Family Health Insurance

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Family Health Insurance Overview

Our Philosophy

Life is about experiencing every good bit of it throughout one's lifetime; be it a walk in the park with your parents or building memories of playing with your little one. At Care Health Insurance , we understand that these experiences can be truly rejoiced when one lives a healthy life without having to worry about any unforeseen medical issues.

Our Solutions

In line with our objective of ensuring good health...hamesha! Our Family Health Insurance Plan – 'Care'; helps safeguard you and your family against financial risks arising out of a medical emergency. With 'Care' by your side, you can be assured that while you're unwell; we'll take up all the hassles related to your treatment so that you can stay worry-free and focus only on your recovery.

Comprehensive Family Health Insurance Plan

Care Coverage

A comprehensive family health insurance plan to meet everyone's healthcare needs.

  • In-Patient Care
  • Pre & Post Hospitalization
  • Individual & Floater Cover
  • Domiciliary Hospitalization
  • Daily Allowance
  • Ambulance Cover
  • Organ Donar Cover
  • Lifelong Renewability
  • Annual Health-Checkup
  • No Claim Bonus
  • Second Opinion
  • Tax Benefit

From Diagnosis to Recovery - Care at every step!

We understand that the meter doesn't start from hospitalization but from the time of diagnosis and goes on even post discharge. We stand with you throughout the journey and not just for an event.

30 Day Pre-Hospitalization Coverage

The procedures that you undergo before getting hospitalized finally lead you to a hospital, such as investigative tests and routine medication, can be quite financially draining. We cover the medical expenses incurred by you up to 30 days before your hospitalization.

Ambulance Cover

It's our utmost concern that you get the medical attention, you require as soon as possible, especially in an emergency. Which is why, we reimburse expenses incurred by you while availing a domestic road ambulance during your hospitalization. Not just this, some plans of our product care also offers coverage for availing an Air Ambulance if suggested by a doctor.

In-Patient Hospitalization

Hospitalization for at least 24 hours

We pay for – room charges, nursing expenses and intensive care unit charges, surgeon's fee, doctor's fee, anesthesia, blood, oxygen, operation theater charges, etc.; If you are admitted to a hospital for in-patient care, for a minimum period of 24 consecutive hours.

Hospitalization less than 24 Hours

We cover medical expenses if you undergo a day care treatment which might not require you to stay hospitalized for 24 hours or more. As a matter of fact we cover over 540+ day care procedures.

Room Rent

We reimburse every expense occurred while you're staying in single or private room. You can also upgrade your room should there be a need to and is recommended by a treating doctor.

ICU Charges:

In time of an emergency we believe your focus should be only on your recovery. Hence we take care of those ICU charges that come in your way of getting a quality treatment.

60-Day Post – Hospitalization Coverage

Expenses don't end once you're discharged which is why even we don't rest unless you're completely ready to take all the challenges of life head on. We reimburse expenses such as doctor consultations,Diagnostic tests, medications etc that you incur up to 60 days post your hospitalization.

Domiciliary Hospitalization

In case of an emergency or a medical condition that does not allow you to get admitted in a hospital, we provide coverage for medical expenses incurred during your treatment at home for a period exceeding 3 consecutive days. So nothing should delay the treatment you deserve.

Annual Health Check-up

We believe in the old adage that an ounce of prevention is better than a pound of cure. This is why we give an Annual Health Check-up for yourself and all members covered by your policy, including children.

Automatic Recharge of Sum Insured

Keep your worries regarding medical expenses outside the door with Automatic Recharge of Sum insured. If you ever run out of your health cover due to claims made, we will reinstate the entire Sum Insured amount of your policy. This additional amount can be used by you for any other ailment or by any other insured member for treatment of any ailment.

No-Claim Bonus

We raise a cheer to good health for every year that you don't claim by increasing your Sum Insured by 10%, up to a maximum of 50% in consecutive 5 years.

Organ Donor Cover

We care about those who help you as much as we care for you. So, beyond ensuring that your medical needs are met, we will reimburse you for medical expenses that are incurred by an organ donor while undergoing the organ transplant surgery.

