Care Advantage Health Insurance
- Care Advantage Health Insurance is a Rs 1 crore health insurance policy that offers comprehensive coverage to individuals and families. The policy is designed to meet the healthcare needs of the insured against emergency planned and emergency medical expenses. It comes with no sub-limits and also offers a co-payment waiver as an optional cover.
Care Advantage Health Insurance: Key Highlights
Categories Specifications
- Sum Insured Rs 25 lakh, Rs 50 lakh, Rs 1 crore
- Policy Tenure 1 year, 2 years, 3 years
- Network Hospitals 19000+
- Incurred Claim Ratio (2020-21) 55.15%
- Claim Settlement Ratio (2019-20) 95.2%
- Pre-policy Medical Check-up Not required up to 50 years
- Pre-existing Diseases Waiting Period 4 years
- Initial Waiting Period 30 days
- Specific Ailments Waiting Period 2 years
- Co-payment 20% for people above 60 years
Benefits of Care Advantage Health Insurance
Check out some of the attractive benefits of Care Advantage Health Insurance:
Automatic Recharge of Sum Insured
In case the sum insured gets exhausted in a claim, the amount will automatically get recharged once in a policy year for up to 100% so that it can be used for another claim. The sum insured recharge can be done an unlimited number of times if you opt for the Unlimited Automatic Recharge cover.
Annual Health Check-up
Policyholders can avail free health check-up facility once every year if they opt for this cover under the Care Advantage plan.
No Claim Bonus
A No Claim Bonus (NCB) of 10% is granted to the policyholder up to a maximum of 50% for every claim-free year. The policyholder can also buy the No Claim Bonus Super optional cover to get 50% NCB for every claim-free year.
No Sub-limits
The Care Advantage plan does not come with any sub-limits on the hospital room rent or ICU charges.
Co-payment Waiver
The policyholder can waive off the mandatory co-payment for policyholders above 60 years if they opt for this cover.
Cashless Hospitalization
The policy allows the insured to avail cashless hospitalization facilities at over 19000 network hospitals of Care Health Insurance Company across India.
Tax Benefits
Policyholders can avail tax benefits on the premium paid for the Care Advantage plan under Income Tax Act, Section 80D.
Care Advantage Health Insurance Eligibility Criteria
Take a look at the eligibility criteria to buy a Care Advantage Health Insurance plan:
Parameters Eligibility Criteria
Minimum Entry Age Adult – 18 years
Child – 5 years (individual), 91 days (floater)
Maximum Entry Age Lifelong
Coverage Type Individual/ floater
Renewability Lifetime
Inclusions of Care Advantage Health Insurance
The Care Advantage Health Insurance plan comes with the following inclusions:
In-patient Hospitalization Expenses – It covers the medical expenses incurred on hospitalization of at least 24 hours, including room rent, doctor’s fee, nursing charges, etc.
Day Care Procedures – It covers the cost of day care procedures/ treatments that requires less than 24 hours of hospitalization.
Pre-hospitalization Expenses – It pays for the medical expenses incurred for up to 30 days before getting admitted to the hospital.
Post-hospitalization Expenses – It covers the medical expenses incurred for up to 60 days after getting discharged from the hospital.
Ambulance Charges – It pays the cost of ambulance services used to transport the insured to a hospital during a medical emergency.
Organ Donor Expenses – It covers the cost of harvesting the organ from a donor for the treatment of the insured.
Advance Technology Treatments – It pays for the medical expenses incurred on treatments taken through advance technology, including robotic surgeries, stem cell therapy, oral chemotherapy, etc.
Optional Covers:
Unlimited Automatic Recharge – It ensures that the sum insured amount is recharged an unlimited number of times in a policy year in case it gets exhausted after a claim.
No Claim Bonus Super – It ensures that the policyholder gets a No Claim Bonus of 50% for up to a maximum of 100% on every claim-free year.
Air Ambulance Cover – It covers the cost of availing air ambulance services for up to a maximum of Rs 5 lakh.
Smart Select – It provides a premium discount of 15% to the policyholder. However, a co-payment of 20% will apply in case the treatment is taken at a non-network hospital of the insurance company.
Reduction in PED Waiting Period – It reduces the waiting period for the coverage of pre-existing diseases from 48 months to 24 months.
Co-payment Waiver – It ensures that policyholders above 60 years do not have to pay any co-payment while raising a claim.
Annual Health Check-up – It offers the insured with the facility of free health check-ups once every year.
Room Rent Modification – It ensures that the insurance company pays for the cost of a single private room in a hospital in case the insured gets hospitalized.
Deductible Option – It provides the policyholder with a discount on premium if he/she chooses to opt for a voluntary deductible.
Daily Allowance – It provides a daily cash allowance to the insured for up to a maximum of 30 days in case he/she is hospitalized for more than a certain number of days. The daily allowance doubles in case the insured is admitted to the ICU.
Additional Sum Insured for Accidental Hospitalization – It provides an additional sum insured to the policyholder in case of accidental hospitalization.
Exclusions of Care Advantage Health Insurance
The Care Advantage Health Insurance plan excludes the following coverage:
Self-inflicted injury
Cosmetic or plastic surgery
External congenital diseases
Maternity expenses
Treatment for alcohol or drug addiction
Unproven treatments
Sterility and fertility treatments
Obesity and weight-control treatments