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Insurance Plans 1716 views December 9, 2019
The title itself speaks about a health insurance plan which is specifically designed for senior citizens who are an integral part of the society. Senior Citizens need special care about their health and here comes the importance of having a comprehensive health insurance plan that will help take care of all the financial requirements for good health and protects against any sudden financial need.
Care Health Insurance Company recognizes the above fact and hence has a product that is only dedicated to senior citizens. We will talk about the Care Care Senior Health Insurance Plan in the below article.
Table of Contents
Benefits of Care Health Care Senior Plan
The plan has many benefits that can be summarized as follows:
- The period of any illness or disease is very uncertain and hence it is essential that a health insurance plan takes care of the Pre and post-hospitalization charges. This plan has the facility to cover the insured individual through an extended period of illness.
- To combat the ever-increasing medical costs, the plan has a high sum insured facility.
- An exhaustive health check-up is an in-built benefit under this plan.
- The plan provides coverage for substitute treatment as well if the insured is interested and wishes to go for the same.
- The plan gives the coverage of ambulance charges and helps an insured get rid of other types of expenses.
The Company understands the following aspects which are essential for health insurance for a senior citizen:
- Cost: Care appreciates the fact that there are individuals with various income categories and hence they have products that suit all categories of individuals.
- Extensive Coverage: The coverage provided by the company is such that it provides and reimburses almost all kinds of medical costs associated with old-age people.
- Ease: The plan comes with all the benefits that are easy to understand and handle.
Features of Care Health Care Senior Plan
- Presence of Individual and Floater Cover Plans.
- The facility of an Annual health check-up for insured individuals
- No requirement of Pre-policy medical check-up
- Automatic recharge of the Sum Insured
- No Claim Bonus and No Claim Bonus Super allows Up to 150% increase in Sum Insured.
- Tax benefit on a premium of up to 75000 u/s 80D of the Income Tax Act, 1961
Policy Terms of Care Health Care Senior Plan
| Minimum Age of Entry | Individual- 61 years and up. Floater- 2 Adults -Self, spouse, Mother & Father |
| Maximum Age of Entry | Lifelong |
| Proposer’s Age | 18 Years and up |
| Age of Exit | Lifelong |
| Type of Cover | Individual up to 6 members and Floater |
| Renewal | Lifetime |
| Co- Payment | 20% per claim, where the age of the Insured individual or the oldest person is 61 years or up. (Non-compulsory for present Insured Individual on reaching 61 years of Age) |
| Waiting period - Explicit | 24 Months |
| Waiting period for Pre-existing Diseases | 24 Months |
| Initial Waiting period | 30 Days |
Policy Details
Now we will look at the details of Care Senior Health Insurance Plan
| Name of the Plan | Care 8 | Care 9 |
|---|---|---|
| Annual Sum Insured (Rs) | 3 Lakhs | 5 Lakhs, 7 Lakhs & 10 Lakhs |
| Tenure of the plan | 1 year, 2 years & 3 years | 1 year, 2 years & 3 years |
| Day Care Charges | Till Sum Insured | Till Sum Insured |
| In-patient Care | Till Sum Insured | Till Sum Insured |
| Annual Health Check up | Once a year | Once a year |
| Pre-Hospitalization Charges | Pre-Hospitalization expenses for 30 days & Maximum up to Sum Insured | Pre-Hospitalization expenses for 30 days & Maximum up to Sum Insured |
| Post-Hospitalization Charges | Post-Hospitalization for 60 days Maximum up to Sum Insured | Post-Hospitalization for 60 days Maximum up to Sum Insured |
| Cover of Ambulance | Rs 1500 /hospitalization | Rs 2000 /hospitalization |
| Sum Insured Recharge | Till Sum Insured which is once in a Policy Year | Till Sum Insured which is once in a Policy Year |
| Domiciliary Charges | Up to 10% of Sum Insured crossing 3 days of hospitalization | Up to 10% of Sum Insured crossing 3 days of hospitalization |
| Cover of Organ Donor | Up to Rs 50000 | Up to Rs 100000 |
| Coverage of Daily Allowance | Rs. 500 per day with a maximum of 5 days per hospitalization | Not Applicable |
| Cost of Second Opinion | On one occasion per Major Illness / Injury per policy year | On one occasion per Major Illness / Injury per policy year |
| No Claim Bonus | In case of no claim a 10% increase in Sum Insured per Policy subject to a maximum of up to 50% of Sum Insured (10% reduction in Sum Insured per Policy Year in case a claim. Such reduction is only in Sum Insured accumulated as No Claim Bonus) | In case of no claim a 10% increase in Sum Insured per Policy subject to a maximum of up to 50% of Sum Insured (10% reduction in Sum Insured per Policy Year in case a claim. Such reduction is only in Sum Insured accumulated as No Claim Bonus) |
| Substitute Treatment | Up to Rs 15000 | Up to Rs 20000 |
| Room Rent | Up to 1% of Sum Insured each day | Single Private Room subject to a maximum of 1% of Sum Insured each day |
| ICU Costs | Up to 2% of Sum Insured each day | Up to 2% of Sum Insured each day |
| Cataract Treatment | Up to Rs 20000 for each eye | Up to Rs 30000 for each eye |
| Total Knee Replacement Costs | Up to Rs 80000 for each Knee | Up to Rs 1 Lakh for each Knee |
Claim Procedure
Here is the step-by-step procedure of claim for Senior Health Insurance Plan
- Emergency Hospitalization: The insured has to intimate the insurer within 24 hours of hospitalization.
- Planned Hospitalization: The insured has to inform the insurer 48 hours before hospitalization.
- The toll-free numbers are 1800 102 4488 and 1800 200 6677 can be contacted where there are specialized people available for assistance.
- For cashless, the pre-authorization form has to be filled in and is available at the hospital’s insurance desk after which the fax is sent. The approval letter is being sent after the fax received. Inquiries need to be answered with details by the insured or the hospital as applicable.
- For reimbursement, all essential documents have to be sent to the insurer for further processing.
- The insurer will notify the insured in case of any rejection with reason.
Documents Necessary for Claiming Care Health Care Senior Plan
The claim is to be made within 30 days from the date of discharge with the following essential documents:
- The Claim Form to be filled with correct details and to be signed by the insured person
- Photo Identity proof of the insured
- Summary of Discharge
- Original bills and receipts
- Doctor’s prescriptions
- All original and pathologic test reports
- Receipt of Ambulance
- Home Care Benefit notes and receipts
- Any document, if needed by the insurer
Conclusion
From the above discussion, it is clear that the Senior Health Insurance Plan of Care is an appropriate health insurance plan to guard senior citizens against the unforeseen medical hazards and protects them financially as well as helps them lead a hassle-free life.