Do health plans cover OPD expenses?

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.

Health Insurance Plans | Buy Best Health Insurance Policy in India

Select from Our Best Health Insurance Plans in India

As one of the best health insurance companies in India, Care Health Insurance ascertains that you and your loved ones receive optimum healthcare coverage complemented with an affordable premium. Here are some of the best health insurance plans in India offered by Care Health Insurance:

Man Illustration — Look for best health plan **that suits your need!**

Care Supreme

Ideal for families looking for capless coverage

Annual Health Checkup & Save Tax
Modern Treatments Coverage

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Care Advantage

Health insurance for domestic and global coverage up to 6 crore

Upto 50% No Claim Bonus
Individual or Floater Option

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Care Senior

Your Parents have always cared for you, Now its your TURN

No Pre-policy medical check-up
Annual Health check-up for all insured persons

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Care Freedom

Health Insurance for listed pre-existing diseases

Dialysis Cover
Day Care Treatments

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Care JOY

Embrace Motherhood With No Financial Worries

Newborn Baby Cover up to the first 90 days
Pre & Post Hospitalization Cover

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CARE ENHANCE

Boost Your Existing Health Cover With Super Top Up Plan

Financial Cushion for Medical Emergencies
Support for Critical Diseases

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Care Heart

Health Insurance that Covers Pre-existing Heart Ailments

541+ Day Care Treatments
AYUSH Coverage

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What is Health Insurance?

Health insurance is a type of insurance that pays for an insured member's medical expenses due to accident, illness, or injury. In a health insurance policy, your insurer bears the cost incurred towards hospitalisation, doctor consultation, diagnostic tests, medication, etc.

Health insurance and medical insurance terms are generally used interchangeably and are further classified into two broad categories-

Typically, there are two broad categories of health insurance:

Indemnity-Based Health Insurance Plans: Indemnity-based health insurance pays for insured members' medical expenses if an accident, injury or illness arises.
Fixed-Benefit Health Insurance Plans:A fixed-benefit health insurance pays a fixed sum to the insured if a medical condition is diagnosed for which coverage is defined in the policy documents. Unlike other medical insurance policies, where you raise a claim for medical cover, in a fixed-benefit plan, you receive the sum insured upon diagnosis of the disease, and it depends on the insured how they utilise the sum insured.

The importance of health insurance has shot up in the last few years due to the alarming spread of lifestyle diseases among people of all ages. Even a single-day hospitalisation can derail your hard-earned savings in no time! Thus, it is crucial to understand and utilise a comprehensive health insurance policy while receiving medical treatment/assistance.

Features of Health Insurance Plans

Addressed below are the features of the best health insurance plans from Care Health Insurance:

Parameter	Definition	Details
Sum insured	The sum insured is an amount paid by the insurer to the insured in case of an unforeseen event.	Ranging from ₹3 lakhs to ₹6 crores
Critical illness	According to IRDAI, illnesses such as Cancer, Pulmonary Thromboembolism, Stroke, Angioplasty, etc. are considered critical illnesses.	Special plans offering coverage for 32 illnesses
Pre hospitalisation expenses	Diagnostic, consultation, and medical charges incurred before hospitalisation are pre-hospitalisation expenses	Covered upto 60 days
Post hospitalisation expenses	The expenses incurred in taking recovery diagnosis, consultation and medication after discharge are called post-hospitalisation expenses.	Covered Upto 180 days
Ambulance charges	The cost incurred in hiring ambulance services if a medical emergency occurs.	Covered
Daycare treatments	A treatment that does not require 24-hour hospitalisation is known as daycare treatment. Examples include dialysis and chemotherapy.	Upto Sum Insured
ICU charges	The cost incurred towards availing of ICU services.	Covered
Add-ons	An additional feature in health insurance plans that can be bought by paying an extra premium.	Available
Hospital Network	The list of hospitals that tie up with the insurance company to provide hassle-free treatments to the insured is called network hospitals in health insurance.	24800+ cashless healthcare providers with 11400+ network hospitals
Tax benefits	The tax benefit is the deduction from the taxable amount you can avail of based on your health insurance premium.	Upto 75000 Under Section 80D~
AYUSH treatments	The medicine practices, including Ayurveda, Yunani, Siddha, and Homeopathy, are AYUSH treatments.	Covered
Domiciliary treatments	Domiciliary treatment is the medical treatment offered to a patient at home when hospitalisation is impossible.	Covered
Grace period	The period after the policy expiry date, when you can renew your policy and retain the existing benefits, is known as a Grace period.	30 days after policy expires
Waiting period	The time that you have to wait before filing a claim for specified diseases is known as the Waiting period.	30 days / 24 months/36 months / 48 months
Policy tenure	Policy tenure is the maximum tenure till which you want your policy to offer coverage.	1 year/ 2 years/ 3 years
Advanced medical treatments	Treatment procedures that require modern methods, such as robotic surgery, laser treatment, stem cell therapy, etc., are known as Advanced medical treatments.	Covered

How Do Health Insurance Plans Work?

A health insurance plan works simply—your insurer provides financial support during medical emergencies in return for a regular premium payment. It's a simple yet powerful arrangement, ensuring that when health hiccups occur, you're not left juggling savings and bills. Let us understand the entire workings of health insurance with an example:

Suvidha purchased health insurance with a coverage of ₹10 Lakh for her family. A few months later, her mother got sick and had to see a doctor. Unfortunately, she had to get hospitalised as her condition worsened.

