Health Insurance

The amount of health insurance coverage you will need depends on your medical needs, age and health risks, the city you live in, and various other factors. Also, you must consider medical inflation and high treatment costs for your specific health condition before finalizing how much sum insured is enough for you and your loved ones.

At Care Health Insurance, medical health covers of 5 Lacs start from a premium as low as Rs. 358/month, subject to specific policy terms and conditions. A host of factors, including the sum insured, type of coverage, policy term, number of insured members, age of the insured members, pre-existing medical conditions, will impact the premium cost of a health insurance policy you have chosen.

Yes, you can get immediate coverage under a medical policies for any accidents or injuries. However, you can only avail of the policy's coverage for any illness-related hospitalization after a standard waiting period of 30 days from the day your policy becomes effective.

The earlier you get a health cover, the lesser the health cover premium you get to bear. While we are witnessing an unbearable hike in medical costs across India, there's a steep rise in lifestyle diseases. The premium costs of health plans increase with age. Besides, the chances of having a pre-existing health condition also increase as we grow older. A pre-existing ailment is a factor that can make you pay a higher premium. Thus, going for a health cover early in life is a wise decision.

Network hospitals are hospitals that are empanelled with us and provide you with cashless medical treatment. At CHIL, we have a network of over 16,500 cashless healthcare providers. You can get admission at any of these hospitals for cashless treatment by presenting your health card and submitting a pre-authorization form at the insurance desk. We will directly settle your hospital bills with the network hospital, subject to policy T&C.
However, those hospitals that do not come under our network are non-network hospitals where you cannot get the cashless facility. If you have opted for a non-network hospital, you can file for a reimbursement claim and submit the necessary documents. After our claim management team verifies your documents, we will reimburse your expenses, subject to policy T&C.

Every health policy comes with a waiting period clause. A waiting period is a pre-defined number of days you must wait before getting a claim for the specified medical expenses. There are three types of waiting periods:

• An initial waiting period of 30 days
• A waiting period for pre-existing diseases
• A waiting period for specified ailments/ treatments

Your health insurance will expire if you do not pay the premium by the policy period end date. However, even if you miss the premium due date, you will be allowed a grace period of 30 days immediately following the policy period end date to pay the renewal premium. The policy will not provide coverage during the period of unpaid premium.

Under a health insurance policy, policyholders are eligible for a No-Claim Bonus (NCB), a reward you receive for not claiming during a policy year. It is a bonus amount that becomes available as an increased sum insured for every claim-free year. Thus, it provides you with an added cushion to bear medical expenses in the future. At CHIL, we offer a 10 percent increase in your sum insured for a claim-free year. The NCB amount will not exceed 50% of the sum insured under any medical policy insurance. The accrued bonus is reduced by 10% if the insurer claims in a particular year.

Pre-existing diseases are the diseases, illnesses, injuries, or related conditions for which a medical practitioner diagnosed a person within 48 months before the effective date of a policy issued by the insurer or its reinstatement. Yes, Care health insurance policies cover pre-existing medical conditions but come with a waiting period to complete before claiming for the specified pre-existing illnesses.

With medical insurance from CHIL, you get a chance to increase your savings as you become eligible to get income tax benefits under Section 80D of the Income Tax Act. That is, you will be allowed to claim a tax deduction on your policy premium for which you have made a payment to us. You can claim the following deductions on your premium, depending on the coverage you have selected.

The sum insured refers to the maximum coverage amount or pay-out that an insurer will be liable to pay an insured in case of an unforeseen medical emergency or planned medical treatment. The sum insured is based on the principle of indemnity, where the insurer will cover the medical expenses one incurs up to the sum insured under the health plan. The claim amount that exceeds the sum insured will have to be borne by the insured person.

Yes. You can buy yourself multiple health insurance policies. If you have opted for more than one indemnity-based plan with other insurers or us, then you can opt for any of these plans to settle your claims, provided that the claim amount payable is up to the sum insured of the chosen policy. If the claim amount under a single policy exceeds the sum insured, you have the right to select the insurer to settle the claim. We will settle the medical expenses if you have opted for our plan, subject to the policy terms and conditions.

Yes, you can include aging parents in your health plan easily by informing the CHIL team. However, for elderly parents above 60 years, we recommend medical health insurance for senior citizens that will better meet their age-related healthcare needs.

Yes, CHIL's comprehensive healthcare insurance policies cover various expenses under advanced medical treatments, including robotic surgery and modern day care treatments. We offer cover for more than 541 day-care procedures.

Smoking is an unhealthy lifestyle habit that can severely damage vital organs in the body, including the lungs, brain, and heart. It can lead to lung cancer, stroke, and heart diseases, exposing people to grave health hazards. We may take this factor into account when assessing your health risks and calculating insurance premium rates.

Yes, an insured person is allowed a grace period of 30 days immediately following the policy period end date to pay the renewal premium for a Care health insurance policy. Timely premium payment is crucial to prevent the policy from getting lapse and ensure you get continued coverage.

Ideally, it would help if you went for separate comprehensive healthcare insurance besides the employer health plan. Merely relying on an employer's mediclaim or health plan is not wise, and there are a few valid reasons. Firstly, there's no tax benefit available under an employer health plan, while you get tax benefits under CHIL's medical covers. Also, your employer may select a lower sum-insured plan based on their bandwidth and budget; the corporate health cover may not fulfil your healthcare needs properly. A separate health plan will enable you to customize your policy and choose the preferred sum insured and optional benefits. This advantage may not be available in a corporate mediclaim policy.

Yes, you can include your children aged 5 years or above under an individual medical plan. For children under 5 years of age, you can include them in a family floater plan with other family members who are 18 years and above.

At CHIL, we offer multiple health covers with the OPD benefit as an optional cover for an additional premium. Under this benefit, the policyholder will get reimbursement for the OPD expenses, including OPD consultations, diagnostics, and medicines, up to a specified limit subject to T&C.

Pre-policy medical tests are usually required for older individuals, those with a pre-existing condition, or opted for a higher sum insured. However, it is best to go for a medical check-up when opting for a health policy to ensure hassle-free claim settlement.

You can increase the sum insured under your mediclaim plans at the time of policy renewal. Policyholders can increase the sum insured after specific medical tests and a revision of the claim history. But the sum insured cannot be increased further if the existing sum has already met the sum insured limit of your policy.

For a cashless claim, you need to submit the pre-authorization form at the hospital's TPA desk. Also, you need to present your health card and identity proof at the network hospital. In case of a reimbursement claim, submit the claim form and documents, such as identity proofs and hospital bills. The details required include name, contact information, policy number, past medical history, proposed line of treatment, duration of treatment, etc.

Yes, the claim may get rejected for several reasons like incorrect facts, non-disclosure of pre-existing conditions, claims under exclusions, etc.