Reassurance of Second Opinion

Sometimes reassurance works better than the cure itself. Which is why if, at any moment you feel uncertain about your diagnosis, you can opt for a second opinion at no extra cost specially arranged by us.

No Upper Age Limit of Enrollment

All our plans including 'care', come with no upper age limit of enrollment i.e. even if a person is 100 years old, they can definitely apply.

Lifelong Renewability

We don't leave you in between the journey and honor our commitment by giving our customers option of lifelong renewability i.e. once enrolled an individual can continue to stay covered throughout one's life, provided they renew their policy on time every year.

Even alternate treatments are covered

We understand that sometimes non-allopathic treatments may prove to be more effective. Whether it is Ayurveda, Unani, Sidha or Homeopathy, choose the treatment that suits you and we will cover it up to a specified limit and varies according to the plan chosen.

Add On Covers with Family Health Insurance Plan

No Claim Bonus Super

By choosing an optional cover – NCB Super – you can further increase your sum insured amount by 50% for every claim free year up to a maximum of 100%. Hence – in total with both NCB & NCB Super one can increase their sum insured up to 150% in 5 years. Help me understand working of NCB & NCB – Super!

Everyday Care

Your family may avoid hospitalization for many years at a stretch. However, you have to be really fortunate to avoid doctor consultation for even a few months. For all the visits for all routine visits to the hospital - we give you 1% of your Sum Insured for doctor consultation & diagnostic tests each. This can be availed via a cashless health card and additional premium paid to avail this add- on cover is also applicable for tax benefit under section 80D of IT act.

Unlimited Automatic Recharge

There should never be a time when you run out of coverage, which is why by selecting this add – on cover your sum insured amount if re-instated in your policy every time your sum insured exhausts. And this can be availed unlimited number of times.

Air Ambulance Cover

The right cure may be miles away but never out of your reach with Air Ambulance Cover. For all those times when you might be recommended a treatment which is not in your city of stay.

Personal Accident Cover

Forget the hassles of maintaining two separate policies, one for a health insurance cover & second for personal accident cover. By selecting this add- on cover you get coverage for Accidental Death and Permanent Total Disability for up to 10 times of the Sum Insured opted.

International Second Opinion

We believe that sometimes reassurance works better than the cure itself. Hence before going ahead with the treatment recommended, we give you an option to consult doctors and take a second opinion.

Global Coverage

Quality Healthcare cannot have boundaries. So if you ever feel the need get treated at an overseas facility, rest assured, since with this add-on cover you get Global Coverage that too on a cashless basis across listed network hospitals.

Plan Details

Elite

Care 4 (5,7,10 Lakh)

Elite Plus

Care 5 (15,20,25,30,40 Lakh)

Global

Care 6 (50,60,75 Lakh)

Global Plus

Care 7 (1,2,3,6 Cr)