Knowing that her mother was covered under her health insurance policy, Suvidha searched for a nearby network hospital and admitted her for further treatment. She then informed her insurer about the emergency hospitalisation and completed the formalities.

Upon discharge, the hospital directly settled the bills with the insurance company, while she paid only for the non-payable items.

Further, she filed a reimbursement claim for the pre-and post-hospitalisation expenses. Suvidha filled out the reimbursement form and attested it with all the bills and reports related to the hospitalisation. Her insurer verified the documents and paid the claim amount to her bank account.

Who Should Buy Health Insurance?

Medical insurance ensures you access the best healthcare regardless of age and financial budget. While a health insurance plan is prudent for everyone, we have highlighted who should opt for one.

Young Adults

Despite being active and healthy, young people are not immune to sudden medical emergencies. Here, a comprehensive medical insurance policy can help avoid hefty expenses from unforeseen medical costs. Further, some health insurance plans also offer free annual health check-ups, which can help detect and prevent potential health issues.

Families

A family medical insurance policy covers parents and children under one plan. These plans provide adequate coverage for emergency treatments and routine check-ups. Family health insurance can be crucial for managing chronic conditions and recurring health issues in the family. It also acts as a protective shield from rising medical care costs.

Middle-aged Individuals

Health insurance is a crucial tool for middle-aged individuals to address the high likelihood of conditions like heart disease, hypertension, and diabetes. Specialised health insurance plan providers cover related medical attention and treatments, ensuring that unexpected emergencies are covered without financial strain.

Senior Citizens

Retirees or seniors can rely on health insurance to manage medical costs without impacting savings. These plans usually cover essential healthcare needs, including treatment and medicine.

Common Health Insurance Terms You Should Know

Understanding the terms and conditions of your health insurance is crucial for policyholders to avoid last-minute hassles. Read out these commonly used health insurance terms to make reading the policy documents easier:

Waiting period

Every health insurance plan comes with certain waiting periods. It is the specified duration for which the insured individual must wait before availing benefits. Typically, a claim for illnesses cannot be made within 30 days of policy purchase- this time is known as an initial waiting period. Furthermore, specific named ailments and pre-existing conditions may have a waiting period between 24-36 months.

Co-payment

Some insurance policies have an inbuilt copayment clause. Copayment, or ‘Copay’, is a specific amount or percentage an insured individual must pay from his/her pocket every time a claim is raised. Simply put, it is a cost-sharing concept between the policyholder and the insurance company.

Deductible

A deductible is the amount you pay from your pocket when a claim is raised. Here is an example of how deductibles in health insurance work: If your health insurance claim amount is Rs. 2,00,000 and your policy’s deductible amount is ₹50,000, then you pay ₹50,000. At the same time, the health insurance company pays the balance of ₹1,50,000.

So, it is essential to check your medical insurance policy documents for a deductible clause and choose one without one unless you are okay with bearing a part of the treatment cost.

Network hospital

A network hospital is where your health insurance provider collaborates to offer the policyholder the advantage of cashless hospitalisation. When you are admitted to a network hospital, your insurer settles your medical bills with the hospital, saving you from the hassle of paperwork and running around arranging funds.

Sum insured

When you buy a health insurance policy, you must choose a coverage amount up to which your health insurance company will cover the medical expenses. The higher the sum insured, the higher the premium and vice versa.

Exclusions

Every insurance provider includes a set of situations and conditions in which they are not liable to provide financial coverage. These limitations will be mentioned in your health insurance policy papers as exclusions.

Top-up plans

These are the best health insurance plans that help you get more coverage if your basic sum insured is exhausted during a medical emergency. Top-up or super top-up policies can be purchased along with a base policy.

Pre-existing Diseases

If someone suffers from an illness before purchasing a health plan, it is called a pre-existing disease. Some common examples are diabetes, asthma, hypertension, or high BMI. People with a pre-existing illness can also be eligible for health insurance. However, they generally have to pay a slightly higher premium or serve a pre-decided waiting period to be able to file a claim against the condition.

Claim Intimation

Claim intimation in health insurance refers to informing insurance providers about the upcoming claim. This usually involves notifying the insurance provider about hospitalisation medical treatment before submitting detailed claim information. It enables insurers to be aware beforehand to streamline the subsequent claims processing. It is important to know that in some cases if the insured person does not submit an insurance claim intimation, the claim might be rejected.

Claim Settlement

Claim settlement is when the insurer pays the costs towards a loss incurred by the policyholder. In the case of health insurance, there are two major types of claim settlement- Cashless and Reimbursement.

In cashless claim settlement, the insurer pays the hospital directly according to the policy T&C. Whereas, in a reimbursement claim settlement, the bill is firstly paid by the policyholder and then is disbursed to his/ her account upon claim acceptance.

Cashless Hospitalisation Claim

A cashless hospitalisation claim is a facility offered by insurance providers to help policyholders access medical services without worrying about the availability of upfront finances. To use this facility best, one has to receive treatment at network hospitals affiliated with the insurance provider.

Reimbursement Claim

The term reimbursement claim refers to the repayment of the claim. In this type of claim settlement, you pay the medical/hospitalisation bills for the medical treatment you avail of. Once you submit the bills to your health insurance provider, you can file a claim and get the covered amount from the insurer.

