What is Covered under Care Health Insurance Plans?
Care Health Insurance offers the best health insurance plans for medical expenses, which provide comprehensive financial protection in times of urgency by covering various medical expenses apart from the bills you incur during hospitalisation. The coverage provided is subject to the policy terms and conditions. The expenses covered in health insurance policies are:
In-Patient Hospitalization
Our medical insurance policies cover your expenses, such as room rent, ICU charges, doctor’s fees, etc., during any planned or emergency hospitalisation up to the sum insured.
Pre-Hospitalization Medical Expenses
We cover your medical expenses, such as doctor’s consultations, medical tests, and medication, up to 60 days before hospital admission.
Advanced Medical Treatments
With our health insurance plans in India, you can access advanced medical care and get coverage for modern treatments, including robotic surgeries and chemotherapies.
Daily Allowance
The everyday expenses during hospitalisation can be burdensome, but our health insurance plans provide a fixed amount to cover them.
Post-Hospitalization Medical Expenses
Medical expenses, such as follow-up visits and medical tests, are covered up to 180 days immediately after discharge from the hospital.
Domiciliary Hospitalization
We offer domiciliary hospitalisation expenses to ensure uninterrupted medical coverage per the policy terms.
AYUSH Treatments
Treat your ailments with a combination of modern and traditional treatments. Our AYUSH coverage helps you avail of alternative treatment as per policy terms and conditions.
Coronavirus Treatment
We offer standard coverage for hospitalisation and medication as per policy terms to ensure you are not strained due to a COVID-19 infection.
The best medical insurance plans also offer maternity benefits as an optional cover for delivery-related expenses. Various add-ons are available at an additional premium, including OPD Care, which covers expenses such as OPD consultations, diagnostics, and medicines.
Disclaimer: For more details on product coverage, please check our product pages and policy documents.
What is Not Covered under Health Insurance Policies?
At Care Health Insurance, we want all our customers to be well-informed before purchasing a health insurance policy. Therefore, we urge you to review the policy documents within the free lookup period to avoid last-minute rejections of claims. Mentioned below are the common exclusions of a health insurance plan that you opt from Care Health Insurance:
- Self-inflicted injuries resulting from suicide or attempted suicide.
- Diseases, surgeries, or medical events(accept accidents), occurring within 30 days of the policy start date.
- Expenses arising out of or attributable to alcohol or drug use/misuse/abuse.
- Treatment arising from or traceable to pregnancy and childbirth, miscarriage, abortion, and its consequences.
- Tests and treatment relating to infertility and in vitro fertilization.
- Cosmetic or aesthetic treatments that do not fall under the 'medically necessary' category.
- War, riot, strike, nuclear weapons induced hospitalization.
Some Myths about Health Insurance Busted
Health insurance is a vital aspect of financial planning, yet various misconceptions surround it. Let us take a look at the most common health insurance myths, and help you understand what is a myth and what’s not.Understanding insurance for medical expenses is crucial to debunking these myths and making well-informed decisions about your health insurance policy.
Health Insurance is only meant for seniors
It is a common myth that only seniors require health insurance to cover the medical expenses of age-related issues. Among younger people aged >50 years, the incidence of cardiovascular disease has been rising due to their poor lifestyle, deficiency of nutrients, and lack of exercise for calorie burn. Therefore, health insurance plans are vital for everyone. If you buy it at an early age, you won’t have to pay an expensive premium. You will be able to buy it at cheaper premium. health insurance plans may come with a waiting period against specified ailments. Thus, insuring your health and wealth is a wise choice to make at an early age.
You will be covered as soon as you buy the plan
Another common myth. While your coverage will start as soon as you buy the plan but you’ll have to first serve a waiting period. This is a 30-day period during which a claim cannot be raised, except for an accidental injury. When you buy a health insurance policy, you should enquire about your policy’s waiting period. For coverage of certain treatments, you may have to wait for a specified waiting period.
You should opt for the cheapest plan
Absolutely not! While the cheapest policy sure looks attractive, you should carefully think about why you want this plan and what benefits you expect from your plan. You should never make the prices the only criteria for choosing the plan. You might not be able to get the required benefits from your plan if it is cheap. Therefore, make sure that the plan that you have been buying is offering you comprehensive coverage for all your medical expenses.