Features/ Plan (SI) Care 4 (5,7,10 Lakh)
Elite
Care 5 (15,20,25,30,40 Lakh)
Elite Plus
In patient hospitalization Upto Sum Insured Upto Sum Insured
Pre-hospitalization 30 days 30 days
Post-hospitalization 60 days 60 days
Day Care Treatments Yes Yes
Room Rent Single Private Room Single Private Room
(upgradable to next level)
ICU charges No Limit No Limit
Ambulance Cover Rs.2,000/ hospitalization Rs.2,500/ hospitalization
Domicilliary hospitalization Upto 10% of SI Upto 10% of SI
Health Check-up Yes, all members Yes, all members
Recharge of SI Yes Yes
No Claim Bonus Yes Yes
Organ Donor Cover Rs.100,000 Rs.200,000
Second opinion Yes Yes
Alternative Treatments Upto Rs.20,000 Upto Rs.30,000
Features/ Plan (SI) Care 5 (15,20,25,30,40 Lakh)
Elite Plus
Care 6 (50,60,75 Lakh)
Global
In patient hospitalization Upto Sum Insured Upto Sum Insured
Pre-hospitalization 30 days 30 days
Post-hospitalization 60 days 60 days
Day Care Treatments Yes Yes
Room Rent Single Private Room
(upgradable to next level)
Single Private Room
(upgradable to next level)
ICU charges No Limit No Limit
Ambulance Cover Rs.2,500/ hospitalization Rs.3,000/ hospitalization
Domicilliary hospitalization Upto 10% of SI Upto 10% of SI
Health Check-up Yes, all members Yes, all members
Recharge of SI Yes Yes
No Claim Bonus Yes Yes
Organ Donor Cover Rs.200,000 Rs.300,000
Second opinion Yes Yes
Alternative Treatments Upto Rs.30,000 Upto Rs.40,000
Care Anywhere - Yes
Maternity Cover - Upto 100,000
Features/ Plan (SI) Care 6 (50,60,75 Lakh)
Global
Care 7 (1,2,3,6 Cr)
Global Plus
In patient hospitalization Upto SI Upto SI
Pre-hospitalization Upto SI ,30 days Upto SI , 30 days
Post-hospitalization Upto SI ,60 days Upto SI , 60 days
Day Care Treatments Upto SI Upto SI
Room Rent Single Private Room
(upgradable to next level)
Single Private Room
(upgradable to next level)
ICU charges No Limit
Ambulance Cover Rs.3,000/ hospitalization Rs.3,000/ hospitalization
Domicilliary hospitalization Upto 10% of SI Upto 10% of SI
Health Check-up Yes, all members Yes, all members
Recharge of SI Yes, Up to SI (Once in a Policy Year) Yes, Up to SI (Once in a Policy Year)
No Claim Bonus Yes Yes
Organ Donor Cover Rs.300,000 Rs.500,000
Second opinion Yes Yes
Alternative Treatments Upto Rs.40,000 Upto Rs.50,000
Care Anywhere Yes Yes
Maternity Cover Upto 100,000 Upto 200,000
Vaccination Cover Yes, Upto Rs. 10,000
Global Coverage: (excluding USA) Coverage outside India & USA - 45 continuous days in a single trip; Max. 90 days on a cumulative basis, in a Policy Year Up to SI for Hospitalization Expenses & up to the limit specified under `Maternity Cover` towards Maternity expenses; With a 10% co-payment per Claim
Special Add on cover:
Global Coverage - Total Geographical scope of Benefit `Global Coverage (excluding USA)` is extended to USA also Up to SI for Hospitalization Expenses & up to the limit specified under `Maternity Cover` towards Maternity expenses; With a 10% co-payment per Claim

For complete product details, kindly refer Prospectus and Sales Literature in the Download Section. Click here

Why should you buy Care:

  • With Care, you get following Key USPs which are not available anywhere else.
  • Annual Health Check-up for all members covered under the policy.
  • Up to 150% No Claim Bonus with NCB Super.
  • Unique Unlimited Automatic recharge.
  • Care anywhere – Global Cover for 12 Critical Illnesses.
  • Care is available with different riders, hence ability to fit your needs.

Policy Terms

Policy Terms
Minimum entry age 91 days
Maximum age No age bar
Renewal Lifelong Renewability. The Policy can be renewed under the then prevailing
Health Insurance Product or its nearest substitute approved by IRDA.
Renewal premium Premium payable on renewal and on subsequent continuation of cover arc subject to change with prior approval from IRDA.
Co-payment No Co-payment in policy, if age of the eldest member insured with us at the time of first policy is below 61 years.
20% Co-payment will be applicable in policy, if age of the eldest member insured with us at the time of first policy is 61 years or above 61 years i.e. you will have to pay 20% of the claim amount under the policy, if any. We pay the rest.
Waiting period 30 days for any illness except injury
Waiting period for pre-existing illnesses Four years of continuous coverage
Change in sum insured You can enhance your sum insured under the policy only upon renewal
Grace period 30 days from the date of expiry to renew the policy
For more details, kindly refer to our health insurance Policy's Terms & Conditions.

Plans Exclusion

The standard policy exclusions are - 
  • Any diagnosis of diseases / undergoing of surgery / occurrence of event, whose signs or symptoms first occur within 30 days of Policy Period Start date.
  • Expenses attributable to self-inflicted injury (resulting from suicide, attempted suicide)
  • Expenses arising out of or attributable to alcohol or drug use/misuse/abuse
  • Medical expenses incurred for treatment of AIDS
  • Treatment arising from or traceable to pregnancy and childbirth, miscarriage, abortion and its consequences
  • Congenital disease
  • Tests and treatment relating to infertility and in vitro fertilization.
  • War, riot, strike, nuclear weapons induced hospitalization.