No Claim Bonus

No claim bonus is an additional benefit offered under a health insurance plan to get a complimentary bonus for every claim-free year. It helps boost the coverage of your health insurance plan.

Sublimits

A sub-limit is a predetermined capping applied by the insurer on certain medical expenses under your health insurance. It works as a limit on how much claim amount the insurer will pay for a given healthcare expense. Sub-limits are usually calculated in percentage and apply to both cashless and reimbursement claims.

Room Type

Room type refers to the kind of hospital room a policy covers. Common categories include general ward, semi-private room, and private room. The type of room you choose can directly impact the overall cost of your hospitalisation bill.

Room Rent Proportionate Charge

Room Rent Proportionate Charge limits the amount an insurer will pay for room rent per day during hospitalisation. If you exceed the room rent limit, you must pay the difference out of your pocket.

Smart Select Hospitals

Smart select at Care Health Insurance is an add-on benefit facility that allows an insured to pay 15% lesser premium and get coverage up to sum insured at Care’s Smart Select Network Hospitals. Please note that getting treatment out of the smart select network may borne a 20% copayment or as specified in the policy documents.

Use of Preventive Care

Taking timely precautions is the need of the hour.Under preventive care, mediclaim policies cover COVID treatment, annual health check-ups, general OPD visits, diagnosis, medical tests, consultations, etc., done to analyse any severe health patterns beforehand. By paying the premium, you can avail of preventive care benefits under your medical insurance plan.

Alternate Treatments in Health Insurance

As of April 1, 2020, the Insurance Regulatory and Development Authority of India (IRDAI) has directed all health insurance companies to include coverage for AYUSH treatments in every health insurance plan. While some health insurance plans previously covered alternative treatments, they often had specific limits on the coverage.

Alternative medicines are better known as AYUSH treatments, which stand for Ayurveda, Yoga, Unani, Siddha, and Homeopathy. These treatments are deemed safe and effective not just in India but worldwide. Studies suggest that the AYUSH treatment sector in India is projected to grow at a CAGR of 8.6% in the period between 2022-27.These treatments rely on natural substances and therapies, resulting in minimal or no side effects.

Should You Get a Health Insurance Policy at an Early Age?

A health emergency may come unannounced and is unpredictable for all ages! Thus, it is crucial to have a financial backup to cope with hard times! While people wait till their 30s or later to secure their finances, here are the advantages of ensuring your hard-earned savings with the help of health insurance at an early age:

When you buy a health insurance policy at a young age, you can serve the waiting period even before the risk of diseases arises.
Considering that young adults are generally less vulnerable to diseases, insurance companies in India may offer significant premium discounts.
If you are a tax-paying individual, your health insurance may help you save on tax under Section 80D of the Income Tax Act.
As a young adult, you may avoid hospitalisations for a long time if you follow a healthy lifestyle. For every claim-free year, you may avail of specific no-claim bonuses and other accrued bonus benefits, increasing your coverage at a standard premium.
Buying a medical insurance plan at a young age can be beneficial, as you can benefit from holistic and comprehensive coverage. Therefore, you can get enhanced security while employed or after retirement.

Benefits of a Medical Insurance Policy

According to a report by Business Standard, wholesale prices in India rose to 0.53% in March 2024. This inflation has also been significant in the medical sector!

The constant year-on-year increase in medicine prices, diagnostic tests, and hospital charges across India have made having affordable health insurance the need of the hour! Mentioned below are the benefits of health insurance that make it an essential healthcare security cover:

Coverage for Hospitalisation Expenses

Hospital expenses can be financially exhausting, and thus, having hospitalisation cover can be very helpful. Health Insurance from Care Health Insurance protects you against pre- and post-hospitalisation expenses, ambulance charges, day-care procedures, domiciliary care expenses, etc.

Coverage for Critical Illnesses

Health Insurance for Critical Illnesses can ensure you do not have to spend your hard-earned savings if a critical illness knocks on your door. Thus, Care Health Insurance caters coverage against 32 major critical illnesses, including Cancer, Cardiomyopathy, paralysis, blindness, etc., under the Critical Illness Mediclaim.

Protection above Corporate Health Insurance

Your corporate health insurance may not be sufficient for your and your loved one’s healthcare needs. At Care Health Insurance, we offer affordable plans that help you cope with expensive medical costs over and above your group health insurance plan.

Cashless Claim Benefit

With an expansive network of 24,800+ cashless healthcare providers, you can ensure that your focus remains on recovery, not paperwork, during a medical emergency. A convenient and stress-free claim procedure gives you the flexibility and peace of mind you deserve.

Tax Benefits under Section 80D

The premium you pay for your health insurance can be utilised to avail of tax benefits under Section 80D of the Income Tax Act, 1961. For example, individuals below 60 (along with senior citizen parents) can avail of tax deductions of up to ₹75,000.

How much Tax Benefit Can I get from Health Insurance?

If you fall into the taxable slab, then your health insurance plan can fetch you tax benefits. Here’s how:

If you are paying the health insurance premium for yourself, your spouse, your children, or your parents, you can avail of tax benefits under Section 80D and save more.
As a policyholder, you can also claim up to ₹5,000 when towards preventive health check-ups.
Take a look at the table to understand the deductions in detail:

Policyholders	Deductions for premium paid for self and family	Deductions for premium paid for parents	Preventive Health Check-Ups	Tax benefit
Self and family below 60 years	₹25,000	-	₹5,000	₹25,000
Self, family, and parents below 60 years	₹25,000	₹25,000	₹5,000	₹50,000
Self and family below 60 years and parents above 60 years	₹25,000	₹50,000	₹5,000	₹75,000

Why is Health Insurance Policy Important to Protect Your Loved Ones?

