Health Insurance 4566 views December 6, 2019

Care Health Care Joy Plan

Health Insurance Plans are always important to cover or guard us against the increased cost of hospitalization. Another aspect of health insurance is to be prepared for a most wonderful tremendous moment of joy in anyone’s life which is childbirth. Needless to say, it is a big responsibility as well from the time one hears this news. Hence, any parent would like to have complete monetary protection for the mother and the new child.

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Care Health Insurance Company recognizes the above fact and provides a unique plan to cover both the mother and the child under their Care Joy Health Insurance Plan. We will study in detail about the Care Joy Health Insurance Plan in the below article.

Benefits of Care Health Care Joy Plan

The plan has various benefits which can be described as follows:

Cover of Maternity

Expenses that are made for Maternity expenses incurred for hospitalization for delivery are covered under the Joy Plan. The plan also covers the pre and post-natal charges.

Coverage of New-born Baby

From birth till full 90 days the plan covers all the medical costs for the newborn and post 90 days, the newborn is covered under the regular plan with a premium as applicable.

New Born Birth Defects

In case, the newborn is detected with Down’s Syndrome or Cerebral Palsy, the company will pay a lump sum amount.

Pre and Post Hospitalization Benefit

The plan compensates the Pre and Post Hospitalization charges that are incurred by the insured before and after hospitalization

  1. Pre-Hospitalization- Up to 30 days all expenses incurred for pre-hospitalization diagnostics and medicines are covered. Daycare medical expenses are also taken care of in case the hospitalization is less than 24 hours. Ambulance costs are also covered under this
  2. Post Hospitalization- Up to 60 days all expenses like medicines, follow-up visits to doctors’ charges, etc are reimbursed

All-Inclusive Coverage

  1. In-Patient Care – This unique plan covers hospitalization expenses like doctor’s fees, surgeon’s fees, room charges, blood, oxygen, ICU charges, etc. in case of a minimum of 24 hours of hospitalization.
  2. Day-Care – In the case of fewer than 24 hours of hospitalization also, the medical costs will be covered.

A Complete Nil Payment

The extensive range of hospital networks ensures a nil payment with a cashless facility.

Ease at Policy Term

The period of the policy is 3 years which makes the policy, an easy one to handle.

Claim Settlement

With the Care Health Insurance Joy Card, the process of claim becomes easy and hassle-free. This card can be shown to the leading 4000 hospitals all over India and one can avail of the cashless facility.

Medical Check-up Before the Policy

The company takes care of the medical costs which are incurred before availing the policy.

Income Tax Benefit

Income Tax Benefit can also be availed under the Income Tax Act, 1961 for the premium paid towards under section 80D.

TypePremium paid towards self, spouse and childrenPremium paid towards parentsTotal 80D Benefit
Self, Spouse and Children<60
Maximum INR 25,000Maximum INR 25,000Maximum INR 50,000
Self, Spouse and Children<60
Maximum INR 25,000Maximum INR 50,000Maximum INR 75,000
Self, Spouse and Children>60
Maximum INR 50,000Maximum INR 50,000Maximum INR 1,00,000

Freelook Period

One can cancel the policy if he/she is dissatisfied with the terms and conditions within 15 days of the receipt of the policy document.

Advantages of Care Health Care Joy Plan

  1. A seamless blend of maternity together with hospitalization plan.
  2. Complete coverage of New-born baby
  3. A rapid 9 months wait to claim the expenses under maternity
  4. Policy term of 3 years
  5. No Claim Facility

Terms of Policy of Care Health Care Joy Plan

Minimum Age of EntryAdult- 18 years
Child- 1 day
New Born-1 day
Maximum Age of EntryAdult- 65 years
Child- 24 years
New Born- 90 days
Type of CoverIndividual up to 6 members and Floater
Proposer’s Age18 years or above
Age of ExitLifetime
Combinations in Floater 2 Adults, 2 Adults and 1 Child, 2 Adults and 2 Children
Coverages Individual: Self, spouse, daughter, son, brother, sister, granddaughter, grandson, niece, son-in-law, Daughter-in-law, nephew, employee.
Family Floater: Self, spouse, daughter, son, mother, father, employee and his/her dependants.
Maximum age of Maternity CoverUp to 45 years of age
Grace Period30 days from the expiry date for renewing the policy