Claim Processing

+

Vast & growing hospital network for cashless claims

Lakh +

Count of Claim Settled^

0%

In-house settlement for better management

0%

Delivering Industry best settlement Ratio^

0%

Less Grievance Ratio per 10,000 claims

Process for Hospitalization

Process for Everyday Care

Claims Procedure

FAQs on Family Health Insurance Plan

Is there a cashless facility with Family Health Insurance Plan?

Yes, cashless facility is available

where can I buy Health Insurance for my Family?

You can buy health insurance through digital direct to consumer, banks, NBFCs, individual agents, brokers, web aggregators, corporate agents and rural banking

who can be covered under a family health insurance policy?

you can cover Self, Spouse, dependent children and parents.

why do I need family health insurance?

Health insurance is necessary owing to increasing medical costs these days & uncertain environment. Therefore, insuring your family against Health Insurance is a must & should surely be a part of your regular financial planning.

a family floater health insurance, as the name suggests is a plan that is made for families. Family floater health insurance plans usually covers the individual, spouse and children or Parents. In general the cost of buying floater coverage for the family is less than buying the Individual policies for each member. However in a Floater Policy the Sum Insured is shared by all members and in Individual policy each member has a separate Sum Insure

What is the difference between a family floater and critical illness or hospital cash insurance?

The individual or family floater health insurance works on the principle of indemnity. This means that these insurance policies will pay you only what you have spent for medical treatment in hospital. On the other hand, the critical illness or the hospital cash insurance pays you the amount insured, irrespective of the amount spent for medical treatment. These are a benefit based policies.

How would I benefit by buying health insurance at a young age?

  • Health insurance premium tends to increase with age - more the age, higher the premium.
  • You can be covered for medical conditions that may be diagnosed over the years provided there is no break in the policy.
  • In addition, each 'no claim’ year would fetch you a discount on your premium or an increase in your sum insured amount at no extra cost. The treatment in case of ‘no-claim’ bonus varies from company to company.
  • Lastly, income tax benefit under Section 80 D of the Income Tax Act.

Why is it necessary for me to disclose my current health status correctly and accurately while I buy a health insurance policy?

Insurance is a contract of utmost good faith. It always pays to be honest. Declaring the correct and accurate health status at the time of buying health insurance ensures smooth processing of your application. This will also help us service you in a better manner.

What is beneficial for me - floater insurance or an individual insurance?

Buying an individual cover or a floater cover is an individual’s perception. However, as a general rule, at younger ages floater cover is advisable. As you grow older, you should go for an individual cover.

How does a Floater cover work?

For instance a person wants a health insurance for himself, his spouse & their children, the Family Floater plan offers insurance coverage to the entire family under one premium payment. Let’s take an example wherein the person insures himself, his spouse & the dependent children with the individual insurance plans with a sum insured of Rs. 1 lakh each, he ends up paying premium ranging between Rs. 1000 - Rs. 2000 for each family member. On the other hand if the person would have opted for the family floater plan with the sum insured of Rs. 3 lakhs, the total premium would surely be less than the separate premium payments in individual health insurance plans. Moreover the separate health plan holds the cover of only Rs. 1 lakh as against Rs. 3 lakh in case of the Floater plan thus helping the family in case the medical treatment costs go beyond that. This Rs. 3 Lac is available for each of the family members individually as well as collectively.

What is a No Claim Bonus?

This concept works on the same lines as the no-claim bonus on your car insurance. A Policyholder, who hasn’t made any claim in a year, can use the bonus to their benefit the following year.

Similarly, CARE offers a 10% increase in the policy sum insured for every claim-free year, with no change in premium. So, a policy with a sum insured of Rs 5 lakh, will get an extended cover of Rs 50,000 the following year at the same premium. A claim-free third year will see him earning another ten per cent extra cover on his base sum insured, taking the total to Rs 6 lakh. A maximum bonus of up to 50 per cent is permissible.

In case of claim, the accumulated bonus is reduced by 10%.