A health insurance policy is crucial for safeguarding the well-being of your loved ones. In today’s disease-prone world, the right coverage can offer financial protection and access to quality healthcare services. The best health insurance policy shall ensure that your family is protected from the exorbitant costs associated with medical treatments.

A health insurance policy acts as a financial safety net for illness or injury by covering everything from hospitalisation expenses to medication costs. This safety net not only eases the burden on your finances but also guarantees that your loved ones receive medical attention without compromises. It empowers you and your family to seek medical assistance promptly without worrying about expenses hindering timely healthcare. Annual health check-ups are also often included in health insurance policies, which can contribute to your family's overall well-being.

Which Type of Health Insurance Should You Buy?

You should determine the ideal health plan for yourself and your family by evaluating the healthcare needs, age, and current health status of every member. To help you select the right health policies for every member, we have created a scenario-based differentiation covering the different needs of individuals and families. Find out which scenario is most relatable to you and secure yourself with our policy offerings-

If You Have Dependent Family Members

Want to safeguard the health of your immediate and dependent family, including your spouse, children, and parents? Here’s a perfect choice: The policy covers your entire family’s medical needs with one comprehensive plan eliminating the struggle of maintaining several policies. With sum insured options up to ₹6 crores, the family plan offers the following features:

● A Single and Affordable Premium Payout
● Wide-ranging Sum Insured Options
● Annual Health Check-ups for Every Insured Member
● Customizable Policy Benefits like OPD, PED, etc.

Family Floater Insurance Policy

If You are Young and Need Complete Coverage

Young adults aged 35 years and below need a complete package of healthcare and financial security. To meet this need, you should choose our inflation-proof insurance: The medical insurance policy comes with all-inclusive healthcare benefits that help keep young adults safe against medical crises. With a no co-payment clause and personal accident coverage, this health insurance policy offers the following benefits to early birds:

● Available on Individual and Family Floater Basis
● Benefits of up to 30% discounts on Renewal Premium & 5% Digital Discounts
● Unlimited Automatic Recharge up to Sum Insured
● Value-added Services Like e-Consultations, Wellness Programs, etc.

Youth Health Insurance Plan

If You Have Elderly Parents to Look After

Your parents and elders need special care when they turn 60 and above. If you are looking for adequate coverage for your elders to enjoy a stress-free and financially secured retirement, here’s your go-to choice: The senior citizen health cover supports older people in paying hefty medical expenses due to old age-related ailments. Available to both individual and floater basis, the policy holds the following unique features:

● No Pre-policy Medical Check-ups*
● Annual Health Check-ups for all Insured Members
● Automatic Recharge of Sum Insured Once in a Policy Year
● Save Tax up to ₹75,000 u/s 80D

Senior Citizen Health Insurance Plan

If You Need Protection Against Critical Illnesses

The treatment of cancer, lung disease, and other critical ailments can completely wash away your savings. So, if you are anticipating any chronic conditions among your family, do check our Critical Illness Mediclaim.The policy offers a shield against the medical treatment expenses of 32 critical ailments, like stroke, paralysis, organ transplant, etc. with the following benefits:

● Mediclaim Policy with Low Premium & Optimum Coverage
● Easy EMI Option Available
● Quick Recovery Counselling
● Coverage for Cancer at all stages

Critical Illness Insurance

Why Choose Care Health Insurance?

At Care Health Insurance, we aim to serve customers beyond basic health insurance services. We offer enhanced medical insurance policies with valuable features to meet the diverse medical needs of people across the country.

At our core, we're not just about health insurance; we're dedicated to exceeding expectations and making the best possible healthcare facilities within everyone’s reach.

Care health insurance plans offer a diverse range of sum insured, starting from ₹3 lakhs to ₹6 crores, enhanced with various healthcare benefits like COVID and OPD care, cashless hospitalisation, day-care treatment, and annual health check-ups, among others. It's a spectrum of possibilities tailored to meet your unique healthcare needs.

At Care Insurance, we strive to provide our customers with the best health plans with wider coverage. Along with in-patient expenses, pre and post-hospitalisation, domiciliary hospitalisation, and organ donation, we also cover AYUSH treatment and modern technology treatments to ensure our customers choose the medical treatments of their choice through our long list of health insurance policies in India.

Take a look at the features of our comprehensive health insurance plans that make us one of the best health insurance companies in India.

Affordable Plans

Our health insurance premiums are designed to align with your budget while offering the desired coverage. Using our health insurance premium calculator, you can understand how much you pay for what benefit and how it will help.

Array of Options for all Kinds of Needs

We believe in empowering you with choices so you get an array of health plan options. Be it for individuals, families, your parents, an expecting mother, or critical illnesses like cancer or a pre-existing disease, you get to choose from several available options.

Wide Network of Healthcare Providers

Cashless benefit has further made health insurance a hassle-free experience. In order to avail of cashless claims, one has to receive medical treatment from one of the network hospitals. Care Insurance has 24800+ cashless healthcare providers with 11400+ network hospitals. Hence, it is very easy to avail cashless benefits during a hospitalisation.

