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Care Enhance Health Insurance

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Care Health Insurance
Care Enhance
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 Enhance Health Insurance

Care Enhance is an advanced super top-up health insurance policy designed to cover critical illnesses with treatment expenses that exceed conventional expectations. The policy offers two variants, Enhance 1 and Enhance 2, each differing in coverage benefits, sum insured, and deductible options.

A noteworthy feature of the policy is the exemption from pre-policy medical check-ups for coverage, provided the combined deductible and sum insured are below Rs. 40 lakh and the insured individual is under 50 years of age. Additionally, the policy includes the Enhance Anywhere feature, allowing access to selected medical treatments globally.

Care Enhance facilitates hassle-free cashless treatments at leading hospitals nationwide. Coverage benefits of this health insurance policy include in-patient care, daycare expenses, pre-hospitalisation, and post-hospitalisation expenses, and the Enhance Anywhere feature.

Care Enhance Health Insurance At a Glance

Highlights of Care Health Care Enhance Insurance are listed below in the table:

Coverage

Both Individual and Family Floater

Riders

Everyday Care, Expert Opinion, etc.

Policy Period

1, 2, and 3 years

Key Features

Flexible Coverage Option, Global Medical Access, etc.

Inclusion

Pre and Post Hospitalisation, Ambulance Expenses, etc..

Exclusion

Pre-existing Conditions, AIDS, etc.

Renewability

Lifelong

Riders Available With Care Enhance Health Insurance

The riders available with Care Enhance Top-up policy are as follows:

  • Everyday Care: In this supplementary benefit, Care Health Insurance extends coverage for your everyday care needs. This includes access to the health portal, a free health helpline, health and wellness offers, and up to four consultations with doctors for the same illness within a policy year.
  • Expert Opinion: Enhance your coverage with the Expert Opinion add-on. This provides additional medical opinions related to major illnesses diagnosed during the policy term. It is specifically arranged for conditions like cancer, multiple sclerosis, end-stage renal failure, benign brain tumors, and more.

Key Features of Care Enhance Health Insurance Plan

The following are the key features of the Care Enhance Health Insurance Plan:

  • Flexible Coverage Options: Choose from a variety of coverage amounts, ranging from Rs. 1 lakh to Rs. 55 lakhs, to suit your needs.
  • Yearly Health Check-Up: Every year, adults covered by the plan can undergo a health check-up, regardless of their past claims.
  • No Pre-Policy Health Check-Up: If your coverage is under Rs. 40 lakhs, no health check-up is required until you reach 50 years of age.
  • Global Medical Access: This feature ensures you can receive medical treatment worldwide, without being limited by location.
  • Effortless Cashless Treatment: Access cashless treatment at over 8350 network hospitals. Forget about upfront payments; just focus on your recovery.
  • Professional Advice: Seek a second opinion from a doctor or expert if you're uncertain about an illness or need professional advice.
  • Comprehensive Coverage: The plan covers pre- and post-hospitalisation expenses, including medical exams, follow-up visits, and consultations.
  • Organ Donor Support: Receive reimbursement for medical expenses incurred by an organ donor during transplant surgery.
  • Tax Savings: Enjoy significant tax benefits under the Income Tax Act, of 1961, while paying premiums for the plan.

Eligibility Criteria of Care Enhance Health Insurance Plan

The eligibility criteria for the Care Enhance insurance plan are as follows:

Parameters

Eligibility Criteria

Minimum entry age

For Adults: 18 years

For Child: 1 Day (Floater) and 5 Years (individual)

Maximum entry age

For Adults: No Age Limit

For Child: 24 Years

Sum insured

Rs. 1 lakh to 55 lakhs

Variants of Care Enhance Health Insurance Policy

The two different variants of the Care Enhance Policy are as follows:

  • Variant 1: This variant offers a sum insured ranging from Rs. 1 lakh to 25 lakh. The deductible options include the existing sum assured or the flexibility to choose a deductible of up to Rs. 1-5 lakhs. This provides a tailored approach to coverage, allowing individuals to select the sum insured and deductible that best suits their needs.
  • Variant 2: For those seeking higher coverage, Variant 2 provides a sum insured from Rs. 6 lahks to 30 lakhs. The deductible options in this variant encompass the existing sum assured or the choice to opt for a deductible of up to Rs. 6-10 lakh. This variant caters to individuals with diverse coverage requirements, offering a broader spectrum of options for both sum insured and deductibles.

