Care Health Insurance

Choose to protect your health and the health of your loved ones with Care Health Insurance plans. These plans offer a high sum assured and ensure that there are network hospitals close to you. Select from multiple add-ons to enhance the cover.
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Health Insurance
  • Claim up to Rs. 55,000 deduction under section 80D*
  • 8350+ hospitals for cashless treatment
  • Insurers offer plans with no limit on room rent

Health insurance has become a necessity with the rising costs of healthcare services and lifestyle diseases. Care Health Insurance Company Limited, considered to be one of the top health insurance providers in India provides a wide range of health insurance products. From healthcare delivery to preventive health solutions, the insurer has a unique business presence in the health insurance market due to its robust distribution channels. Care Enterprises Ltd, Union Bank of India, and Corporation Bank are the shareholders of Care Health Insurance Company Limited.

Care Health Insurance Highlights Updated on 26 Jan 2021

Features  Specifications 
Network Hospitals  15500+ 
Waiting Period for Pre-existing Disease  4 years 
Claim Settlement Ratio  92.30% 
Renewability  Lifetime 

*For Year 2017-2018

Overview of Care Health Insurance:

Founded in 2012, the insurance company is headquartered in Gurgaon, Haryana. Care Health Insurance offers various health insurance plans at attractive prices. The plans offered by the company provides cover for the individual as well as his/her family. Some of the features of the products offered by Care Health Insurance are maternity cover, top-up cover, personal accident cover, and critical illness cover.

Key Benefits and Features of Care Health Insurance Plans:

  • Sum Insured: Care Health Insurance offers health cover with a sum insured of up to Rs.6 crore.
  • Renewal: Health insurance policies from Care Health Insurance come with a lifelong renewability option.
  • Cashless hospitalisation: Insured members can avail cashless hospitalisation at total cashless hospitals which are 8350+ and total cashless healthcare providers which are 15500+.
  • Restore benefit: Sum insured will be automatically recharged at no extra cost if the claim amount exhausts your insurance coverage.
  • No-Claim Bonus: For every claim-free year up to 100% increase in sum insured with No Claim Bonus. Ambulance expenses are reimbursed by the company
  • Health checkup: Insured members can avail super annual health check-up regardless of their claim history.
  • Claim process: Care Health Insurance doesn’t deal with a third-party. The company has a hassle-free direct claim settlement process.
  • Premium payment: No paperwork needed to make premium payments to purchase or renew a health insurance policy as it can be done online through the company website.
  • Insurance coverage: Pre and post-hospitalisation expenses covered, no sub-limit on vital expenses, and no co-payment up to 60 years of age.

Types of Health Insurance Policies Provided by Care:

Policies forming a part of the company’s health insurance plans portfolio are listed below:

  1. Care 
  2. Care Freedom 
  3. Care Heart 
  4. Care Senior 
  5. Enhance 
  6. Care Advantage 
  7. Arogya Sanjeevani Policy 
  8. Joy 
  9. Cancer Mediclaim 
  10. Critical Mediclaim 

The main features to be considered in each of these policies are highlighted below:

  1. Care Health Insurance Care Plan 
  2. This health insurance plan provides cover for the policyholder and his/her family in the case of any medical emergencies. 

     
    Age Limit  The minimum age of entry is 91 days. There is no upper age limit. 
    Renewability  Lifelong 
    Waiting Period  30 days 
    Grace Period  30 days from the date the policy expires 
    Exclusions 
    • Congenital disease. 
    • Hospitalisation due to nuclear weapons, strikes, riot, or war. 
    • Self-inflicted injuries. 
    • Expenses that have been incurred due to drug or alcohol use. 
  3. Care Freedom 
  4. The Care Freedom is a diabetes health insurance plan that comes without any pre-policy check-up. The cover is available on an individual as well as a floater basis. 

     
    Age Limit  The minimum age of entry is 91 days. There is no upper age limit under the policy. 
    Renewability  Lifelong 
    Initial Waiting Period  30 days 
    Grace Period  30 days from the date the policy expires 
    Waiting Period for Pre-Existing Diseases  24 months 
    Exclusions 
    • Congenital disease. 
    • Hospitalisation due to nuclear weapons, strikes, riot, or war. 
    • Self-inflicted injuries. 
    • Expenses that have been incurred due to drug or alcohol use. 
    • OPD treatment 
    • Treatment of AIDS 
  5. Care Heart 
  6. The Care Heart is a heart insurance policy that provides cover for pre-existing heart ailments.  

