Care Group Health Insurance

Care Health Insurance offers a wide range of health insurance plans to take care of people’s health. As far as group health insurance plans are concerned, the insurer has ‘Group Care’ that covers all the necessary and reasonable medical expenses of employees working in an organization. The policy remains valid till the time you are with your workplace. Read this page further and know more about the coverage, exclusions and terms and conditions of this Care Group Health Insurance plan.

Group Care Insurance Base Cover

If any of the insured members get sick or injured during the policy period, the said Care Group Health Insurance Plan will cover the following medical expenses:

1. In-patient hospitalization expenses
2. 541 day care treatments/procedures as specified in the policy schedule
3. Modern treatments such as – Uterine artery Embolization and HIFU, Balloon Sinuplasty Deep Brain Stimulation, Oral Chemotherapy, Immunotherapy-Monoclonal Antibody to be given as an injection, Intra Vitreal injections, Robotic surgeries, Stereotactic radio surgeries, Bronchial Thermoplasty, Vaporisation of the prostate (Green laser treatment or holmium laser treatment), IONM-(Intra Operative Neuro Monitoring), Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions.

Sub-Limit On Room Rent

The insurer shall cover the room rent for in-patient hospitalization as follows:

1. Room rent limit – 1% of the sum insured per day
2. ICU Charges – 2% of the sum insured per day

Note: If the room rent is higher than the limit set by the insurer, the insured member has to bear the extra amount.

Optional Covers Available Under Group Care Insurance

Your employer can choose any of the following optional covers to provide extra coverage against medical expenses:

1. Pre & Post-hospitalization Expenses
2. Domestic Road Ambulance
3. Maternity Expenses – Delivery Only
4. Maternity Expenses – Comprehensive Benefit
5. Donor Expenses
6. OPD Treatment
7. Second Opinion
8. Domiciliary Hospitalization
9. Dental Treatment
10. Alternative Treatment (IPD Basis)
11. Patient Care
12. Major Diagnostics
13. Comprehensive STD Cover
14. Durable Equipment
15. Maternity Complications
16. Domiciliary Treatment
17. Cover Extended Outside India
18. Corporate Floater
19. Health Check-up
20. Alternative Treatment (OPD Basis)
21. Additional Services
22. Floater
23. Sub-Floater
24. Modification of Waiting Period
25. Premium Installment Facility
26. Network Limited to Specified Geographies
27. Network Limited to Preferred Providers
28. Sub-limit on Medical Expenses
29. Deductible
30. Hospital Accommodation – Twin sharing Room
31. Hospital Accommodation – Single Private Room
32. Sub-Limit on Illness/Surgeries/Procedures
33. Co-Payment
34. STD Cover

Waiting Period Applicable to Group Care Insurance

The following waiting period shall apply to this policy individually to each insured member:

1. Initial Waiting Period – 30 days (Applicable to Treatment of Illness)
2. Pre-existing Disease – 48 months
3. Specific Illnesses/Treatments – 24 months

Exclusions from Group Care Insurance

The insurer shall not pay for the medical expenses arising out of the following:

1. Investigation & Evaluation
2. Rest Cure, rehabilitation and respite care
3. Obesity/Weight Control Programs
4. Change-of-Gender treatments
5. Cosmetic or Plastic Surgery
6. Self-inflicted injuries or attempted suicide
7. Participation in hazardous or adventure sports
8. Breach of law
9. Treatments received by excluded providers
10. Treatment for, Alcoholism, drug or substance abuse or any addictive condition and its consequences
11. Treatments received in health hydros, nature cure clinics, spas or similar establishments
12. Unprescribed dietary supplements and substances
13. Treatment for correction of eyesight due to refractive error < 7.5 diopters
14. Unproven treatments
15. Sterility and infertility treatment
16. Medical treatment expenses traceable to childbirth, miscarriage and lawful medical termination of pregnancy
17. Circumcision unless necessary for the treatment of a disease or injury
18. Cost of spectacles, contact lenses and hearing aids
19. Dental treatment or surgery unless requiring hospitalization
20. Convalescence, general debility, ‘run-down’ condition venereal disease
21. Medical expenses arising out of Human T-Cell Lymphotropic Virus Type III (HTLV III), Lymphadenopathy Associated Virus (LAV), the Mutants Derivative or Variations Deficiency Syndrome or any Syndrome or condition of a similar kind
22. Disease or injury caused by nuclear weapons/materials.
23. Any non-medical expenses as specified in the policy schedule
24. War and warlike occurrence or invasion
25. Out-patient Treatments
26. Non-allopathic treatments