care Freedom Plan provide coverage for PEDs?
Yes, the Care Insurance Care Freedom Plan includes coverage for expenses related to Pre-existing Diseases (PEDs), such as diabetes, hypertension, and BMI, after a waiting period of 2 years.
Are consumables/non-medical expenses covered under Care Freedom?
Yes, the Care Insurance Care Freedom plan extends its coverage to all consumables, including masks, gloves, etc., covering these non-medical expenses up to the chosen sum insured.