     
    Age Limit  The minimum age of entry is 18 years. There is no upper age limit under the policy. 
    Renewability  Lifelong 
    Initial Waiting Period  30 days 
    Waiting Period for Pre-Existing Diseases  24 months (continued coverage) 
    Waiting Period (Named Ailment)  24 months (continued coverage) 
    Exclusions 
    • Congenital disease. 
    • Hospitalisation due to nuclear weapons, strikes, riot, or war. 
    • Self-inflicted injuries. 
    • Expenses that have been incurred due to drug or alcohol use. 
    • Treatment due to abortion, miscarriage, childbirth, and pregnancy 
  7. Care Senior 
  8. Individuals who are 61 years and above can purchase the policy.  

     
    Age Limit 
    • Minimum: 61 years 
    • Maximum: Lifelong 
    Renewability  Lifelong 
    Grace Period  30 days from the date the policy expires 
    Waiting Period for Pre-Existing Diseases  48 months 
    Waiting Period (Named Ailment)  24 months (continued coverage) 
    Exclusions 
    • Congenital disease. 
    • Hospitalisation due to nuclear weapons, strikes, riot, or war. 
    • Self-inflicted injuries. 
    • Expenses that have been incurred due to drug or alcohol use. 
    • Treatment due to abortion, miscarriage, childbirth, and pregnancy 
  9. Enhance 
  10. A top-up health insurance plan that comes with various features such as in-patient care, tax benefits, pre- and post-hospitalisation, and day care treatment is the Enhance plan. 

     
    In-Patient Care  Up to the Sum Insured 
    Post Hospitalisation  60 days 
    Room Rent Category  Single Private Room 
    Health Check-Up  Yes 
    Pre Hospitalisation  30 days 
    Day Care Treatment  Yes 
    Doctor’s Fee, ICU Charges, etc.  No Limit 
    Organ Donor Cover  Yes 
    Exclusions 
    • Congenital disease. 
    • Hospitalisation due to nuclear weapons, strikes, riot, or war. 
    • Self-inflicted injuries. 
    • Expenses that have been incurred due to drug or alcohol use. 
    • Treatment due to abortion, miscarriage, childbirth, and pregnancy 
    • Treatment of AIDS 
  11. Care Advantage 
  12. The Care Advantage is a health insurance plan that comes with a cover of up to Rs.1 crore. Rs.25 lakh, Rs.50 lakh, and Rs.1 crore are the different sum insured options that are available. 

     
    Age Limit 
    • Minimum: 91 days 
    • Maximum: Lifelong 
    Renewability  Lifelong 
    Grace Period  30 days from the date the policy expires 
    Waiting Period for Pre-Existing Diseases  48 months 
    Waiting Period (Named Ailment)  24 months (continued coverage) 
    Initial Waiting Period  30 days 
    Exclusions 
    • Mental retardation treatment 
    • Expenses that have been incurred due to infertility and sterility 
  13. Arogya Sanjeevani Policy 
  14. The Arogya Sanjeevani Policy is a standard health insurance policy that comes with AYUSH cover. Pre- and post-hospitalisation is covered under the policy. The policy is available on an individual or a floater basis.  

     
    Age Limit 
    • Minimum: 3 months 
    • Maximum: No upper limit 
    Renewability  Lifelong 
    Waiting Period  30 days, except for injuries 
    Grace Period  30 days from the date the policy expires 
    Waiting Period for Pre-existing Diseases  48 months 
    Exclusions 
    • Hospitalisation due to nuclear weapons, strikes, riot, or war. 
    • Self-inflicted injuries. 
    • Expenses that have been incurred due to drug or alcohol use. 
  15. Joy 
  16. This is a maternity health insurance policy that comes with baby cover. The policy is available in two plans, Joy Today and Joy Tomorrow. The policy comes with several benefits such as ambulance cover, day care treatment, in-patient care, etc. 

     
    Sum Insured Options  Rs.3 lakh and Rs.5 lakh  Rs.3 lakh and Rs.5 lakh 
    Waiting Period (Maternity)  9 months  24 months 
    Exit Age  Lifelong  Lifelong 
    Cover Type  Individual  Individual 
    Initial Waiting Period  30 days  30 days 
    Pre-existing Diseases  48 months  48 months 
    Named Ailments  24 months  24 months 
    Exclusions 
    • Congenital disease. 
    • Hospitalisation due to nuclear weapons, strikes, riot, or war. 
    • Self-inflicted injuries. 
    • Expenses that have been incurred due to drug or alcohol use. 
    • Treatment due to abortion, miscarriage, childbirth, and pregnancy 
    • Treatment of AIDS 
  17. Cancer Mediclaim 
  18. Under the policy, cancer cover is provided and does not depend on the type or stage. Some of the main features of the policy are day care treatment, OPD expenses, organ donor cover, annual health check-ups, alternative treatments, doctor on call, global coverage, ambulance cover, and air ambulance. The different sum insured options that are available are Rs.10 lakh, Rs.25 lakh, Rs.50 lakh, Rs.1 crore, and Rs.2 crore. 

