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Care Insurance Care Plan

What’s The Plan All About?

Care Insurance Care is a plan provided by Care Health Insurance Company. Its primary aim is to restore your well-being and contentment by offering a seamless claims experience. With a variety of coverage options ranging from Rs 3 Lakhs to 75 Lakhs, it caters to different needs. Care Insurance has established partnerships with 21,500+ healthcare providers across India, ensuring convenient cashless services.

Check Your Eligibility!

Minimum Age of Entry

  • Individual Plan: 5 years
  • Floater Plan: 91 days, provided that at least one family member is covered by the plan and is above 18 years old.

Maximum Age of Entry

  • No upper limit on the age of enrollment for adults and 24 years for children.

Let’s Know The Benefits and Limits Better

The Care Insurance Care Plan offers coverage for inpatient hospitalisation expenses. These expenses include the cost of staying in the hospital for more than 24 hours, such as room and boarding charges, nursing fees, medical practitioner's fees, prescribed medicines and drugs, ICU charges, and other related costs.

Additionally, the plan covers various other expenses, providing you with comprehensive protection. Let’s see -

  • Pre & Post Hospitalisation Coverage

    You don't need to fret about the expenses for diagnostic tests, etc. before or after your hospitalisation because the Care Insurance Care Plan has you covered. They will take care of these costs for a reasonable period – 30 days before your admission and 60 days after you are discharged. However, remember that the insurer will cover these expenses only if they are related to the medical condition for which you were hospitalised and they must be approved as part of your inpatient hospitalisation coverage.

  • Daycare Treatment Coverage

    With the Care Insurance Care Plan, you receive coverage for daycare treatments. These are medical procedures or surgeries that once required long hospital stays but can now be completed within 24 hours, thanks to medical advancements. The plan covers a wide range of 541 daycare procedures and there are no limits on the coverage for these treatments. All eligible expenses will be covered up to the sum insured.

  • Domiciliary Treatment Coverage

    Under the Care Insurance Care Plan, you will be covered for domiciliary treatments. These are medical treatments that require hospitalisation but are administered at home due to the patient's severe illness or injury or because there are no available hospital beds nearby. The plan provides coverage for domiciliary treatment expenses up to 10% of the sum insured.

  • Organ Donor Coverage

    In addition to its other benefits, the Care Insurance Care Plan offers coverage for organ donor expenses. This includes the costs related to harvesting the organ from the donor for transplantation (when the insured person is the recipient). The coverage amount is subject to a limit based on the sum insured you choose.

  • Coverage for Modern Treatment

    As the field of healthcare advances rapidly with cutting-edge technology, modern treatments that were once unimaginable are now a reality. The Care Insurance Care Plan is designed to keep up with these advancements, providing coverage for expenses related to these modern treatments. All eligible expenses will be covered up to the sum insured, ensuring you have access to the latest medical breakthroughs without financial worries.

  • Coverage for Non-Medical Expenses

    The Care Insurance Care Plan also includes coverage for non-medical expenses, specifically the cost of consumables required for your treatment. These consumables, like gloves, nebulization kits, oxygen masks, etc. can be costly and can quickly accumulate. The plan offers coverage for these expenses up to the sum insured.

  • No Claim Bonus

    With the Care Insurance Care Plan, you receive a pretty cool No Claim Bonus for every claim-free year. Your sum insured increases by 10% every year with a maximum limit of 100%. However, if you make a claim in the future, the accumulated bonus will decrease at the same rate.

  • Recharge Benefit

    With the Care Insurance Care Plan, you enjoy a valuable Recharge Benefit. If your sum insured gets used up due to a claim, it will be fully reinstated once during a policy year. This replenishment can be utilised for any future claims that are made for an unrelated illness.

    Moreover, you have the option to choose an additional cover called Unlimited Automatic Recharge, which allows your cover to be refilled an unlimited number of times within a policy year. This ensures that you always have sufficient coverage for unexpected medical expenses, providing you with continuous financial protection.

  • Room Rent Limit

    The room rent limit is the maximum amount your insurance company will cover for the hospital room during your stay. If you choose a room within your plan's limit, you won't have any out-of-pocket expenses. However, selecting a room with a higher rent than your eligible limit will lead to a proportionate deduction. This means you will be responsible for paying a share of the entire bill and not just the difference in the room rent. The Care Insurance Plan sets a limit on room categories based on your chosen sum insured.

Some More Great Features of the Plan

Here are some of the other features that the Care Insurance Care plan offers –

  • No Financial Limits on Common Treatments/Diseases

    One significant feature of the Care Insurance Care Plan is there are no disease-specific sub-limits for common treatments like cataracts, etc. As long as the insurer hasn't explicitly excluded coverage for a particular illness, you can make a claim for it to the sum insured, regardless of the disease you are facing. This means you won't have to worry about any treatment or disease sub-limits, giving you comprehensive coverage for a wide range of medical conditions.

  • Global Coverage

    With the Care Insurance Care Plan, you enjoy worldwide coverage without any geographical restrictions if your chosen sum insured is above Rs 50 Lakhs. For certain listed treatments, you can avail of medical services anywhere in the world, excluding the USA, as per the policy's terms and conditions.

  • NCB Super

    You can choose the optional cover super claim bonus and enjoy an additional reward for maintaining a claim-free record and renewing your policy without any breaks. This bonus offers a progressive increase of 50% in your sum insured, accumulating over time up to a maximum of 100%. But it is essential to note that if you make a claim in the future, the accumulated bonus will decrease at the same rate.