I can’t buy health insurance if I have an illness
Another myth that needs to be debunked right away, as it tends to restrict a lot of people from buying a health insurance policy. It is not correct to think that you are not eligible to purchase health insurance because of your pre-existing disease. You can buy it right now without any ado. However, you have to complete the health insurance specified waiting period. But the good thing is that the best health insurance plans offer an add-on cover i.e. reduction in the PED waiting period to reduce the waiting period.
Group health insurance is enough
While it is a great perk to have corporate group health insurance, you should not entirely depend on it. In most cases, a group plan will offer you limited coverage because its premium is deposited by your employer. In case you lose your job, you will lose your health insurance policy also. Furthermore, group health insurance might not be able to beat medical inflation. With a modest sum insured, you won’t be able to cover the medical expenses for critical illness and hospitalization. Hence, think of buying an individual health insurance plan, over and above the group coverage.
All my hospital bills will be covered
Despite a comprehensive plan, not all your bills will be covered by your insurer. Read the policy wording, and understand its terms and conditions. You need to know about exclusions, which are conditions that are not covered under your health insurance plan. Similarly, you should know about the co-payment clause of your insurer where you need to bear a part of the claim amount. Additionally, you can’t claim the uncovered expenses.
How to File a Claim under Health Insurance Plans
STEP 1
Emergency
Intimate within 24 hours of your hospitalization
Planned Hospitalization
Intimate us 48 hours prior to your hospitalization
STEP 2
Cashless
Request for pre-authorization
Reimbursement
Claim form submission
Complete the pre-authorization form available
at the hospitals' insurance/TPA Desk and send us through fax.
Approval
Approval letter sent by the claim management team
Query
Hospital/Insured to respond to the query raised by the claim management team
Rejected
You may initiate the treatment and file for reimbursement claim
Submission of claim form along with required
documents, as per the policy terms & conditions
Approval
Approval letter sent by the claim management team
Query
Insured to respond to the query raised by the claim management team
Rejected
We will communicate the reason in case of rejection
Documents required to File a Claim under Health Insurance
Some paperwork would be required to file a claim. Typically, in the case of a cashless claim, the documentation is minimal, and most of the formalities would be completed by the TPA. The reimbursement claim procedure would require you to submit all the paperwork so there is no verification delay. It is suggested that you keep the following documents handy to ensure a smooth and quick claim settlement process:
- A duly filled and signed claim form
- Insured person’s details like name, policy number, nature of the illness, address, etc.
- All the diagnostics and medical test reports
- Original payment receipts, hospital bills, and discharge summary papers
- Original pharmacy bills with prescriptions
- Doctor’s referral letter
- Police FIR and post-mortem report in case of an accident etc.
Hassle-free Claim Settlement Through Care Health Customer App
Care Health Insurance strives to make quality health care accessible to everyone while maintaining a quick and hassle-free claim experience. The Care Health Customer App is an integrated app for all your health insurance needs. You can use this app for claim intimation, fill out a claim form online, upload the necessary claim documents, and track your claim status. Given below is the step-by-step process to file claim intimation using ‘Claim Genie’:
- Step 1:Open the Care Health-Customer App on your phone.
- Step 2:Click on ‘Claim Genie’ on the home screen. Click ‘claim intimation’.
- Step 3:Select claim type.
- Step 4:Select the member and enter all the claim related information.
- Step 5:Upload any claim related medical documents.
You can also track the status of the claim, just click on the ‘Claim Tracking’ option on the homepage. The list of active claims will be presented on the screen. Click on “Track Claim” on the relevant claim. The latest claim status will then be displayed on top of the screen. This app can also be used to download the query/settlement letter or approval letter.
How to Buy Health Insurance Online?
The best part about the online availability of health covers is the secure payment gateways. With easy-to-follow steps and trust-backed payment partners, we offer you a seamless experience of buying the best health insurance plans in India completely online. Also, our digital portal enables you to effortlessly make premium payments through a hassle-free digital payment gateway. Welcome to the future of hassle-free health coverage with Care Health Insurance!
Here is a quick 6-step guide you should follow for making online insurance payments:
- Go to our home page and select a health policy based on your needs and sum insured requirements.
- Click on ‘Get Quote’ and provide relevant details.
- Enter the required information and customise your policy.
- You will be redirected to the payment section.