  19. Critical Mediclaim 
  20. Cover is provided in case the individual is diagnosed with a critical illness. In-patient hospitalisation, dialysis cover, day care treatment, organ donor cover, no claim bonus, doctor on call, global coverage, ambulance cover, and air ambulance are some of the features of the policy. The different sum insured options that are available are Rs.10 lakh, Rs.25 lakh, Rs.50 lakh, Rs.1 crore, and Rs.2 crore. 

Care Health Insurance Policy Renewal:

In order to provide a continuous comprehensive health insurance coverage for yourself and your family, make sure to renew your policy on time. For insurance plans provided by Care Health Insurance, renewal can be done online through the company website. Renewal premium payment can also be paid online using net banking, credit card, or debit card. Click on the 'Renew' tab available on the top right-hand corner of the page. Enter your policy number and date of birth to initiate the renewal process.

Care Health Insurance Premium Calculator:

The online insurance premium calculator available on the Care Health Insurance website can be used to calculate the monthly premium and gross premium including tax for the chosen policy. Here is how Care Health Insurance premium calculator works:

  • Navigate to the insurer’s official website.
  • Enter the number of members to be insured (number of adults and children in the case of a floater plan).
  • Provide your contact details such as phone number and email ID.
  • Enter the sum insured amount and policy term in years.
  • Click on calculate and the total premium will be displayed onscreen.

Care Health Insurance premium calculator is simple and easy to use. Knowing the insurance premium of a policy can help you choose a suitable health insurance plan.

Care Health Insurance Customer Care:

Care Health Insurance has a dedicated Helpdesk to resolve customer queries on its official website. Visit the website and click on 'Helpdesk' tab which on the top right corner of the page. The following customer service tools can be found under Helpdesk:

  • Customer Support: To give feedback, make a request or register a complaint, click on the Customer Support link and fill in the online form with your policy number and contact details. Queries can be regarding your policy, claim, refund, service, etc. The customer support centre of Care Health Insurance is dedicated to making the process engaging for its customers.
  • Contact us: For any policy-related queries, you can also contact the company's Customer Service Team on their dedicated toll-free numbers or send them an email. Customers can also use the ‘Live Chat’ feature on the insurer’s website to communicate with the insurer’s representative.
  • Branch Locator: Care Health Insurance branch offices are located across India. The nearest branch office can be located by selecting a state and city from the drop-down box.
  • e-policy: Policyholders can view their e-policy and tax receipt by providing their policy number and date of birth.
  • Hospital Locator: There are over 8350+ network hospitals across India. You can use the Hospital Locator tool to check out the list of network hospitals in a particular location by selecting the state and city from the dropdown box. The address, phone number, and list of doctors working at the hospital will be displayed on screen. You can send an email or SMS to the hospital through the insurer's website regarding an appointment.
  • Claim Search: For reimbursement claims, payments are made through online bank transfers for which a cancelled cheque, claim form, and supporting documents have to be submitted by the policyholder to the insurer. Claim forms can be downloaded from the company website.
  • Grievance Redressal: In case you have any complaints or grievances, you can contact the insurer through the toll-free number or email ID provided on the website. Customers can also write to the insurer or walk into the nearest branch. If one is not satisfied with the resolution, the matter can be taken up with a higher authority, through the insurer’s website.

Care Cashless Network Hospitals:

Individuals with a Care Health Insurance policy can avail cashless hospitalisation at over 8350+ network hospital across India. Medical treatment can be availed at any one of the network hospitals that have tie-ups with Care Health Insurance. In the case of a cashless treatment, you can avail treatment without paying for the medical expenses upfront. To locate a network hospital in your area, just enter your state and city on the Network Hospital Locator tool. You will instantly get a list of network hospitals with names, phone numbers, and addresses.

Find cashless network hospitals nearby: Care Cashless Network Hospitals

How to File a Claim With Care Health Insurance?

Unplanned Hospitalisation: In the case of an emergency or unplanned hospitalisation, intimate the insurer within 24 hours of hospitalisation.

