Zone Based Health Insurance

Key Features of Health Insurance Zones Plan

The Care zone-based medical insurance policy offers comprehensive coverage to your entire family. This exclusive healthcare plan includes several valuable features, such as:

• Zone-based premium calculation to potentially reduce insurance payouts
• Available on a family floater basis
• Inclusive Annual Health Check-up Benefit
• OPD care (Optional Benefit), including consultation & diagnostic charges
• A wide range of sum insured options from 5 Lakhs to 15 Lakhs
• Coverage for compassionate travel
• Unlimited E-Consultations with General Physicians
• Cashless hospitalisation facility across 11400+ network hospitals
• Offers value-added services such as a health portal with doctor chat, healthy tips reminders, and discount connect for discounts on services within our network.

Benefits of Buying Zone-based Health Insurance

Buying health insurance is imperative to your financial well-being. However, opting for zone-based health insurance will benefit you in the following ways-

• Reduced Premium: There's a reasonable difference in the premium paid by city dwellers and smaller district families. With this plan, you pay an affordable premium determined by the zone in which your city falls.
• Extensive Coverage: Our zonal health plan offers comprehensive coverage during an emergency or planned hospitalisation. It provides expansive insurance coverage from pre and post-hospitalization medical expenses to domiciliary hospitalisation and a no-claim bonus.
• Cashless Facility: Every Care Health Insurance plan is associated with 11400+ cashless network hospitals. You do not need to pay hefty hospital bills out of your pocket; we will directly settle your insurance claim with our network of hospitals spread across India.
• Easy Claim Settlement: At Care, you can rely on us to make a hassle-free claim. Filing a medical insurance claim involves a few simple steps to get immediate financial assistance during an emergency.
• Inclusive Annual Health Check-up: Like all our health insurance covers, the Care Classic plan comprises a mandatory annual health check-up for all insured members. The cost of these yearly health check-ups is already included in the basic premium amount.
• Add-on Benefits: This plan is complemented with essential, optional benefits of OPD care. OPD care covers your OPD visits for minor ailments, such as minor injuries, ENT consultations, diagnosis, etc.
• Unlimited E-Consultations: With a health insurance policy, you can receive unlimited online consultations from general physicians without paying anything extra.
• Tax Benefit: Under section 80D of the Income Tax Act of India, you can now avail yourself of up to Rs. 75,000 in tax benefits with this family health insurance policy.

What is Covered under Health Insurance Zones?

Securing your health with our zone-based insurance plan is better than facing an unforeseen emergency. Investing in zone-based health insurance is a wise decision to obtain comprehensive coverage at an affordable premium.

Let's understand in detail what all the policy covers:

• In-Patient Care: We cover the expenses incurred for in-patient care, including doctor's fees, ICU charges, OT charges, room charges, etc.
• Pre- and Post-Hospitalisation Expenses: Medical expenses for 60 days before and 90 days after hospitalisation, ensuring that minor medical expenditures do not cause financial stress.
• Daycare Treatments: You can get daycare treatments requiring hospitalisation for less than 24 hours. We cover all daycare procedures under Care Classic.
• Advance Technology Methods: The plan covers advanced technology methods such as robotic surgery, balloon sinuplasty, and brain stimulation, which are minimally invasive surgeries with fewer side effects.
• AYUSH Treatment: If you are also an Ayurveda believer, you can go for the AYUSH (Ayurveda, Unani, Siddha, and Homeopathy) treatment without hesitation, for we cover its expenses under the policy.
• Domiciliary Hospitalisation: We cover expenses up to the sum insured (SI) if your medical condition prevents you from visiting a hospital or if no beds are available in nearby hospitals.
• Organ Donor Cover: This is a life-saving initiative, and we cover medical expenses up to the sum insured (SI) incurred by you for your organ donor while undergoing organ transplant surgery.
• Ambulance Cover: You will get ambulance coverage for an all-road emergency ambulance you hire. We reimburse your ambulance expenses up to Rs.1,000 per policy year so that nothing hinders your treatment.
• No Claim Bonus: We offer a no-claim bonus for every claim-free year, up to 150% SI, reducing the claim at the same rate as it was accrued.
• Second Opinion: We arrange a second opinion for you within India from our empanelled doctors once a policy year for significant illness/ injury for all the insured members without impacting the sum insured.

What is Not Covered in Zone Insurance?

Listed below are the exclusions of family health insurance plans that are not admissible under the policy:

• Any diagnosis of diseases / undergoing surgery/ occurrence of an event whose signs or symptoms first occur within 30 days of the policy period start date
• Expenses for self-inflicted injuries, including those resulting from suicide or attempted suicide
• Costs arising from alcohol or drug use, misuse, or abuse
• Treatment related to pregnancy, childbirth, miscarriage, abortion, and their complications
• Tests and treatments for infertility and in vitro fertilization
• Hospitalisation due to war, riot, strike, etc

How is the Premium Calculated under Zone-Based Health Insurance Policies?

Premiums are estimated depending on the specific features of each zone under zone-based health insurance. Here are the factors that influence zonal premium calculations:

• Healthcare Expenses: Increased medical expenses in a particular zone cause higher premiums.
• Risk Assessment: It is standard for premiums to be higher in zones with higher health risks or more prevalent diseases.
• Demographics: Age distribution and population health metrics within a zone impact premium costs.
• Claim History: Past claim data from a zone can affect future premium pricing.

Insurance service providers ensure that the zonal health insurance policy is reasonable and sufficiently covers the healthcare needs of policyholders in each zone.

What Happens if a Person Moves from One Zone to Another?

When a person shifts from one zone to another, the influence depends on the type of zone involved. Variations in time, laws, or environmental factors can all impact how the shifting impacts them. Here's a breakdown:

• Time Zones: Adapting to a new local time may lead to jet lag.
• Geographical Zones: Variations in taxes, services, and local constraints may apply.
• Climate Zones: Adjusting to diverse weather conditions and seasonal changes.
• Zoning Laws: Property usage and local business regulations may differ.
• Economic Zones: Financial incentives or obligations may change depending on local policies.

Which Zone is better- Zone 1 or Zone 2?

Here's a comparison between Zone A and Zone B in terms of the premium amount, facilities, waiting period, and other factors, represented in a tabular format:

How to Buy a Care Classic Health Insurance Plan Online?

We ensure you can seamlessly opt for every health insurance policy at Care’s online portal. You can opt for the Care Classic plan online in a few simple steps:

• Step 1: Go to our official website and select Care Classic
• Step 2: Enter the required details, including mobile number and pin code
• Step 3: Click on "Get the Quote"
• Step 4: Choose the plan that suits your health insurance needs
• Step 5: Customize your policy by selecting the ideal policy tenure, the sum insured, and optional benefits
• Step 6: Fill in the relevant details, such as age, occupation, pre-existing diseases, etc.
• Step 7: Submit the documents if required
• Step 8: You can choose convenient payment modes using any secured payment mode like net banking, debit or credit card, payment wallet, and pay your health premium online
• Step 9: You will receive a health insurance policy document on your registered email ID, including your policy numbers and e-card.