Now we will have a detailed view of the benefits under Care Joy Health Insurance Plan

Name of the PlanJoy TodayJoy Tomorrow
Tenure of the plan 3 years1 year, 2 years & 3 years
Cover for Maternity (inclusive of Pre & Post Natal costs)Up to Rs. 35,000 for 3 Lakhs SI
Up to Rs. 50,000 for 5 Lakhs SI
Up to Rs. 35,000 for 3 Lakhs SI
Up to Rs. 50,000 for 5 Lakhs SI
Cover for New Born BabyUp to Rs. 35,000 for 3 Lakhs SI
Up to Rs. 50,000 for 5 Lakhs SI
Up to Rs. 35,000 for 3 Lakhs SI
Up to Rs. 50,000 for 5 Lakhs SI
Defects for New Born BirthNot Valid Rs 50000
Day Care ChargesApplicableApplicable
In-patient CareUp to Sum InsuredUp to Sum Insured
Pre-Hospitalization ChargesTill 30 daysTill 30 days
Post-Hospitalization ChargesTill 60 daysTill 60 days
Ambulance ChargesTill Rs 1000/ hospitalizationTill Rs 1000/ hospitalization
Coverage of DialysisTill Rs 1000/ sittingTill Rs 1000/ sitting
Room Single AC Private RoomSingle AC Private Room
Initial Waiting Period 30 Days 30 Days
Termed Ailments24 Months24 Months
Pre-Existing Diseases48 Months48 Months

Pre-Policy Medical Tests of Care Health Care Joy Plan

The following grid will be applicable in case of pre-policy medical check-up

Age and Sum Insured3 Lakhs5 Lakhs
46 years till 55 yearsRefer List 1 belowRefer List 2 below
56 years and aboveRefer List 2 belowRefer List 2 below

List 1 & List 2

Routine and Microscopic Urine AnalysisRoutine and Microscopic Urine Analysis
Medical Examination ReportMedical Examination Report
Complete Blood Count with ESRComplete Blood Count with ESR
ECGLiver Function Test
Serum Total CholesterolKidney Function test
SGPTLipid Profile Fasting
Female- USG (Abdomen Pelvis)HBsAg
S CreatinineTMT/ ECG with 2-D Echo
Serum PSA (Male) USG

Claim Procedure of Care Joy Health Insurance Plan

Step by step procedure on how to claim

  1. Emergency Hospitalization: The insured must notify the insurer within 24 hours of hospitalization
  2. Planned Hospitalization: The insured must notify the insurer 48 hours before hospitalization
  3. Contact: The toll-free numbers are 1800 102 4488 and 1800 200 6677 where once can speak to an expert. Also, once can write to
  4. Pre-authorization: In case of cashless hospitalization, the preauthorization form needs to be completed which is available at the hospital’s insurance desk post which a fax copy will be sent and thereafter, the approval letter. Any inquiries, when asked by the insurer needs to be responded with particulars.
  5. Reimbursement Claim: In the case of reimbursement, all mandatory documents need to be referred to the insurer for further processing of the claim.
  6. The insurer will apprise the insured with reason in case the claim is rejected, else the claim will be easily admitted.

Documents for Care Health Care Joy Plan

The claim is to be made within 30 days from the date of discharge with the following required documents:

  1. The Claim Form to be filled with correct details and to be signed by the insured person
  2. Photo Identity proof of the insured
  3. Discharge Summary
  4. Original bills and receipts
  5. Doctor’s prescriptions
  6. All original and pathologic test reports.
  7. Receipt of Ambulance
  8. Home Care Benefit notes and receipts
  9. Any document, if needed by the insurer.


We can conclude from the above discussion that the Care Joy Health Insurance Plan is a wide-ranging health plan which takes care of uncertainties and tension which arise at the of the newborn baby. One can safely apply for the plan and enjoy the joyous occasion and welcome the new member in the family in peace.

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