  • Display your health card at the network hospital desk.
  • The hospital will submit a duly-filled and signed pre-authorisation request form to the insurance company or it’s Third-Party Administrator (TPA) via fax.
  • The claim management will send an approval letter to the hospital.
  • The hospital will proceed with the cashless treatment for the insured member.
  • If the cashless claim is rejected, the insured member can initiate the treatment and file for a reimbursement claim after discharge.

Incurred Claims Ratio of Care Health Insurance for the year 2017-18

Net Earned Premium (in Crore) Net Claims Paid (in Crore) Incurred Claims Ratio (in %)
Rs.679.67 crore Rs.353.21 crore 51.97%

Planned Hospitalisation: In the case of a planned hospitalisation, intimate the insurer 48 hours prior to your hospitalisation.

  • The reimbursement claim form has to be submitted to the insurer along with the required supporting documents such as discharge summary, medical reports, hospital bills, pharmacy bills, prescriptions, etc.
  • An approval letter will be sent by the claim management team. You will have to respond to the queries raised by the claim management team for a smooth claim processing experience.
  • The claim amount will be sent to the insured member after approval.

Care Health Insurance FAQs:

  1. What are the benefits of buying health insurance?

  2. With the help of health insurance, you can enjoy a number of benefits such as nursing care, surgeries, consultation fees, cashless hospitalization for more than 24 hours, consultation fees, diagnostic tests, hospital accommodation etc. Your health insurance provider will pay off the coast incurred in your entire treatment procedure.

  3. What is a network hospital?

  4. A network hospital is a hospital with which your health insurance provider has tie up. In a network hospital, you can enjoy cashless treatment. Care Health Insurance has tie up with many leading hospitals where you can enjoy cashless hospitalization.

  5. What is a health card?

  6. It is a kind of identity card that your health insurance provider gives you. You need to show this card at the network hospital to get the benefits of health insurance policy.

  7. What is the meaning of cashless hospitalization? Does Care Health Insurance provide it?

  8. Cashless hospitalization is a benefit you get from your health insurance provider under which your insurance company will pay for your hospitalization cost. Yes, Care Health Insurance does provide cashless hospitalization facility at network hospitals, across India.

  9. What is the meaning of a premium?

  10. A premium is the total amount of money you pay to your health insurance provider in return for the services it provides.

  11. What do you mean by a family floater plan?

  12. A family floater plan refers to a health insurance policy that includes your entire family under it. It is a customised policy to meet the health needs of your family.

  13. How is the customer service at Care Health Insurance?

  14. Care provides 24/7 customer support. You can call them at any time for any of your queries.

  15. Can I correct the relationship in my policy document?

  16. Yes, you can correct or rectify the relationship in your policy. Care will do it after proper verification. However, it is subject to your declaration of relationship at the time of buying the policy.

  17. Is it possible to increase or reduce the sum insured in the policy?

  18. It is not possible to reduce or increase the sum insured in the main policy during the tenure of the policy. However, you can do it at the time of renewal. It is subject to terms and conditions of the policy.

  19. Can I add and remove family members in my current policy?

  20. You can add and remove family members at the time of renewal of your policy, but not during the tenure of your policy. However, you can buy separate policy for separate members of your family.

  21. Can I change my date of birth, if it gets written incorrectly in the policy document?

  22. Change in your DOB may affect your premium. For further details, you need to contact the nearest branch of Care Health Insurance.

  23. What are the formalities do I need to do get a claim?

  24. In order to enjoy a hassle-free completion of your claim settlement formalities, you can contact Care’s customer help desk. Also, you can visit its 'Claims' webpage to know more about your particular insurance cover.

  25. What are the benefits of a health card?

  26. Health Card has to be displayed at the time of admission at a network hospital to avail cashless hospitalisation. This ID card has the contact details of the Third-Party Administrator in the case of a medical emergency, you can call the given number for assistance with cashless hospitalisation claims.

  27. Can I revise the relationship in my plan?

  28. Revising relationship in a policy document is subject to verification of details with the proposal form at the time of purchasing the policy. Call the insurer's toll-free number 1800 200 4488 with your policy details or visit the nearest branch office to rectify the relationship in your policy document.

  29. Can I change my DOB and will that affect my policy?

  30. Changing your Date of Birth (DOB) in the policy document can affect your insurance premium. Higher the age, higher the insurance premium.

  31. What is the need to buy a Care Health Insurance Policy?

    • Get timely and adequate healthcare for you and your family.
    • Avail cashless hospitalisation in over 8350+ network hospitals across the world.
    • Enjoy tax benefits under Section 80D of the Income Tax Act, 1961.
  32. What are the benefits of buying Care Health Insurance at an early age?

