Awarded as the ‘Best Health Insurance Company of The Year’ at the India Insurance Summit and Awards 2023, Care Health Insurance is a specialised health insurer providing health insurance plans with a comprehensive set of benefits and new-age features such as wellness benefit, alternative treatment cover, global coverage, day care treatment cover, automatic recharge, unlimited e-consultation, NCB bonus etc. Furthermore, the insurer ensures quality healthcare at more than 22900 cashless healthcare providers across the country.
Care Advantage Plan is one such plan that is famous for its extensive and customisable coverage. This can be a perfect option if you are willing to cover your family, specially the children. Keep reading to learn more about the plan, its features, inclusions and exclusions and how you can be benefitted by adding your child.
Care Advantage Health Insurance at a Glance
Care Advantage health plan is a comprehensive health insurance plan available on an individual and family floater basis. The plan provides financial protection against expensive medical treatments with high-sum insured options going up to ₹ 6 crore. The plan is suitable for families of varying sizes and varying medical needs and offers many optional covers to enhance coverage. The table below explains the features of the plan.
| Sum Insured (₹) |
25L, 50L, 1cr, 2cr, 3cr, 6 cr |
| Entry Age |
Adult: 5 years to lifelong
Child: 91 days to 24 years with at least 1 individual of age 18 years or above
|
| Policy Term |
1/2/3 years |
| Renewability |
Lifelong |
| Relations Covered |
Individual: Self, spouse, son, daughter, parents, brother, sister, parents-in-law, grandparents, grandson, granddaughter, uncle, aunt, nephew, niece, employee and any relation with an insurable interest
Family Floater: Self, spouse, son, daughter, parents, employee and his dependents and any relation with an insurable interest
|
| Waiting Period |
Initial wait period - 30 days
Specific ailment wait period - 2 years
Pre-existing disease wait period - 4 years
|
| Pre-policy Checkup |
- 25Lac SI - Pre-policy check-up not required till the age of 60 years if no pre-existing conditions are declared.
- 50 Lacs and above SI - Not required till the age of 50 if no pre-existing conditions are declared.
|
From the aforementioned table we can check that children from 91 days to 24 years of age can be covered under Care Advantage plan. The multiple sum insured options make it convenient for you to choose a plan as per your family needs. This plan also ensures that your family can never remain undercover with its extensive coverage up to INR 6 crore. Under the floater option, the sum insured is equally shared by the insured family members. Let’s consider the scope of coverage under this plan to understand and make the best out of your health insurance.
Care Advantage Health Plan: Benefits
Care Advantage health plan offers a wide range of coverage benefits, add-on cover and optional covers that let you customise your coverage as per your and your family’s requirements.
1. Inpatient Care - Expenses for a minimum of 24 hours of hospitalisation due to illness or injury are covered up to the sum insured. It includes room rent, nursing charges, ICU charges, operation theatre charges, doctor’s fees, surgeon fees, anaesthesia, blood, oxygen, etc.
2. Daycare Treatment – 540+ medical procedures that do not require more than 24 hours of hospitalisation are covered under this plan.
3. Advanced Technology Treatments - Modern treatments as specified in the policy document are also covered.
4. Pre and Post-hospitalisation - Pre and post-hospitalisation expenses are covered for 60 and 180 days respectively on a reimbursement basis.
5. Ambulance Cover - Ambulance charges are covered up to a specified amount per hospitalisation. Additionally, necessary transportation charges for shifting from one hospital to another for better treatment are also covered.
6. Organ Donor Cover - Expenses incurred towards organ donors while undergoing organ transplant surgery.
7. No Claim Bonus - For every claim-free year, you get a 10% no-claim bonus maximum of up to 50% of the sum insured.
8. Automatic Recharge - If the sum insured is exhausted in a policy year, the entire sum insured is reinstated once in a policy year.
9. Ayush Treatment - AYUSH treatments taken in recognised AYUSH hospitals are also covered up to the specified limit.
10. Health Services - The insurance company provides access to health-related services such as online consultation, digital medical records, and health tip reminders through the health portal. The policyholder also gets special rates for OPD, diagnostics, and pharmacy under discounts connected through the company’s website.
11. Global Coverage - Global coverage is one of the major USPs of this plan, which is available with the sum insured options 2, 3 and 6 cr. The insured can get global coverage for the planned treatment for diseases diagnosed in India.
Optional Covers
The following optional covers are available with the Care Advantage plan. These covers can be opted at the time of purchase or renewal of the policy.
1. No Claim Bonus Super - If this cover is opted, 50% of the sum insured is added to your sum insured to a maximum of 100% sum insured, for a claim-free year. If a claim is paid in the policy year, no claim bonus is reduced by 50% of the sum insured.
2. Air Ambulance Cover - If an air ambulance is medically necessary and this is opted by the policyholder, air ambulance expenses are covered up to ₹ 5 lakh.
3. Smart Select - If you opt for this cover, you get a discount on the premium amount up to 15%. You can avail treatment at any of the listed smart select network hospitals. If the treating hospital is not listed, a co-payment of 20% is applicable on each claim.
4. Reduction in PED wait period - Choosing this cover reduces your PED wait period to 2 years from 4 years.
5. Co-payment Waiver - For a policyholder buying the policy at an age of 61 years or above, there is an option to waive off the compulsory co-payment of 20%.
6. Annual Health check-up - If you opt for this cover, you get the facility of free preventive annual health check-up at a network hospital above the sum insured value.
7. Room Rent Modification - This cover lets you change your room category from ‘No limit’ to a single private room.
8. Care Shield - This optional cover has 3 benefits, claim shield, NCB shield and inflation shield.
Exclusions under the Care Advantage Health Plan
There are certain conditions and situations under which no coverage is provided. Here are the exclusions under the Care Advantage Health Plan.
- Investigation and evaluation
- Any item, condition or treatment listed as non-medical
- Rehabilitation and respite care
- Obesity treatment
- Change of gender treatments
- Cosmetic surgery
- Injuries due to participation in adventure sports
- Breach of law
- Unproven treatments
- Infertility treatments
- Maternity treatments
*Refer to the policy document for complete list of exclusions
Wrap it Up
Parents always want a secure and healthy life for their children. When it comes to securing the future of your family, nothing will be the best option than investing in a health insurance plan. It protects your hard-earned money and ensures quality health care. If you are also looking for securing your family or children Care Advantage Health Plan can be an ideal pick. Consider the aforementioned features and benefits of this plan and select wisely. You can allow our experts to connect with you for more details.
Disclaimers: The above information is for reference purposes only: Policy Assurance and Claims at the underwriter’s discretion.
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