Care Insurance
  • calendar_monthPublished on 7 Mar, 2024

    autorenewUpdated on 7 Mar, 2024

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Traditional treatments have always been considered alternative treatments to conventional medicine. However, in the case of critical illnesses conventional treatments and medicines leave the patients with severe side effects that affect the quality of their life. The long course of treatment and drug therapy causes long-term symptoms also. Traditional treatments including ayurveda and yoga use natural ways to heal the body and focus more on wellness and therefore help in better recovery when used in integration with conventional medicine. 

Recognising the benefits of these alternative treatments more people now prefer alternative treatments for rehabilitation post-critical illness. Thus, health insurers have started reconsidering the coverage under AYUSH treatment. 

In this blog we’re going the discuss about one such policy that has been gaining popularity for its coverage is Care Critical Mediclaim that comes with alternative treatment coverage for specified critical illnesses. Keep reading to learn about what is covered in mediclaim for critical illnesses.

Features of Care Critical Mediclaim

Care critical mediclaim is a top-up mediclaim plan offered by Care Health Insurance that provide coverage for 32 major life-threatening illnesses including cancer, paralysis, stroke and liver failure. Apart from critical illness coverage the policy comes with 3 more variants including cancer mediclaim, heart mediclaim and operation mediclaim. Some of the primary features of this plan are:

Sum Insured (₹) 10L, 25L, 50L, 1cr, 2cr
Illnesses covered 32 critical illness
In-patient care Up to sum insured
Day care treatments Up to sum insured
Chemotherapy and radiotherapy cover Up to sum insured
Dialysis cover Up to sum insured
Alternative treatments Up to 25% sum insured
Annual health check ups Available from 2nd policy year provided the policy is continued without any break
Waiting period

Initial 90 days

4 years for pre-existing diseases

Not applicable for specific ailments

Care Health Insurance Critical Illness List

There are 32 conditions covered under the critical care health insurance plan. These conditions include diseases, illnesses and surgical procedures which are covered as per the definition and coverage scope mentioned in the policy terms and conditions.

  1. Cancer including leukaemia, lymphoma and sarcoma
  2. Pulmonary Thromboemobilism
  3. Primary Pulmonary Hypertension
  4. Infective Endocarditis
  5. Heart Valve Repair / Replacement
  6. Surgery of Aorta
  7. Cardiomyopathy
  8. Surgery for Cardiac Arrhythmia
  9. Angioplasty
  10. Balloon Valvotomy
  11. Carotid Artery Surgery
  12. Coronary Artery Bypass Graft
  13. Pericardectomy
  14. Implantation of Ventricular Assist Devices
  15. Myocardial Infarction
  16. Implantation of Pacemaker of Heart
  17. Implantable Cardioverter Defibrillator
  18. End Stage Renal Failure
  19. Multiple Sclerosis
  20. Benign Brain Tumor
  21. Parkinson’s Disease
  22. Alzheimer’s Disease
  23. Motor Neurone Disease
  24. End Stage Lung Disease
  25. Stroke 
  26. Bacterial Meningitis
  27. Aplastic Anaemia
  28. Paralysis
  29. Organ Transplant
  30. Major Burns
  31. Blindness
  32. Surgical Procedure

What are Traditional / Alternative Treatments Covered under Care Critical Mediclaim?

The traditional or alternative medicine systems include Ayurveda, Yoga, Unani, Siddha and Homeopathy, together called AYUSH treatments. As these treatments are non-invasive, affordable and safe they are most trusted and popular among people. Care critical mediclaim provides coverage for the hospitalisation expenses for AYUSH treatments according to the policy terms and conditions. Some benefits of alternative treatment coverage are

  • Coverage for hospitalisation expenses at a government-recognised AYUSH hospital.
  • Easy access to AYUSH day care centres for treatment.
  • Any gaps in the conventional treatments can be covered by AYUSH treatments.
  • Affordable AYUSH treatments do not exhaust the sum insured of your mediclaim.

Things to Remember before Claiming for Alternative Treatment

Here are some important points to keep in mind before you claim alternative treatment coverage.

  • Read the policy terms and conditions carefully to understand the inclusions and exclusions of alternative treatment coverage.
  • Check the network of government-recognised AYUSH hospitals and clinics.
  • Check the limit of coverage for alternative treatments. Care critical mediclaim covers alternative treatments up to 25% of the sum insured.
  • Check whether cashless treatment is available or not.
  • Treatment should be taken at a state/government-recognised AYUSH hospital, teaching hospital attached to an AYUSH college or a stand-alone clinic or hospital attached to a recognised in-patient facility.
  • To file a claim for alternative treatment a written prescription from a medical practitioner is required stating that alternative treatment is required.
  • A minimum 24-hour hospitalisation is required for the claim to be approved. If hospitalisation is for evaluation purposes only the claim will not be approved.
  • OPD and pre and post-hospitalisation expenses are not covered.
  • Diagnostic tests required for alternative treatments are also not covered.
  • Not all alternative treatments are covered. Naturopathy or any rejuvenation procedures are not covered and the policyholder will have to bear the cost of any such treatment.

To Conclude

Alternative treatments play a very important role in your recovery after a critical illness and can help you restore your energy levels. However, it is crucial to be aware of what is covered in mediclaim. Care critical mediclaim provides coverage for alternative treatments as per the government regulations and any medically necessary traditional procedure within the scope of AYUSH guidelines is covered provided the treatment is availed at an accredited healthcare facility. For more details read the policy document and understand the terms and conditions to learn the inclusions and exclusions under the policy.

>> Also Read: Benefits of Critical Illness Health Insurance

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.

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