- Make payment through any secure digital payment mode.
- You will get the new health policy documents on your registered email-id.
Advantages of Buying Health Insurance Online
Embrace the ease of securing your health online, with our digitally-enhanced portal. All you need to do is simply select your preferred health cover plans, fill up the details, and pay through secure transaction modes. Here’s why and how we ensure customer-friendly purchase a medical insurance plan online:
Chat Option for Queries
Our team is always available for all your queries concerning the terms and conditions of our healthcare policies. By accessing the live chat option, you can quickly discuss any policy-related matter at your convenience. No appointment is required.
Instant Premium Quote Calculation
We facilitate digital premium calculators to help you evaluate and opt for customised healthcare insurance for your family members.The ability to choose your desired health coverage and optional benefits helps us serve you the best mediclaim policies.
Secure Payment Modes
Our fortress-like secure payment gateways offer various digitally secure modes, including credit/debit cards or net banking. Once purchased, you will receive authentic policy documents immediately.This way, we help you get an instant mediclaim policy in less than an hour.
Transparent Policy Evaluation
What we promise on paper is what you get in times of emergencies. All our healthcare insurance plans include all the terms and conditions for your ready reference. Our commitment to transparency knows no bounds!
Readily Available Value Added Services
While browsing online through our mediclaim policies, you can easily check out other add-on benefits. These include OPD care, co-payment waiver, and reduced wait time for pre-existing diseases, among others, to cover your specific needs.
Helps Save Money
The offline method of buying mediclaim policies usually result in increased costs due to numerous factors like agent fees. Insurance agents get a commission for selling mediclaim policies , which increase the cost of the policy. Purchasing a health insurance plan online can help eliminate overhead expenses. Further, some insurance companies also offer an additional discount when you purchase plans using their online platform.
How to Renew Health Insurance Policy Online?
Every medical policy terminates when the term for policy ends. That’s why renewing a mediclaim is crucial to ensure uninterrupted healthcare coverage and added advantages like no claim bonus, coverage for a pre-existing ailment, etc. The process of renewing insurance involves the following steps:
- Visit our official website for health insurance policy renewal.
- Go to the renew section.
- Enter the complete details, such as insurance policy number, contact number, etc.
- Under the payment section, pay the renewal premium through any secure payment mode.
The way you buy health policy online, you also have the facility to renew your health plan through the digital mode, thus saving much effort.
What are the Factors Affecting Premium of Medical Insurance Policies
We adhere to the underwriting process and consider many factors on which your insurance premium will depend. Listed below are some determining factors:
- Age Factor: The risks of illnesses go up as we age, so the premium will cost you more as you grow older since there are health risks to consider.
- Pre-existing Conditions: Premium costs are high if one has any pre-existing medical condition, such as hypertension, asthma, and diabetes when buying a health cover.
- Body Mass Index: A high BMI indicates that a person may have higher health risks; thus, one is likely to spend more on the premium.
- Lifestyle: Some risky lifestyle habits, including tobacco consumption, drinking, and smoking, can lead to a high premium.
- Type of Plan: Depending on the type of plan you choose, the premium also changes. For instance, the premium for a family health insurance is typically lower than that of an individual health plan.
- The Sum Insured: Sum insured is the maximum coverage that your health plan offers. The higher the sum insured, the higher the premium charged.If you pick a plan with ₹1 crore sum insured, the premium charged will be higher than that of a health plan with ₹50 lakhs sum insured. So, it is essential that you assess your medical requirements carefully before deciding the sum insured.
- Deductibles and Co-Payment: Deductibles and co-payment refer to the portion of a claim the insured has to pay during claim settlement.If you choose a higher deductible/co-pay, the premium charged will be low and vice-versa. If you are young or at low risk of medical conditions, you may opt for higher deductibles/co-pay to lower the premium.
- Add-On Covers:If you wish to increase the coverage of your health insurance plan, you may purchase the required add-on covers. However, you must keep in mind that with each add-on, the premium increases. So, make sure you only buy the ones that you really need.
- Your Location: Your health insurance premium tend to vary depending on the city you reside in. Areas with high medical costs have higher premiums as well. For instance, medical treatment in metropolitan cities like Delhi or Mumbai may be higher than that in non-metro cities. In such a case, your location may impact the premium charged.