Waiting Period

When you buy a health insurance policy, there is a waiting period for certain illnesses and diseases, during which these conditions will not be covered. Once the waiting period is over, you can claim for these conditions. It is essential to be aware of the waiting period and plan your coverage accordingly to ensure you get the maximum benefits from your health insurance policy.

The different types of waiting periods that are generally applicable include –

  1. Initial Waiting Period

    For all medical conditions, except accidents, there is an initial waiting period of 30 days. This means that during the first 30 days of your policy, you won't be able to make a claim, except in the case of accidents.

  2. Waiting Period for Pre-existing Diseases

    A pre-existing disease refers to any medical condition or illness that you had in the 48 months before the issuance of the health insurance policy. With the Care Insurance Care Plan, there is a waiting period of 48 months for pre-existing diseases. This means that during this period, any expenses related to your pre-existing conditions will not be covered by the policy.

  3. Waiting Period for Specific Diseases

    Apart from pre-existing conditions, some health insurance policies have a waiting period for certain specific diseases. These waiting periods are predetermined by the insurer and apply regardless of your medical status. Under the Care Insurance Care Plan, there is a waiting period of 24 months for specific diseases.

What Ain’t Covered By The Plan?

Your health insurance policy may have certain situations that will never be covered. These are known as exclusions. They typically include –

  • Standard Permanent Exclusions

    IRDAI, the governing body for insurance in India, has set up a list of Standard Permanent Exclusions that all insurance companies must follow –

  1. Hospital admission specifically for observation or monitoring purposes.
  2. Admission to a facility for bed rest without active medical treatment.
  3. Treatment or surgery related to weight control or obesity.
  4. Medical procedures aimed at changing one's gender.
  5. Treatment or surgery for cosmetic purposes, altering body characteristics or appearance.
  6. Expenses incurred for treatment while participating in hazardous or adventure sports as a professional. This includes activities like river rafting, mountaineering, scuba diving, horse racing, and others.
  7. Coverage for expenses related to the treatment of a person who has committed or attempted to commit a breach of law with criminal intent.
  8. Treatment from providers not included in the insurance network.
  9. Medical care for conditions like alcohol or drug addiction.
  10. Treatment received in establishments like health spas, nursing homes, etc. that are meant for domestic purposes.
  11. Expenses for dietary supplements or substances bought without a doctor's prescription, such as vitamins and minerals.
  12. Costs associated with correcting refractive errors up to 7.5 diopters to improve eyesight.
  13. Surgeries, medical procedures, or treatments that have not been proven to be effective.
  14. Expenses related to birth control, sterility, and infertility, including contraception, sterilisation, artificial insemination, IVF, ZIFT, GIFT, ICSI, and gestational surrogacy.
  15. Maternity expenses, including pre-and post-natal costs and hospitalisation related to childbirth.
  • Additional Permanent Exclusions

    Apart from the standard permanent exclusions mentioned earlier, insurance companies can impose extra exclusions for specific situations or medical conditions. If you have certain diseases or severe medical conditions that insurers deem too risky to cover, they may permanently exclude them from your policy. However, it's important to note that insurers can only apply a permanent exclusion to illnesses listed by the Insurance Regulatory and Development Authority of India (IRDAI).

  • Non-Standard Exclusions

    Specific exclusions, also known as non-standard exclusions, go beyond the standard permanent exclusions set by the IRDAI. These exclusions can differ among insurance companies and depend on the specific terms and conditions of each policy.

    The Care Insurance Care Plan has some specific exclusions you should know about. Here's a list of the top ones -

  1. Circumcision is not covered unless it's necessary for treating an illness or resulting from an accident.
  2. Treatment for external congenital anomalies, defects, or birth-related issues is excluded.
  3. Non-allopathic treatments or those related to unrecognised systems of medicine are not covered.
  4. Any expenses for RMO charges, service charges, surcharges, or night charges imposed by the hospital are not included.
  5. Costs for alopecia wigs, toupees, hair fall treatments, and related products are excluded.
  6. Impairment of mental faculties due to stimulant or depressant abuse, unless prescribed by a medical practitioner, is not covered.
  7. Participation in naval, military, air force operations, or aviation in a professional or semi-professional capacity is excluded.
  8. Treatments taken in certain establishments like addiction clinics, detoxification centres, and homes for the aged are not covered.
  9. Self-harm and suicide are excluded.

Care Insurance Care - Summed Up!

Product Benefits Coverage Limits
Pre-Hospitalisation Expenses

30 days up to the sum insured

Post-Hospitalisation Expenses

60 days up to the sum insured

Daycare Treatment Coverage 541 treatments covered up to the sum insured
Domiciliary Treatment Coverage Up to 10% of the sum insured
Organ Donor Coverage Harvesting expenses up to a certain limit based on the sum insured you choose
Non-Medical Expenses Up to the sum insured
Modern Treatment Coverage Up to the sum insured
Room Rent Limit Limits set on the basis of your sum insured
No Claim Bonus 10% increase in sum insured up to a max of 100% for every claim-free year. If you make a claim, it will decrease at the same rate.
Recharge Benefit Up to 100% of the sum insured
Pre-existing Disease Covered after a 48-month waiting period
Specific Diseases Covered after a 24-month waiting period
Questions about Car Insurance

Frequently Asked Questions (FAQs)

Yes, it covers alternative treatments up to a specified limit like Ayurveda, Homeopathy, Unani, and Sidha. This limit varies depending on the chosen plan.

Care Insurance Care provides health coverage up to Rs 75 lakhs.

Yes, there is a limit on the room category you can choose during hospitalisation under the Care Insurance Plan.

Yes, expenses related to maternity are covered under the plan.

There is no upper age limit for enrollment under the Care Insurance Care Plan for adults. For children, the maximum age of entry is 24 years.