Easy Claim Procedure

With the introduction of both online and offline claim filing options, the claim procedure has become quite easy. We understand the value of quick claim approval, so we approve and settle the claims within a short span of time.

Efficient Customer Care Support-including Live Chat options

You may have several queries regarding your health insurance plan, and visiting a nearby office may not always be possible. Fret not; we’ve got your back! With our live chat feature and quick customer care support, you can clear out all your doubts in no time.
On the website, you can easily spot the live chat feature or get a callback from our executive to resolve your query. Alternatively, you can reach us at our toll-free number: 1800-102-4499 for sales and +91 88604 02452 for service-related queries. You can also receive policy updates on WhatsApp.

Which Add-ons are Included in a Care Health Insurance Policy?

Health Insurance plans from Care Health Insurance come with different add-on benefits that help you customise premiums and/or expand your coverage. Listed below are a few add-ons that our customers love the most.

Air-ambulance cover:Air ambulance cover offers financial coverage if a doctor recommends transferring an insured patient from one hospital to another through air ambulance.
Care Sheild:Care Shield is a comprehensive add-on that offers three unique benefits:
- Claim Shield:There’s a list of around 105 items that are considered non-payable items. Generally, a health insurance plan does not cover expenses on such items; however, with a claim shield, you can get financial coverage for 68 non-payable items out of the list. For example, the expenses on gloves and masks will be covered under this benefit.
- No Claim Bonus Sheild:If your total claim amount is less than 25% of your sum insured, the NCB, as applicable, will not be reduced at the time of renewal.
- Inflation Sheild:With an Inflation shield, your sum insured will increase annually based on the previous year’s CPI.
Co-payment waiver for senior citizens:With this benefit, you may waive the co-payment clause from senior citizen health insurance by paying an extra premium.
Annual health check-up:Care health insurance allows the insured member to avail of cashless annual health check-ups at the company’s network labs.
Smart Select:You can get a 15% discount on your premium with the Smart Select option. Under the Smart Select Benefit, Care Health Insurance offers cashless treatment up to the sum insured at a list of Smart Select network healthcare providers. However, you may have to pay up to 20% of the co-payment if you get treatment out of the smart select network hospitals.
Reduction in the PED Waiting Period:By buying an add-on benefit for a reduction in the PED waiting period, you can reduce your waiting period for pre-existing diseases. Your waiting period will be reduced from 3 years to 2 or 1 year.
No Claim Bonus Super:This is an extended benefit to your policy's Cumulative bonus. As a result, you can increase your sum insured by 50% within 5 consecutive years.
Care OPD:Care OPD offers reimbursement for 4 general physician consultations and 4 specialist consultations a year.

Eligibility Criteria and Health Insurance Policy Details

While most of our health insurance plans have standard eligibility criteria, you can check the desired policy for specific conditions, like co-payments, waiting periods, etc.
Tabulated below are the eligibility criteria to purchase health insurance plans from Care Health Insurance:

Minimum Entry Age	Individual- 5 years \| Floater- 91 days with at least 1 insured person of age 18 years or above
Maximum Exit Age	Lifelong for Adults
Tenure Options	1/2/3 Years
Cover Types	Individual and Family Floater basis
Waiting Period	30 days for illnesses, except injury \| 24 months for named ailments \| 36 months for pre-existing diseases
Grace Period	30 days to renew your policy post expiry

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(except 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.

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.

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.

How to Choose the Best Health Insurance Plans in India?

To choose the best medical insurance in India, you must consider the below-mentioned advantages:

Verify Eligibility: Often, health policies come with entry age restrictions. With Care Health Insurance, you face minimum age restrictions with a minimum entry age of 91 days on a floater basis and get lifelong renewability.
Ensure Maximum Coverage: Our health insurance plans provide pre and post-hospitalization expenses, diagnosis expenses, treatment, medication, organ donor cover, and annual health check-ups.
Look for Affordable Premium: A budget-friendly premium is always on your mind while buying a medical policy. In our digital portal, you can utilise the health policy calculator to estimate the premium rates by customising the covers and sum insured as per your needs.
Check Exclusions: Check the exclusions list carefully before choosing a health policy. There are certain pre-defined conditions under which you cannot make a claim. So, go for the cover that offers maximum coverage with minimal exclusions.
Understand the Co-Payment Clause: Before investing in insurance for medical needs, it's advisable to check the co-payment clause. Co-pay in health policies refers to a specified percentage of the claim amount that needs to be borne by the insured person.
Select Wide Cashless Network Hospitals: Easy access to our empanelled network hospitals provide you with cashless treatment in the least time. Ensure a widespread cashless hospital network, and don't forget to look for well-renowned hospitals in your vicinity.
Bid for Higher Claim Settlement Ratio: Claim Settlement Ratio proves the company's reliability in settling claims. We promise the highest claim settlement ratio of 95.2% CSR (F.Y. 19-20).

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.

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.

By buying a health policy online, you can also renew your health plan digitally, thus saving much effort.

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.

Some Myths about Health Insurance Busted

Health insurance is vital to financial planning, yet various misconceptions surround it. Let us examine the most common health insurance myths and help you understand what is a myth and what is not.

