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Care Advantage Health Insurance

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Care Health Insurance
Care Advantage
Cashless Approval TAT2 hr Cashless Claim Processing
Claim Settlement Ratio95.22%
Network Hospitals21,100+
Pre-existing Disease Coverage FromDay 1
Special BenefitsNo Extra Premium for Disease Coverage
Starting Premium for Rs. 5 lakhs coverageRs. 546/month

About Care Advantage Health Insurance

Care Advantage is a comprehensive health insurance policy that offers wide coverage to you and your family so that you are adequately covered at all times. The policy covers you for hospitalisation expenses incurred during hospitalisation exceeding 24 consecutive hours. You can buy the policy for 1 year, 2 years, or 3 years, depending on your budget and other requirements. Read on to learn more about the Care Advantage Health Insurance plan.

Care Advantage Health Plan at a Glance

Coverage

Individual and family

Riders

NCB Super, Co-payment waiver, Air ambulance cover, etc

Variants

N/A

Key features

Flexible sum insured, add-ons, cashless hospitalisation, etc

Inclusion

AYUSH Treatment, organ donor expenses, Pre and post hospitalisation, etc

Exclusion

Self-inflicted injuries, injuries due to consumption of alcohol, etc

Features of Care Advantage Health Insurance

Listed below are some of the key features of the Care Advantage Health insurance plan that you should know about:

  • Cashless Hospitalisation: Care Health Insurance has a tie-up with over 22,900 network hospitals. With an extensive number of network hospitals, you can get cashless hospitalisation when you buy the Care Advantage health insurance plan.
  • Sum Insured: There is a wide range of sum insured available with the Care Advantage health insurance plan. The sum insured option available includes Rs. 25 lakhs, Rs. 50 lakhs, Rs. 1 crore, Rs. 2 crore, Rs. 3 crore, and Rs. 6 crore.
  • Add-ons: To enhance the benefits of the Care Advantage health insurance plan even more, you can include a number of add-ons. However, while buying these add-ons, you need to pay additional premiums.
  • Coverage: The policy offers you several coverage benefits such as in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, organ donor expenses, daycare expenses, etc. Other benefits offered include automatic restoration of the sum insured, No Claim Bonus for every claim-free year, etc.

Eligibility Criteria for Buying Care Advantage Health Insurance Plan

Here are the eligibility criteria for buying the Care Advantage health insurance plan:

Parametres

Eligibility Criteria

Minimum entry age for child

91 days

Maximum entry age for child

24 years

Minimum entry age for adult

5 years

Maximum entry age for adult

Lifelong

Coverage type

Family or individual

Renewability

Lifelong

Benefits of Buying Care Advantage Health Insurance Plan

Some of the benefits of buying the Care Advantage health insurance plan are as follows:

  • Wider Coverage of Pre and Post Hospitalisation: With the Care Advantage health insurance plan, you will get coverage for pre-hospitalisation expenses for up to 60 days and the post-hospitalisation expenses are covered for up to 180 days of hospitalisation.
  • Restoration Benefits: The Care Advantage plan has unlimited restoration benefits. This means that if the sum insured gets exhausted after a health insurance claim, then it will automatically get restored up to 100%.
  • High Sum Insured: Unlike many other health insurance plans that Care offers, the Care Advantage has the highest sum insured option. It has a sum insured of up to Rs. 6 crores. So, depending on your budget and health insurance requirements, you can choose a sum insured of your choice.
  • Unlimited e-consultation: The Care Advantage health insurance plan also has unlimited e-consultation benefits. So, whenever you face a health issue, you can enjoy the benefit of e-consultations with a general physician of Care’s network.
  • AYUSH Treatment: In addition to modern treatment, you can also seek alternate treatments like AYUSH when you buy Care Advantage health insurance. The coverage for AYUSH treatment is up to the sum insured.
  • Tax Benefits: The Care Advantage health insurance also has tax benefits as specified under Section 80D of the Income Tax Act, 1961. So, save on taxes and get health insurance coverage at the same time with the Care Advantage plan.

Inclusions and Exclusions of Care Advantage Health Insurance

Inclusions:

  • Room rent: There is no limit on room rent when you buy the Care Advantage health plan. This means you can choose any room of your choice without worrying about the expenses.
  • ICU Charges: The Care Advantage health plan offers coverage for the ICU without any limit.
  • In-patient Care: The coverage for in-patient care is offered up to the sum insured.
  • Day care treatment: The coverage for daycare procedures is offered up to the sum insured.
  • Ambulance cover: The coverage for ambulance expenses is offered up to the sum insured.
  • Organ donor: For organ donor expenses, the coverage is offered up to the sum insured.
  • AYUSH treatment: The Care Advantage health plan has coverage for AYUSH treatment up to the sum insured.

Exclusions:

  • Any self-inflicted injury
  • Any injury due to consumption of alcohol or drugs
  • Cosmetic surgery
  • Pre-existing conditions during the waiting period

Riders Available with the Care Advantage health plan

Listed below are the riders you can include in your Care Advantage health plan:

  • Air ambulance cover: With this add-on, you will get coverage for air ambulance for up to Rs. 5 lakhs.
  • Reduction in PED waiting period: This add-on reduces the waiting period from 4 years to 2 years.
  • NCB Super: If you include this add-on to your Care Advantage health plan, the sum insured gets increased by 50% per year in case of a claim-free year. The maximum increase is up to 100%.
  • Co-payment waiver: This add-on waives off the co-payment clause if the policyholder is 61 years or older.
  • Annual health check-up: With this add-on, coverage is offered for annual health check-ups.

