Health Insurance 1203 views May 11, 2021

Care Health Grameen Care Plan is a micro health insurance plan that offers coverage against hospitalization expenses to a group of people at an affordable price. This plan also pays when a policyholder meets with an accident resulting in his/her death or permanent total disablement during the policy term.

With the Care Health Grameen Care Plan, Policyholders can opt for either Benefit 1 (Hospitalization expenses) or Benefit 2 (Personal Accident) or both according to their needs. However, the coverage under benefit 2 is available only on an individual basis. You should check some prominent features of this plan before going any further. We are mentioning the same below. Please check!

  1. A choice to make from two benefit options
  2. No pre-policy issuance medical check-up
  3. Lifelong exit age
  4. A 15-day free look period

This article will help you understand the benefits of the Care Health Grameen Care Plan in detail so that you can decide accordingly. Without any further delay, let’s start!

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Let’s Understand the Benefits of Care Health Grameen Care Plan in Detail

Care Health Grameen Care Plan is a micro-insurance plan that provides a wide range of benefits to a group of people in a medical emergency along with death or permanent total disability due to an accident. Want to know these benefits in detail? Well, keep reading!

Hospitalization Expenses

Care Health Grameen Care Plan covers the hospitalization expenses if the insured member needs hospitalization due to a diagnosed illness or injury (including pre-existing diseases coverage from Day 1). The sum insured under this benefit stands at INR 50,000. Also, to get coverage for hospitalization expenses, you should be admitted to one of the Care network hospitals in India.

Under Benefit 1, policyholders will receive coverage against the following expenses incurred during their treatment.

In-patient Care

This micro-insurance plan provides coverage (up to the sum insured limit) if the insured member needs hospitalization for a minimum of 24 consecutive hours and is advised by a medical practitioner.

Day Care Treatment 

Policyholders will also get coverage against medical expenses incurred on day care treatments (the period of these treatments in a network hospital does not exceed 24 hours) up to the sum insured limit.

Advanced Technology Methods

Care Health Grameen Care Plan will also provide coverage against expenses incurred on in-patient care and day care treatment with the following advanced technology methods.

  1. Uterine Artery Embolization and HIFU
  2. Balloon Sinuplasty
  3. Deep Brain stimulation
  4. Oral chemotherapy
  5. Immunotherapy- Monoclonal Antibody to be given as an injection
  6. Intra vitreal injections
  7. Robotic surgeries
  8. Stereotactic radio surgeries
  9. Bronchial Thermoplasty
  10. The vaporization of the prostate (Green laser treatment or holmium laser treatment)
  11. IONM – (Intra Operative Neuro Monitoring)
  12. Stem cell therapy

Pre and Post-Hospitalization Expenses Coverage

With this plan from Care Health, policyholders will also get coverage up to the sum insured against pre-hospitalization (for 1 day immediately before the policyholder’s date of hospitalization) and post-hospitalization expenses (for a maximum of 5 days after the date of discharge from the network hospital).

Maternity Expenses 

If an insured member needs hospitalization to get the treatment for pregnancy (including normal delivery/ cesarean/ miscarriage/ and/ or abortion by accident or other medical emergencies), this policy will cover the expenses up to the sum insured.

However, policyholders need to complete a waiting period of 9 months to get this benefit and only the first two children will be considered in respect of any insured member covered under the policy.

Personal Accident

Policyholders can also choose this benefit option (individually or with the benefit 1 option) offering a minimum sum insured of INR 25,000. However, it can be increased up to INR 1 lakh in the multiples of INR 1,000.

With this benefit option, policyholders will get a fixed benefit amount as 100% of the sum insured in case of accidental death or permanent total disability (within 12 months from the occurrence of the accident). This benefit is only applicable to primary insured members and their spouses. To know more, please check the below table.

Insured EventAmount Payable = % of the Benefit 2 (Personal Accident) Sum Insured
Loss of sight of both eyes, or speech or hearing of both ears, or

Loss by physical separation of two entire hands or two entire feet or One entire hand and one entire foot, or

Loss of sight of one eye and loss by physical separation of one entire hand or one entire foot
Paraplegia or Quadriplegia or Hemiplegia100%

What is the Policy Term and Group Size?

The maximum tenure of the Care Health Grameen Care Plan can be 1 year. When we talk about the group size, there should be a minimum of 10 members to opt for this plan, whereas there is no maximum limit.

You can also add or exclude insured members mid-way by paying or refunding an additional premium if an individual has joined or separated the group after the inception of the policy.

Care Health Grameen Care Plan Eligibility Criteria

What are those conditions that an individual should keep in mind when choosing this plan? Check them out below!

  1. The minimum entry age for adults (including primary insured members) stands at 18 years, while children can get coverage from Day 1.
  2. The maximum entry age for primary insured persons can be 70 years, while for adults (other than primary insured members), it can be lifelong.
  3. The maximum entry age for children stands at 24 years.
  4. The insured member should be a member of the group.
  5. The dependent members should be a family member (legally married spouse or legally adopted child, dependent parents, dependent parents-in-law) of the primary policyholder.

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