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

While your coverage will start as soon as you buy a health insurance plan, you must first serve a waiting period. This is a 30-day period when 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 instance, coverage of certain treatments may require you 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

Having a pre-existing illness doesn’t make you ineligible to make a claim. Your insurer may ask you to serve a specific notice period before being eligible for the coverage, or you may ask for an additional premium or both.
Did you know? Health insurance plans such as Care Supreme even offer add-on benefits to reduce your Pre-existing disease waiting period for specified ailments!
Simply put, if you secure your pre-existing health condition with Care Supreme, you may reduce your waiting period by paying a slightly higher premium!

Group health insurance is enough

While it is a great perk to have corporate 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. You may lose all the accrued bonuses and other benefits when you change or leave your job. 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 hospitalisation. Hence, consider 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.

Porting Your Health Policy to Care Health Insurance

There are more than one reasons to port your policy to Care Health Insurance. As an insured person, we promise you unique benefits with lifelong renewability under most of our health insurance plans. Porting a medical plan is easy and can be done before the policy renewal stage. Just notify your existing insurer at least 45 days before the policy renewal date of an existing medical cover.

You will be able to retain your medical insurance policy benefits and accrued bonuses and transfer the time-bound exclusions, including credit for the waiting period for pre-existing diseases. It is possible to port a policy from one insurance company to another and from one health insurance policy to another policy with the same insurance company.

How to Port a Medical Insurance Policy?

Here is a step-by-step guide to port your health insurance scheme and get covered under Care Health Insurance plans:

Step 1

On the home page of Care Health select the “port existing policy” option and follow the premium calculation journey.

Step 2

Fill up the proposal form and the portability form with relevant details and submit the required documents along with it.

Step 3

The requisite data will be furnished on the official portal of IRDAI.

Step 4

The new insurance company will underwrite the proposal and inform you within 15 days.

Things to Keep in Mind When Porting Health Insurance

When you port a health insurance policy to a new insurance provider, the aim is to get better services and coverage. Keeping in mind the following aspects will help you in a seamless transition.

Inform your previous insurer

Before switching to a new health insurer, it is vital to inform the current insurer. You should write an application for this purpose. You can make this request to your insurer at least 45 days before your policy’s expiry date. Also, keep in mind that you should avoid making this request before 60 days of the renewal. Let’s understand how to make the portability permission request. You should write an application in which you have to mention the name of your new insurer and other personal and details. Once you apply, your application will be reviewed and you will receive an acknowledgement within 3 business days.

Keep an eye on the premium

When you decide to port your health insurance policy to a new insurer, you should enquire about the premium. You should check whether its premium will increase or decline on porting. The change in premium indicates the changes in your coverage or benefits. So, gather this information before you finalise the porting.

Check for the available add-ons

If you are thinking of switching to a new insurer to enhance coverage or benefits, you should check for the available add-ons. You can buy the add-ons of your current insurer to avail of the extended benefits.

Understand the waiting period

You should understand the waiting period cycle before you port to a new insurer. Simply put, the waiting period is divided into three parts.

The first waiting period starts with buying the policy. This is for only 30 days.
The second waiting period is from 1 year to 2 years for the diseases of kidney stones and appendicitis.
The third waiting period is 3-4 years, and it applies to pre-existing diseases. The good news is that when you switch to a new insurer, your waiting period does not start from the beginning. It starts where you left it with the previous insurer.
Suppose you have completed the waiting period of 2 years for a pre-existing disease that has a total waiting period of 3 years. Then, you need to complete the waiting period of only one year.

Give correct details about your medical health

Hiding your medical history when you make a porting request to the new insurer can be a mistake. Your new insurer may or may not make you undergo a medical test. In case you have been suffering from any chronic illness or severe comorbidities, your porting request may be rejected. Because in such medical cases, the threat of hospitalisation and the frequent visits to check-ups or treatment always persists.

Choose a higher sum insured

Obviously, you have decided to port to a new insurer because you are optimistic about new benefits there. Hence, you should try to choose a higher sum insured when you port.

Check Insurer Details

Before you decide to port your mediclaim policies to a new insurer, it might be a good idea to be aware of a few metrics. You should always check for details like discounts being offered, any consumer complaints, company’s empanelled network healthcare providers and the claim settlement ratio. It might also help to check the ratings on the company’s social media handles to understand the overall customer experience.

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Nitin Padegaonkar August 23, 2024

Care Supreme

Thanks to care health insurance

Fantastic company accross the India wide cashless network... good service

Manoj kumar August 23, 2024

Care Supreme

Family

Satya Prakash August 23, 2024

Care Supreme

Hassle free treatment

Whenever I got treatment done, I never faced any kind of policy related problem. I got the operationtreatment done in the hospital without any worries. I thank CARE. I would suggest everyone to join Care, because only after joining will you know the truth and goodness.

Naresh kumar August 23, 2024

Care Supreme

Care health Best health insurance company

I am very happy for care health insurance , very fast service for claim settlement. Thankyou care

Sai nagendra reddy August 23, 2024

Care Supreme

Best forever

I recommend going with care health insurance to save your life and expenses ...

D GANGADHAR July 08, 2024

Care Supreme

Tension Free Service

I admitted my child due illness.I just intimated the company regarding the admission into hospital.within in the 30min.they approved pre authorisation for cashless treatment.really its wonderful....Thank God being a care policy holder because no one expects that hardles in our life .

abhishek April 23, 2024

Care Supreme

best health insurance

care is best health insurance best plan supreme

Reema Kumari April 23, 2024

Care Supreme

Mrs Reema Kumari

very good claim settlement care health support Mr Tushar Chandok And Chetan Sharma My Spouse Hospitalization Very good service i am happy care health insurance

Keshav Rawat January 18, 2024

Care Supreme

Best Health Insurance Company

Rupali DHAINJE December 26, 2023

Care Supreme

Best Service in Claim

Care Health give us full Claim settlement in cashless and Reimbursement cases. With Advisor Mr. Rakesh Wani help us time to time in claim support services. Thank You CHIL Team and Mr. Wani.