How does the Auto recharge work?

We will automatically recharge the sum insured, in case the sum insured and any no claim bonus accumulated is exhausted during the policy year. The sum insured will be recharged once in a policy year. Recharge Sum Insured can be used for future claims and not against an illness/disease (including its complications) for which a claim has already been made in the current policy year.

Do I need to undergo a medical check-up while buying a health insurance policy?

You may be required to undergo a medical check-up after you buy, incase any member to be insured is above 45 age or for  sum insured Rs. 15 Lakhs or above. In most of the cases, the medical tests are done in your home, after taking appointment from you. No payment is required upfront for the same. Incase the policy is issued, you will not be charged anything. However, if the policy is declined/Canceled, medical charges will be deducted from the refundable premium amount. This will enable us a better understanding of your current and future health requirements. For further details, please refer to the prospectus or call 1800-102-4488 (Toll free).

How do I cancel my Family health insurance policy?

We offer a free look period to review your policy terms and conditions. In case you are not satisfied with these, you can request for cancellation of your policy during this period. You will be charged the pro-rated premium for the period during which your policy was in-force, the cost of pre-policy health check-up, if any, and the stamp duty. The balance premium would be refunded.

Also, you can request for cancellation of your policy at any time during the policy period. You will be refunded the premium amount as per the short scale grid. The grid is available in your Policy Terms and Conditions. However, in case you have reported any claim with us, you will not be entitled to any refund of premium on cancellation of the policy.

What is Co-payment?

Health Insurance companies use Co-Payment after insured member turns a certain age. Co-pay is that part of your claim amount, which you have to bear. Co-pay can be in % terms or an absolute amount. For example, in case of co-pay of 20% and claim of Rs. 10,000, we will pay you Rs. 8,000 (80% of 10K) and you will bear 20% (Rs. 2,000). In Religare Health Insurance policy there is No Co-payment ever, if insured with us before age of 61.

What are the documents required for portability?

You can apply for CARE under portability with following documents:

  • CARE proposal form
  • Portability form
  • Copy of expiring health insurance policy
  • Copy of renewal notice

Industry News

Vehicle, health insurance to cost you more from April 1

Via Financial Chronicle | New Delhi | Mar 27, 2017

Car, motorcycle and health insurance premiums are set to cost more from April 1 with regulator Insurance Regulatory and Development Authority of India (Irdai) giving its nod for revision in commission to agents. The change in premiums after modification will vary up to 5 percent either way. "There will be different slabs of hike in commission for different lines of insurance. The companies can modify the pricing of the product marginally. The company can take a call on this," said a top official of a public sector general insurer. The increase in premium will be in addition to the enhanced third party motor insurance rates that come into effect from the start of next fiscal. The Irdai (payment of commission or remuneration or reward to insurance agents and insurance intermediaries) Regulations, 2016 will be effective from April 1, 2017. The insurance regulator has said that the new regulations will bring about certain revisions in commission/remuneration rates and also introduce the reward system.

These may prompt insurers to revisit the pricing of their products, in so far as the costing input relating to commission or remuneration is concerned, it said. "The change in premium due to the new regulations should be limited to plus-minus 5 percent of the existing premium rates of products/add-ons", Irdai has said. SR Balachandher, company secretary and chief compliance officer of Royal Sundaram Alliance Insurance, noted there would be no change in retail health, but the commission for employee group insurance would go up by 2.5 percent. "Retail property insurance will go up by 1.5 percent. Insurance firms are free to make modifications in the premium to accommodate the commission hike. But they will have to file the product with new pricing once again with the Irdai," Balachandher said. A senior official of a top private general insurance company, however, disagreed. "In retail health policies, commissions are part of the premium rates filed with the regulator. The regulator allowing insurers to change commissions to distributors by 5 percent does not mean that the premium rates will automatically increase for customers."

