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In the evolving world, one of the things people want is peace of mind. They desire assurance that their insurance will cover them in a medical emergency without incurring unexpected expenses or a complicated claims process. Care Health Insurance, a top provider in India, addresses this concern and offers a solution called Care Shield Benefits. But what is Care Shield, and how does it work?
This blog will look at how Care Shield works, its benefits, the types available, and other key details about Care Health Insurance policies. This way, you can make a smart choice for your health coverage.
What is Care Shield?
Care Shield is an add-on or optional benefit you can buy with your main policy for a bit more money. With this rider, you can increase your coverage amount at the time of renewal based on the inflation rate, which will help you cover future medical costs.
This policy lets you cover more medical expenses and makes sure you don't lose your No Claim Bonus throughout the policy term.
Care Shield Policy is especially useful for dealing with higher medical costs, particularly during the coronavirus pandemic. In simple terms, it helps fill the gaps that regular health insurance might leave, making sure you won't have to dig into your savings when you need care.
Why was it introduced?
Traditional health insurance usually covers hospital stays, surgeries, room rent, ICU fees, doctor visits, and some treatments. But there are a lot of non-payable items like gloves, oxygen masks, disposable supplies, syringes, and even some admin charges that you can't claim.
Patients typically discover these exclusions upon receiving their hospital bill, which can surprise them and leave them unhappy with their insurance provider. That's where Care Shield from Care Health Insurance can help!
Care Health Insurance provides Care Claim Shield as an added benefit to help with this and make the process smoother.
Care Shield Benefits
Care Health Insurance offers "Care Shield" as a smart add-on pack that includes three Care Shield benefits, each targeting a specific area of financial protection. Below are the three significant coverage benefits:
Claim Shield
The Claim Shield helps reduce out-of-pocket costs during hospital stays by covering items often not included in regular policies, like gloves, oxygen masks, bandages, and other essentials used in treatment. If you're looking for a smooth, cashless claim process and want to avoid unexpected medical bills, the Care Shield add-on will be the best decision.
No Claim Bonus (NCB) Shield
To understand NCB Shield, it is important to learn about the No Claim Bonus (NCB). If no claims were filed the previous year, the policy's coverage amount will increase by 10% of the base sum insured. However, if the insured person filed a claim, the first NCB will be deducted based on the FIFO formula (First in, First Out).
But, with Care Shield Benefits, policyholders can protect their accumulated NCB, even if they raise a claim. The accrued No Claim Bonus remains unaffected if you submit a low-value claim, meaning it is less than 25% of the total covered. This is a win-win situation.
Inflation Shield
Inflation Shield addresses how patients find it more difficult to access medical services due to the rising cost of healthcare brought on by inflation in India. To cover the increased expenses of hospitalisation, policyholders can purchase a new health plan or raise the sum insured under their current policy. By purchasing Care Shield, the policyholder can cover the cost of expensive treatments.
At the time of renewal, the sum insured amount is raised each year by the Consumer Price Index (CPI) inflation rate. This guarantees that the insured and their family members have sufficient coverage for future medical expenses.
Key Features of Care Shield
Here are the primary components and aspects of the Care Shield benefits:
Coverage for Non-Payable Items
According to conventional IRDAI (Insurance Regulatory and Development Authority of India) criteria, Care Claim Shield covers the majority of goods that the insurer normally excludes. These include:
- Surgical accessories (like gauze, gloves, and bandages)
- Medical supplies (like cotton and syringes)
- Sterilisation Charges
- Administration fees
- Disposable gear (like infuser sets and catheters)
By providing coverage for these goods, Claim Shield ensures that you will not be shocked by a bill that includes items that are categorised as "non-payable."
Add-On Flexibility
Claim Shield is offered as an optional rider or add-on in some Care Health Insurance policies. This enables policyholders to tailor their coverage to their risk tolerance and financial situation. It can be included when purchasing or renewing insurance.
Zero Deduction on Covered Claims
Usually, when you make a claim, a small part of it typically gets deducted because of things like co-pays, room limits, or items that aren't covered. However, with Care Shield Benefits, the insurer promises fewer or no deductions on the covered expenses as long as they fit within the policy rules. This helps, especially when making a big claim because even a 10% deduction can cost you a lot.
How Does It Work in Real-Time?
Here's a simple breakdown of how Claim Shield works:
Hospitalisation
A network hospital admits the policyholder or insured individual under a valid health insurance plan with Care Health Insurance.
Claim Intimation and Processing
The network hospital sends a request for pre-authorisation to Care Health Insurance for cashless treatment. The insurance company checks the claim against your policy.
Application of Claim Shield
If you have Claim Shield, the insurer looks at the whole hospital bill, even the parts that usually aren't covered. Instead of leaving those out, Claim Shield includes them in the claim settlement, depending on the policy terms.
Settlement with Fewer or No Deductions
Due to Claim Shield, you get coverage for items not covered under a basic policy. This means you might receive better claim payments, reducing your out-of-pocket expenses.
Discharge with Less Hassle
You get discharged without unexpected deductions. If you received treatment at a network hospital, the process is cashless. If it's a reimbursement claim, you'll get reimbursed more than you would have without Claim Shield.
Eligible Plans for Care Shield Benefits
The Care Shield add-on offers several Care Health Insurance plans, like Care, Care Classic, and Care Heart. Here's a quick look at these plans and who can sign up:
Care
Care is a comprehensive health insurance policy that covers hospital stays, day treatments, pre- and post-hospital care, and more. It's available for individuals and families. However, the minimum entry age is 91 days. If you have this plan, you can add Care Shield when you purchase the policy or at renewal.
Care Heart
If someone already has heart-related illnesses, they can get Care Heart. This plan comes with great coverage that helps take the stress out of paying for costly heart treatments or surgeries. It's designed to make things easier for those who need it most. However, the minimum entry age to buy this plan is 18 years.
Care Shield is like a friend in need of a Care Heart Plan. You can file a claim for non-payable items, unnecessarily increasing your bills. Hence, choose the riders wisely!
Care Classic
Care Classic is a health insurance plan that considers your location when setting your premium. This means that your premium cost can vary based on where you live. The best part is that it ensures you can access good healthcare services, regardless of your area. However, there are eligibility criteria for buying this plan.
Minimum Entry Age - 91 Days
Maximum Entry Age - 60 years (Adults); 24 years (Child)
To avoid surprise bills, people can add Care Shield benefits to the Care Classic insurance plan.
Things to Consider Before Opting for Care Shield Benefits
While Claim Shield is highly beneficial, you should keep a few things in mind:
- It is an optional add-on that is not included by default.
- It applies only to eligible expenses - you should check the exact list of covered items.
- It must be selected at the time of policy purchase or renewal.
- The benefit applies only if you have an active base policy and meet the claim conditions.
In short, Care Shield benefits can be a great addition, but it's all about knowing what you're getting into and ensuring you follow the rules!
Choose Claim Shield Benefit Today!
In the world of health insurance, it's not just about having a policy - it's about having the proper protection. Care Shield Benefits goes beyond the basics to ensure your hospital bills don't come with hidden shocks. With wider coverage, minimal deductions, and maximum peace of mind, it's the smart, stress-free way to secure your health and finances. So, why leave room for unpleasant surprises? Add Claim Shield to your policy and experience health insurance as it should be - complete, clear, and comforting.
Disclaimer: 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.