Mahima December 19, 2023

Care Supreme

Nice service

This review is for the call centre person who suggested me to buy care supreme. I believe it is the best plan with best benefits and services.

Sandeep Singh December 18, 2023

Care Supreme

bad experience

6 months after buying this plan, i got gal bladder stones. I had to undergo surgery for which company did not settle my reimbursement claim saying I have to serve waiting period. Whats the point of buying insurance if i dont get claim Bad experience

Mahadeb Ghatak December 18, 2023

Care Supreme

Great Customer Service

I got full cooperation from care health Insurance specially Manicanchan Gupta regarding our claim under care supreme. Thanks

Megha Shailesh Gupta December 17, 2023

Care Supreme

Satisfied

Thank you for providing me plan like care supreme and your team gives good response regarding services and helps a lot. ek star wait karane ka kaatungi

Vinayak Chaturvedi December 15, 2023

Care Supreme

Disappointed

The claim team asked for too many bills and receipts i did not keep all of them with me. so only got partial claim approval.

Mithilesh Tyagi December 01, 2023

Care Supreme

Good product

I had a good experience bcz good product given for my father in law and mother in law.. i would like to inform to my relatives and friends to take insurance in care health. Thank you CARE HEALTH INSURANCE.

Rashmi Sharma December 01, 2023

Care Supreme

Helpful plan

I got care supreme for myself and my husband. My husband had dengue and care health insurance helped me with fast claim process. Amazing service

Snigdha Tripathi December 01, 2023

Care Supreme

Good plan but average service

I buy this plan for myself last year and i needed to get hospitalised due to knee injury. Claim process took time but it happened. Please make your claim process fast.

Mahima December 01, 2023

Care Supreme

Nice service

This review is for the call centre person who suggested me to buy care supreme. I believe it is the best plan with best benefits and services.

Vikram Gupta December 01, 2023

Care Supreme

Nice product

The product seems extensive with the kind of riders provided. Highly recommended.

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My appreciation for your prompt service

Recently, I’ve purchased JOY Maternity insurance for my expecting wife and my experience was excellent with the claim settlement team who helped me deal with all the formalities smoothly. Thank you for making my decision the right one!

Rahul Sangwan

Health Insurance

We will continue to avail of your scheme

I ported my healthcare plan last year; it is the wisest decision I made by choosing Care Health Insurance. I recently got admitted due to a viral infection, and all my expenses got covered under my plan.

Samanway Barik

Health Insurance

Everything went very smooth

Thank you for helping me when I needed help the most, being in the hospital. Buying Care’s health insurance plan is my best decision so far.

Soubhagya K Kulkarni

Health Insurance

Really helpful explaining the process in advance

Thank you for helping me with your fastest claim settlement process. I didn’t have to wait much for the approval. Everything was quick and seamless.

Vaibhav Rai

Health Insurance

Zeroing in on a health insurance plan for your family is a tricky choice, given the number of insurers in the market who offer similar policies. It is not wise to simply choose the policy with the lowest amount of premium. You need to compare different policies, their features and benefits. Care Health Insurance (CHI) is a specialist Health Insurer and offers products keeping in mind the needs of a customer in the event of a medical exigency. CHI offers a distinct set of benefits giving a clear choice for providing you with the best possible health insurance.

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^**Number of claims settled as of 30th March 2024 ^*India Insurance Summit & Awards 2023

FAQs on Health Insurance

Q. How much health policy insurance coverage do I need?

The amount of 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 the treatment costs for your specific health condition before deciding how much sum insured is enough for you and your loved ones.

Q. How much does health insurance cost?

At Care Health Insurance, a 5-lakh medical cover starts with a premium as low as Rs. 358/month, subject to specific policy terms and conditions. Factors like the sum insured, type of coverage, policy term, count and age of insured members, and their pre-existing medical conditions, impact the chosen health plan’s premium cost.

Q. What documents do I need to purchase mediclaim health insurance?

While purchasing a mediclaim insurance policy, you will require a few important documents to complete the process. Some of the documents required include ID proof, age proof, income proof documents, age proof, photographs, and relevant medical records.

Q. Can I buy health insurance and use it immediately?

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

Q. What is the right age to invest in Health Insurance? Which is the best health insurance for myself and my family?

The earlier you get a health cover, the lesser the premium you get to bear. 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– resulting in an increased premium. Thus, going for a health cover early in life is a wise decision.

Q. What is the benefit of porting health insurance?

Medical insurance portability can help you switch a health insurance plan without having to go through a new waiting period. Once you have finished the waiting period in your previous plan, you do not have to serve it again.

Q. How many claims can I make in a medical insurance policy?

You can make multiple insurance claims during the policy term, provided that it remains within the sum insured limit.

Q. What is domiciliary hospitalisation?

Domiciliary hospitalisation is a situation in which the insured receives treatment at home either because the doctor has declared that they cannot be admitted to the hospital, or there is a non-availability of rooms at the hospital.

