Health Insurance 406 views November 13, 2021

Care Advantage offers you wide coverage for your medical needs and keeps your savings intact with the same. The plan covers persons aged 91 days and above, and you can continue this policy for lifelong. The key features of this Care Health Insurance Policy are as follows –

  • Coverage for Hospitalization Expenses
  • Pre & Post-Hospitalization Cover
  • Ambulance Cover
  • No Claim Bonus
  • Organ Donor Cover
  • Automatic Recharge
  • Optional Covers

Read this page below and know more about the coverage and benefits of the Care Advantage Health Insurance Plan.

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Coverage Under the Care Advantage

If you purchase this Care Health Insurance Plan, the company shall pay for the following medical expenses –

  • In-patient care
  • Daycare treatment
  • Advance technology methods
  • Pre and post-hospitalization expenses up to 30 and 60 days, respectively
  • Ambulance cover up to an amount specified in the policy schedule per hospitalization
  • Organ donor expenses incurred during the transplant surgery

Benefits Available Under Care Advantage Health Insurance Plan

The company shall provide you the following benefits under Care Advantage, such as –

No Claim Bonus (NCB) – This is available to you after every claim-free year, subject to a maximum of 50% of the sum insured. The NCB shall accrue 10% after each claim-free year. And if a claim is filed, the same will reduce at the same rate it is accrued.

Automatic Recharge – In case your sum insured is exhausted, the insurance company will restore it to 100%, so that you can file a claim in case of a hospitalization. You can utilize the restored sum insured for hospitalization, pre and post-hospitalization, ambulance and daily cash allowance only.

Care Advantage Optional Covers

The company shall provide you with the following add-on covers to enhance the coverage.

No Claim Bonus Super – Under this, you’ll get a 50% NCB besides the above for each claim-free year, subject to a maximum of 100%.

Air Ambulance cover – The company shall cover the expenses of air ambulances in India, provided the same is offered by the hospital or ambulance service provider.

Deductible Option – With this add-on, the medical cover shall begin as soon as the expenses cross the deductible chosen by you. Suppose the deductible is INR 10 Lakh, the insurer will cover your expenses once the deductible limit is crossed after one claim or multiple claims in a year.

Smart Select – If you choose this add-on, you’ll get a discount on the total premium. However, the discount won’t apply for the air ambulance, annual health check-up and daily allowance cover. You can receive treatment at the listed hospitals as mentioned in the prospectus of Care Advantage. If you don’t receive treatment at the listed hospitals, a 20% copayment shall apply above the existing copayment (if any).

Reduction in PED Waiting Period – With this cover, you can reduce your waiting period from 48 months to 24 months. So, the regular waiting period shall not apply and you can get coverage for pre-existing diseases after a continuous cover of 24 months.

Copayment – Under this add-on cover, you’ll get two options – copayment and copayment waiver. If you choose copayment, you can choose to copay – 5%, 10%, 15% or 20% of your claim amount, and the rest will be paid by the company, provided your entry age is less than 61 years. And if you choose a copayment waiver, the company will waive the mandatory copayment of 20%.

Annual Health Check-up – The insurer shall cover the annual medical tests if the sum insured is up to INR 75 Lakh and the person is aged 18 years or above.

Room Rent Modifications -If you choose this add-on cover, you’ll get a discount on the premium you pay, and the room rent which has ‘no limit’ shall be limited to a single private room.

Daily Allowance – The company shall pay you a daily allowance if you’re hospitalized for up to 24 hours or more. You can avail of this benefit up to 30 days in a policy year.

Additional sum Insured for Accidental hospitalization – If you’re hospitalized due to an accident, the company shall pay an additional sum insured besides the above coverage. The additional sum insured shouldn’t exceed the sum of base sum insured, NCB and NCB Super.

Unlimited Automatic Recharge – In case the sum insured is exhausted due to claims, with this add-on, you can restore the sum insured as many times you want in a policy year with no restrictions. But for this, you need to pay an extra premium.

Who can be Covered Under Care Advantage?

The policy can be purchased on an individual or family floater basis, and you can cover the following relationships –

Individual Plan – Self, spouse, son, daughter, father, mother, brother, sister, mother in law, father in law, grandmother, grandfather, grandson, nephew, niece, uncle, aunt, employee or any other relationship with an insurable interest.

Family Floater – Self, spouse, son, daughter, father, mother, employee and his/her dependents or any other relationship with an insurable interest.

Eligibility Criteria for Care Advantage

You can buy this Care Health Insurance Plan if you meet the below criteria –

  • Minimum Entry Age – 5 years for an individual plan and 91 days for a family floater plan
  • Maximum Entry Age – Lifelong
  • Minimum Entry Age of the Proposer – 18 years

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