Tax deductions on health insurance premiums

Via Hindustan Times | New Delhi | Mar 25, 2017

The financial year is drawing to a close, and if you are still scurrying about to save on taxes, here is the harsh truth: you have made a classic financial mistake. Tax planning needs to be incidental to financial planning and you need to adopt a proactive approach to both. For now, let's look at your options. Today, we shall focus on health insurance which qualifies for tax deduction under section 80D. Under section 80D, the premiums paid towards a health insurance policy for self or family can be claimed as a deduction of up to Rs 25,000. If you also pay premiums for your parents who are not senior citizens—less than 60 years of age—then you can claim an additional deduction of Rs 25,000. So the total deduction that you can claim is Rs 50,000, which translates into a tax saving of Rs 15,450. For senior citizens, the deduction limit is Rs 30,000. But if you are buying a health insurance policy for your parents who are senior citizens then you can claim a deduction up to Rs 55,000—Rs 25,000 for self and Rs 30,000 for parents. Keep in mind that this deduction limit includes expenses incurred towards preventive health check-ups to a maximum of Rs 5,000. "Premiums will qualify for tax deductions for the financial year in which the policy is issued. For young individuals who don't need medicals, a health insurance policy can be issued the same day of paying the premium. Even for individuals who require medicals, policy can be issued within 3-4 days," said Puneet Sahni, head, product development, SBI General Insurance.

Buy an OPD cover if you visit the doctor frequently

Via Business Standard | Yashish Dahiya | Mar 26, 2017

When health insurance was developed initially, it was meant only to cover a person's hospitalisation and surgical expenses. It has since then evolved steadily in its effort to take care of all the health problems that customers may face. Surgical treatments of haemorrhoids, tonsil removal, cystoscopic removal of stones, and so on were not covered by traditional health insurance plans until a few years earlier, but are taken care of under day care benefit by most plans today. In some areas, such as OPD (out-patient department) cover, however, limitations remain.

Owing to growing risks from environmental hazards and lifestyle diseases, people are visiting hospitals frequently nowadays for smaller medical interventions, such as consultations for minor health issues, diagnostic tests, pre-emptive check-ups, etc. At least the one-fifth of Indians who have chosen to buy health insurance don't like to take a chance with their health, according to reports. However, these visits burn a hole in the pocket, especially of those who live in the big metros.

While day care treatments have now been integrated into most new health insurance offerings, OPD cover continues to be omitted by most flagship products. This is seen as a major irritant by the population that buys health insurance. Buyers believe that a health insurance policy should take care of every small cost they might incur on health. If they still have to pay for health issues, they become disgruntled.

The rising burden of OPD spending is making such a cover even more critical. In India, a whopping 60 per cent of health care spend is on OPD treatment. The lack of an efficient mechanism and absence of a closed network structure are the chief obstacles preventing insurers from introducing worthwhile and sustainable OPD products.

Insurance cos must play active role in investee cos' meetings: Irdai

Via The Economic Times (Bangalore edition) | Mumbai | Mar 24, 2017

The insurance regulator has asked companies to play an active role in the general meetings of investee companies and engage with the management at a greater level to improve governance so as to increase returns on investments for insurers. "Insurance companies are significant institutional investors in listed companies and the investments are held by them as custodians of policyholders," Insurance Regulatory and Development Authority (Irda) stated in a circular. "Therefore, it is felt that insurance companies should play an active role in general meetings of investee companies and disclosures relating thereto." This will be applicable from next financial year. The regulator said the state of governance at the companies where insurance companies have invested is important. It has also laid out a set of principles, which insurers will have to adopt.

The principles are being uniformly adopted for institutional investors like mutual fund, pension funds, foreign portfolio investors and alternate investment funds. Irdai has also decided to implement a code of stewardship for insurers. The regulator said all insurers need to draw up a policy based on principles spelt out in stewardship code within six months from date of issue of these guidelines and the board of directors should approve the same. Globally, companies are required to say which are the companies they have voted for and against in general meetings and disclose their stance.

About Care Health Insurance

At CHI, we endeavour to financially safeguard your family by offering comprehensive health insurance plans that are specifically designed to offer coverage for various medical expenses at the best premium. We are committed to delivering impeccable services by providing specific travel insurance while guaranteeing the benefits of hassle-free claims procedures.

^Claim settlement ratio is for FY 19-20 and ^number of claims settled as on February, 2022

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Disclaimer: For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale.

UIN: IRDAI/HLT/RHI/P-H/V.II/253/16-17. UAN2: 19032845.

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