- Your Occupation: Your occupation also decides the premium of your health insurance plan. This is because certain occupations have higher medical risks than others, and so, the premium charged is also high. For example, workers at a factory or construction site have higher risks of accidents and mishaps than bank employees.
- Medical History of Family: Certain diseases can be hereditary. For instance, if any of your parents has a history of diabetes, Alzheimer's, etc., you are also at risk of welcoming such diseases. In such a case, the premium charged may be higher than others with no such family medical history.
How to Calculate Premium of Health Insurance Plans?
You can now calculate the premium using a simple digital calculator designed especially for medical insurance policies. This tool helps you get the right estimate of the amount of premium you will have to pay for your policy. It considers various factors to calculate the premium, including the information you have entered. Here are the steps to calculate your premium:
- Step 1: Visit the Health Insurance Premium Calculator page.
- Step 2: Choose the desired policy and enter your mobile number in the 'Get Quote' section.
- Step 3: Enter the pin code and email, followed by the details of all the members to be insured.
- Step 4: Customize the policy by changing the sum insured and add-ons as per your needs.
- Step 5: That's it! Your instant health insurance quote is calculated, including 18% GST.
We offer three policy estimation options: family cover, pre-existing diseases cover, and senior citizen insurance. The premium calculator will automatically calculate the amount you must pay to be eligible for the coverage. You can check the premium and critical benefits in your base mediclaim insurance policy.
How to Reduce Your Health Insurance Premium?
You know by now that your health insurance premium is not a random number but a thoughtful calculation based on unique facts. Our underwriting process ensures a personalised touch, from your health history to lifestyle choices. However, some easy tips and tricks can help you reduce your health insurance premium without cutting back on the coverage.
Buy a health insurance plan today
Age is the primary factor that influences the cost of your premium. With your age, your premium amount also rises because you become prone to critical health issues in your old age. In contrast to this, the young age is generally considered to be risk-free. Therefore, you can purchase health insurance at a lower premium amount when you are young.
Pick the right add-ons
Instead of opting for an expensive health insurance plan, you can play it smart and opt for the right add-ons. These add-ons are designed to cater to your health needs per your pocket. With the right add-ons, you can get guaranteed medical coverage in need.
Make the most of the tax benefits
Your health insurance plan can offer tax benefits based on your premium. You can maximise your tax deductions by paying a premium for your parents above 60. Get in touch with an expert to understand how you can avail tax benefits with your health insurance benefit.
Choose a medical insurance policy that you can afford
When you start exploring health insurance plans, you will get several options to lure you. But you should not opt for that plan, which requires you to bend backwards. Choose a plan that you can afford comfortably.
Pick the right co-pay and deductibles
You can choose the high amount of deductibles and co-payments to reduce the burden of premiums on your shoulders. Deductibles and co-payments are fixed amounts the insured must pay before availing of coverage benefits. While this will minimise your premium, remember that it will increase your share in claim settlement. Therefore, you should consider this option carefully.
Choose a multi-year policy
Another way to reduce your health insurance premium is to choose a policy with a longer tenure. This can give you the benefit of concessions on the premium amount.
Follow a good lifestyle
The simplest way to keep the premium under control is to follow a good lifestyle. If you are suffering from pre-existing diseases while buying a health insurance policy, the amount of your premium will also rise. Hence, it is vital to avoid alcohol, cigarettes, and caffeine, as they can pose the threat of serious health issues. Furthermore, you should incorporate nutritious food, a good amount of water intake and regular exercise into your daily routine.
Compare Mediclaim Policies
Before deciding on the right mediclaim policy, it is important to compare multiple plans from different insurers. Different insurers offer coverage options with different premium costs. This makes it imperative to compare and research multiple policies and consider factors like customer reviews, coverage, and network hospitals. This way, you can ensure you purchase the perfect policy at reasonable rates.
Does Health Insurance Cover COVID-19 Expenses?
As per the Insurance Regulatory and Development Authority of India (IRDAI), health insurance companies should mandatorily offer coverage for standard treatment of COVID-19 infections if the insured is affected by the infection and has to get hospitalised for the treatment.
The global pandemic outbreak has compelled people to opt for exhaustive health insurance plans that cover global health issues as well. Therefore, Care Health Insurance offers coverage for COVID-19 Infections per the policy terms & conditions.