  33. Here is a list of reasons why you should buy health insurance at a young age:

    • Premium of a health insurance policy increases with age.
    • Senior citizen health insurance plans can be restrictive compared to a regular health insurance plan.
    • You can get coverage for medical conditions that may be diagnosed over the years, provided there is no break in the policy.
    • Every claim-free year will give you a no-claim bonus that can be accrued over the policy term, resulting in an increase in your sum insured at no extra cost.
    • You can avail tax deduction on premiums paid towards a health insurance policy under Section 80D of the Income Tax Act, 1961.
  34. Explain the working of a floater cover under Care Health Insurance?

  35. The floater plan from Care Health Insurance covers the entire family which includes self, spouse, children, and parents under one single policy and single premium payment. The sum insured can be utilised by a single individual or shared by all the insured members and any number of claims can be made during the policy term, subject to the sum insured limit. A floater plan is cost-effective in comparison to paying premium for an individual policy for each member for the family.

  36. What are excluded from a standard Care Health Insurance Policy?

  37. Exclusions of a standard Care Health Insurance policy includes:

    • There is an initial waiting period of 30 days for all illnesses except an accidental injury.
    • Treatment for AIDS/HIV.
    • Congenital disease treatment.
    • Pregnancy related treatments.
    • Hospitalisation due to a war or nuclear threat.
    • Medical expense incurred due to alcohol or drug abuse.
    • Self-inflicted injuries and suicide attempts.
    • Pre-existing diseases for a period of 4 years since the inception of the policy.
  38. How does the auto recharge feature under Care Health Insurance work?

  39. If the sum insured and No-Claim Bonus has been exhausted during the policy year, the sum insured will be automatically recharged once in a policy year. The recharge sum insured can be used for future claims but not for an illness or disease for which a claim has already been made in the current policy year.

  40. What is a No-Claim Bonus under Care Health Insurance?

  41. For every claim-free year, the insurer will provide a No-Claim Bonus to the policyholder in the form of an increase in sum insured (up to 50%) or discount on premium. If a claim is made, the accrued bonus will be reduced by 10%.

  42. For what reasons can there be a deduction in the claim amount of Care Health Insurance?

  43. Claim amount can be deducted for the following reasons:

    • Non-medical expenses like snacks and telephone bills are not payable.
    • Treatment details without supporting documents like original bills and prescriptions.
    • If the sum insured is exhausted.
    • If the expenses exceeds specified sub-limits for certain expenses like room rent and doctor's fees.
    • If the policy has a co-payment clause.
    • Investigative or experimental treatment expenses that are not related to the ailment for which the insured member has been admitted are not payable.
  44. How can an individual make a cashless hospitalisation claim?

  45. In the case of an emergency hospitalisation, intimate the insurer within 24 hours of hospitalisation. Intimate the insurance company 48 hours prior to admission for planned hospitalisation. For cashless hospitalisation claims, fill the pre-authorisation request form at the hospital desk, and the network hospital will send the filled form to the insurer. The approval or rejection letter will be sent by the claim management team. In the case of rejection, you can initiate the treatment and file for reimbursement.

  46. Explain the Claim Processing and Reimbursement under Care Health Insurance Policy?

  47. In the case of an emergency hospitalisation, intimate the insurer within 24 hours of hospitalisation. Intimate the insurance company 48 hours prior to admission for planned hospitalisation. For reimbursement claims, download the claim form from the insurer's website, fill it and submitted it at the nearest branch office along with the supporting documents such as discharge summary, hospital bill, prescription, etc. The approval or rejection letter will be sent by the claim management team. The claim amount will be transferred to the policyholder's bank account.

  48. How can one cancel his or her Care Health Insurance Policy?

  49. During the free-look period, the policyholder can return the policy and get a refund of the premium after certain deductions if he or she has an objection to the terms and conditions of the policy. Cancellation request can be made at any time during the policy period provided no claims have been made. If a claim has been made and he or she wants to cancel the policy then premium will not be refunded.

Examples of Network Hospitals in Major Cities

CITY NAME OF HOSPITAL
BANGALORE K.R.Puram Super Speciality Hospital
DELHI Aakash Hospital
KOLKATA Ruby General Hospital
CHENNAI Aditya Hospital
MUMBAI Phoenix Hospitals Pvt Ltd.

*Disclaimer - This is not an exhaustive list but an indicative representation of hospitals that form a part of the company's wider network.

Display of any trademarks, tradenames, logos and other subject matters of intellectual property belong to their respective intellectual property owners. Display of such IP along with the related product information does not imply BankBazaar's partnership with the owner of the Intellectual Property or issuer/manufacturer of such products.

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