Insurance Plans 974 views December 9, 2019

Care Senior Health Insurance Plan

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 which 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.

Benefits of Care Senior Health Insurance Plan

The plan has many benefits which can be summarized as follows:

  1. 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.
  2. To combat the ever-increasing medical costs, the plan has a high sum insured facility.
  3. An exhaustive health check-up is an in-built benefit under this plan.
  4. The plan provides coverage for substitute treatment as well if the insured is interested and wishes to go for the same.
  5. The plan gives the coverage of Ambulance charges which helps an insured to get rid of other types of expenses.

The Company understands the following aspects which are essential for health insurance for a senior citizen:

  1. Cost:  Care appreciates the fact that there are individuals with various income categories and hence they have products which suit all categories of individuals.
  2. Extensive Coverage:  The coverage provided by the company is such that it provides and reimburses the insured person with almost all kinds of medical costs which are associated with old age.
  3. Ease: The plan comes with all the benefits that are easy to understand and handle.

Features of Care Senior Health Insurance Plan

  1. Presence of Individual and Floater Cover Plans.
  2. The facility of an Annual health check-up for insured individuals
  3. No requirement of Pre-policy medical check-up
  4. Automatic recharge of the Sum Insured
  5. No Claim Bonus and No Claim Bonus Super allows Up to 150% increase in Sum Insured.
  6. Tax benefit on a premium of up to 75000 u/s 80D of the Income Tax Act, 1961

Policy Terms of Care Senior Health Insurance Plan

Minimum Age of EntryIndividual- 61 years and up.
Floater- 2 Adults -Self, spouse, Mother & Father
Maximum Age of EntryLifelong
Proposer’s Age18 Years and up
Age of ExitLifelong
Type of CoverIndividual up to 6 members and Floater
RenewalLifetime
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 - Explicit24 Months
Waiting period for Pre-existing Diseases 24 Months
Initial Waiting period30 Days

Policy Details

Now we will have a look at the details of Care Senior Health Insurance Plan

Name of the PlanCare 8Care 9
Annual Sum Insured
(Rs)
3 Lakhs5 Lakhs, 7 Lakhs & 10 Lakhs
Tenure of the plan1 year, 2 years & 3 years1 year, 2 years & 3 years
Day Care ChargesTill Sum InsuredTill Sum Insured
In-patient CareTill Sum InsuredTill Sum Insured
Annual Health Check upOnce a yearOnce a year
Pre-Hospitalization ChargesPre-Hospitalization expenses for 30 days & Maximum up to Sum InsuredPre-Hospitalization expenses for 30 days & Maximum up to Sum Insured
Post-Hospitalization ChargesPost-Hospitalization for 60 days Maximum up to Sum InsuredPost-Hospitalization for 60 days Maximum up to Sum Insured
Cover of AmbulanceRs 1500 /hospitalizationRs 2000 /hospitalization
Sum Insured RechargeTill Sum Insured which is once in a Policy YearTill Sum Insured which is once in a Policy Year
Domiciliary ChargesUp to 10% of Sum Insured crossing 3 days of hospitalizationUp to 10% of Sum Insured crossing 3 days of hospitalization
Cover of Organ DonorUp to Rs 50000Up to Rs 100000
Coverage of Daily AllowanceRs. 500 per day with a maximum of 5 days per hospitalization
Not Applicable
Cost of Second OpinionOn one occasion per Major Illness / Injury per policy year
On one occasion per Major Illness / Injury per policy year
No Claim BonusIn 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 TreatmentUp to Rs 15000Up to Rs 20000
Room RentUp to 1% of Sum Insured each day
Single Private Room subject to a maximum of 1% of Sum Insured each day
ICU CostsUp to 2% of Sum Insured each day
Up to 2% of Sum Insured each day
Cataract TreatmentUp to Rs 20000 for each eyeUp to Rs 30000 for each eye
Total Knee Replacement CostsUp to Rs 80000 for each KneeUp to Rs 1 Lakh for each Knee

Claim Procedure

Here is the step by step procedure of claim for Senior Health Insurance Plan

  1. Emergency Hospitalization: The insured has to intimate the insurer within 24 hours of hospitalization.
  2. Planned Hospitalization: The insured has to inform the insurer 48 hours before hospitalization.
  3. The toll-free numbers are 1800 102 4488 and 1800 200 6677 can be contacted where there are specialized people available for assistance.
  4. For cashless, the preauthorization 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.
  5. For reimbursement, all essential documents have to be sent to the insurer for further processing.
  6. The insurer will notify the insured in case of any rejection with reason.

Documents Necessary for Claiming Senior Health Insurance Plan of Care

The claim is to be made within 30 days from the date of discharge with the following essential 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. Summary of Discharge
  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.

Conclusion

From the above discussion, it is clear that the Senior Health Insurance Plan of Care is an appropriate health insurance plan for Privileged citizens, namely, senior citizens to guard them against the unforeseen medical hazards and protects them financially as well to lead a hassle-free life.

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