Documents Required to Buy Care Advantage Health Plan

Some of the documents required to buy the Care Advantage Health Plan are as follows:

  • A duly-filled proposal form
  • PAN card
  • Aadhaar card
  • Bank account details
  • Previous medical reports
  • Passport
  • Birth certificate
  • Driving licenses

How to Buy Care Advantage Health Plan?

You can buy the Care Advantage Health Plan with InsuranceDekho in a few simple steps:

Step 1: Visit the InsuranceDekho website and navigate to the "Health Insurance" section under Insurance.

Step 2: Select "Care Health Insurance" from the list of Health Insurance Companies.

Step 3: Choose the "Care Advantage" plan from the available health insurance options.

Step 4: Review the terms and conditions outlined in the Care Enhance policy document.

Step 5: Complete the KYC process by uploading all necessary documents.

Step 6: After KYC, make the online premium payment.

Step 7: You will receive the policy document in your email.

Claim Process of Care Advantage Health Plan

To raise claims with the Care Advantage Health Insurance plan, you can follow two processes, either cashless or reimbursement. Under cashless claim, you need not spend anything to get the required medical treatment, on the other hand, you first have to spend for the medical expenses which will be later reimbursed by the insurance company.

Cashless Claim

  • Visit a nearby network hospital that has tie-ups with Care
  • Submit all the required documents like your policy papers at the hospital along with duly-filled form
  • Then, the insurance company will verify all the documents
  • Once all the documents have been approved, the bills will be directly settled at the network hospital

Reimbursement Claim

  • Choose a nearby hospital, either network or non-network
  • Settle your medical bills at the hospital to get started with the treatment
  • Request a reimbursement claim on the insurance company's website
  • Submit the Care Advantage claim form and all relevant plan information.
  • After the insurance company verifies your claim, they will reimburse you for the medical expenses

Health Insurance Calculator

Whom do you want the insurance for ?

You
Couple
Family
Father
Mother

Select the age of all members

  • You

Where do you live ?

Choose required Coverage for yourself?

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Disclaimer : Actual Premium might vary basis your location, age and number of members
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Key Inclusions and Exclusions of the Plan

What's Included

  • In-patient hospitalisation expenses
  • Daycare expenses
  • Ambulance expenses
  • Organ donor expenses
  • Pre-hospitalisation and post-hospitalisation expenses

What's Not Included

  • Change of gender treatments
  • External congenital disease
  • Alcohol or drug use/abuse/misuse related expenses
  • Diagnostic and evaluation based treatment expenses
  • Expenses arising due to self-inflicted injury resulting from suicide or attempt of suicide

6003 Care Cashless Network Hospitals in India

Choose Care Health Insurance Critical Illness Plan

Add-ons to Enhance Benefits

  • Smart Select

    With this add-on feature, you can avail a 15% discount by restricting treatment on especially created smart select network hospitals.
  • No Claim Bonus Super

    No Claim Bonus allows you to increase the sum insured amount by 50% for every claim free year up to a maximum of 100%.
  • Room rent modification

    If you choose this add-on cover, then the room rent or room category will be limited to a single private room.
  • Care Shield

    There are 3 benefits offered under the Care Shield add-on benefit. These are the claim shield, No Claim Bonus shield, and inflation shield. 1. Claim Shield: It covers several non-payable expenses including attendant expenses, gloves, mask etc. 2. No Claim Bonus Shield: If the total claim amount payable under your policy is less than 25% sum insured, then NCB or NCB super will not be reduced. 3. Inflation Shield: This benefit increases the sum insured of the base policy on cumulative basis at every renewal on the basis of inflation rate in the previous year.
  • Co-payment waiver

    If you opt for this add-on, then if the age of the eldest member is 61 years or above, you can get rid of the 20% co-payment clause. The insurance company will pay as per the terms and conditions of the policy.

Claim Process at Care Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

FAQs on Care Advantage Health Insurance Plan

  • What is the minimum and maximum age limit for a Care Advantage plan?

    The minimum entry age for Care Advantage policy for adults is 5 years and for child is 91 days (floater policy). Whereas there is no limit on maximum entry age for adults. For children, the maximum entry age is 24 years. 

     

  • What are the waiting periods under Care Advantage policy?

    Care Advantage policy comes with an initial waiting period of 30 days. Whereas for specific ailments and pre-existing diseases, the waiting period is of 24 months and of 48 months respectively. 

  • Is there any co-payment clause under Care Advantage policy?

    Yes. A co-payment of 20% per claim is applicable where the insured or the eldest member is 61 years or more. 

  • What are the floater combinations under Care Advantage policy?

    The floater combinations under Care Advantage policy are: 1 adult+1 child, 1 adult+2 children, 1 adult+3 children, 1 adult+4 children, 2 adults, 2 adults +1 child, 2 adult+2 children, 2 adult+3 children, and 2 adult+4 children. 

  • What are the policy terms for Care Advantage policy?

    Care Advantage policy can be purchased for terms of 1 year, 2 years, or 3 years. 

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