Q. Can I buy a medical insurance plan in India if I am not an Indian national?

Yes, foreigners who are living in India can buy a medical insurance policy in India.

Q. What is the process for a reimbursement claim settlement of medical insurance?

Typically you will have to inform the insurance company about your hospitalisation. Submit the claim form and all the stamped and verified documents within the stipulated timeline. Once the claim is verified, it will be settled within 2-3 weeks.

Q. Is overseas treatment of an illness covered in my insurance plan?

Generally, any type of treatment taken overseas is not covered. However, you can opt for a global coverage option if you wish to continue treatment abroad.

Q. What do you mean by network and non-network hospitals?

Network hospitals are empanelled with a health insurer and provide you with cashless medical treatment. Here, you can present your health card to avail of a cashless hospitalisation facility and the insurer will directly settle the claim with the hospital. Whereas, non-network hospitals are not empanelled with the insurer and thus require reimbursement claim filing.

Q. What is Waiting Period under Health Insurance?

A waiting period is a pre-defined number of days you must wait before raising a claim under a standard health insurance plan. There are three types of waiting periods, namely– an initial waiting period of 30 days, a waiting period for pre-existing diseases, and a waiting period for specified ailments/ treatments.

Q. What happens if I don't pay my mediclaim insurance premium?

Your health plan 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. Neglecting your mediclaim insurance premium is like playing a risky game. Letting the due date slide means your coverage will leave you without the magical safety net promised in your policy. So, try not to let your health plan expire.

Q. How does no claim bonus work in a healthcare insurance policy?

A no-Claim Bonus (NCB) that is given to the policyholder for not raising any claim during a policy year. It is a bonus amount that becomes available as an increased sum insured for every 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% in the next policy year, if the insurer claims in a policy year.

Q. What are the pre-existing diseases in health insurance? Will my health policy cover the same?

Pre-existing diseases are illnesses, injuries, or related conditions for which a medical practitioner diagnosed a person within 48 months before the effective date of policy issuance by the insurer or its reinstatement. Yes, Care Health Insurance policies cover pre-existing medical conditions but come with a waiting period as per the chosen policy.

Q. How can I get tax benefits from medical covers?

With our medical insurance, 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.

Q. What does the sum insured mean under a mediclaim policy?

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 claim amount that exceeds the sum insured will have to be borne by the insured person.

Q. Can I have multiple health insurance plans in India?

Yes, you can buy yourself multiple health 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.

Q. Can I add my ageing parents to my medical insurance policy?

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

Q. How does smoking affect the insurance premium for medical cover?

Insurers consider the habit of smoking as a factor when assessing your health risks and calculating insurance premium rates. Generally, smokers need to bear a higher premium for any health cover, given that smoking makes people more vulnerable to chronic diseases and other health hazards.

Q. Is there a grace period for renewal under health insurance?

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 insurance policy. You can the premium within the grace period to renew the benefits of your medical health insurane policy.

Q. I'm covered under a corporate group policy. Do I still need a separate health cover?

Yes, it is wiser always to have separate healthcare insurance besides the employer health plan because the corporate plan does not offer extensive coverage, no tax benefits, and customisable features. Thus, it is better to protect your finances and health with a separate cover that meets all your healthcare needs effectively.

Q. Can I take a health insurance policy for my 5 years old kid?

Yes, you can include your children aged 5 years or above under an individual health 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.

Q. Do health insurance policies cover robotic surgery & modern treatments?

Yes, our Yes, our specialised health insurance plans cover various expenses under advanced medical treatments, including robotic surgery and modern-day care treatments. We offer cover for more than 541 daycare procedures.

Q. Are medical tests mandatory while buying health and medical insurance?

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 insurance plan to ensure hassle-free claim settlement.

Q. How can I increase the sum insured for my health insurance?

You can increase the sum insured of your health plan at the time of policy renewal. The same can be done 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.

Q. What are the details required for making a health insurance claim?

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. Under 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.

Q. Can my claim get rejected? If yes, under what conditions?

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

Q. Will maternity expenses be covered under Care Health Insurance plans?

Yes. Under our Maternity Health Insurance plan, the expenses of an expecting mother and the newborn baby (up to 90 days) are covered. Expenses for daycare treatment, in-patient costs, expenses on pre and post-hospitalisation, room charges, etc. are covered.

Q. Will Care Health Insurance cover alternate treatments?

Yes. Alternative treatment like AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) is included in most of the Care Insurance plans.

Q. Can I get any discounts on the health insurance premium?

Yes. There are various ways in which you can enjoy a relatively cheaper health insurance premium. It depends on factors like who you are insuring, your location, credit score, past claim history, no claim bonus, any on-going discount/offer, higher deductibles, policy term etc.

*Please read the policy T & C, brochure, and prospectus to know more about our medical plans cover as it may vary.

~Tax benefit is subject to changes in tax laws. Standard T&C Apply

**Number of Claims Settled as of 31st March 2024

^10% discount is applicable for a 3-year policy

~~Premium calculated for an individual (Age 18) for sum insured 5 Lakhs in Zone 2 cities with Care Supreme Policy.

^^ Number of Cashless Healthcare Providers as of 31st March 2024

Health Insurance

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Alternate Treatments in Health Insurance

Should You Get a Health Insurance Policy at an Early Age?

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Why is Health Insurance Policy Important to Protect Your Loved Ones?

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