Benefits of Care Enhance Health Insurance Plan

The benefits of the Care Enhance Health Insurance Plan are as follows:

  • Comprehensive Daycare and Hospitalisation Coverage: Enjoy coverage for 170 daycare treatments along with hospitalisation expenses if the stay exceeds one day.
  • Extensive Network for Cashless Treatment: Access cashless medical treatment at more than 15,000 network hospitals, ensuring convenient healthcare services.
  • Annual Health Check-ups: The primary policyholder and adult members receive complimentary comprehensive health check-ups every year, promoting proactive health management.
  • Pre and Post-Hospitalisation Benefits: Receive coverage for 30 days pre-hospitalisation and 60 days post-hospitalisation expenses, ensuring a holistic approach to healthcare.
  • No Caps on Specific Expenses: Benefit from a policy with no restrictions on expenses such as operation theater costs, doctor/surgeon fees, and allied charges, providing financial flexibility for medical procedures.
  • No-Claim-Based Premium Loading: Enjoy the advantage of no premium loading based on the absence of claims, rewarding policyholders for maintaining a healthy lifestyle.
  • Unlimited Hospitalisation Coverage: Experience peace of mind with no limits on hospitalisation expenses, up to the chosen sum insured, ensuring comprehensive financial protection during medical emergencies.

Inclusions of Care Enhance Health Insurance Plan

Below listed are the inclusions of the Care Enhance Health Insurance Plan:

  • Pre and Post-Hospitalisation: Ensure your peace of mind with coverage extending 30 days before hospital admission and 60 days after discharge, taking care of expenses on both ends of your medical journey.
  • Ambulance Expenses: Rest easy knowing that any costs related to ambulance services are covered, ensuring you have a worry-free journey to the care you need.
  • Organ Donor Medical Expenses: Support the noble act of organ donation without concerns about medical expenses, as the policy takes care of the costs associated with this life-saving procedure.
  • Domiciliary Hospitalisation: The Care Enhance policy covers domiciliary hospitalisation, allowing for treatment at home instead of a hospital when your health condition requires it.
  • Single Private Room: Experience a more comfortable recovery with the option of a single private room during your hospital stay, providing a personalised and serene environment.
  • Organ Donor Cover: For those choosing to be organ donors, our policy extends coverage for related medical expenses, supporting your altruistic decision to contribute to saving lives.

Exclusions of Care Enhance Health Insurance Plan

The following are the exclusions:

  • Initial 30-day: During the first 30 days of the policy, no coverage is provided for surgeries, diagnosed diseases, or events with symptoms that first occur.
  • Pre-Existing Conditions: Any injuries or ailments existing before policy issuance and diagnosed within four years of the first policy are not covered.
  • Substance Abuse and Rehab: Treatment related to drug or alcohol use, misuse, or abuse, as well as rehab therapy, is excluded from coverage.
  • AIDS and HIV: Medical treatment for AIDS and HIV is not covered under the policy.
  • Pregnancy and Childbirth: Treatment arising from or related to pregnancy, childbirth, miscarriage, abortion, and their consequences is excluded.
  • Self-Inflicted Injuries: Injuries intentionally inflicted by the insured individual are not covered.
  • War, Riot, Strike, Nuclear Weapons: Hospitalisation resulting from war, riot, strike, or nuclear weapons is excluded from coverage.
  • Congenital Diseases: Diseases present at birth are not covered by the policy.
  • Fertility and Sterility Treatments: Treatments related to fertility, sterility, IVF, and associated procedures are excluded.

Documents Needed to Buy Care Enhance Health Insurance Plan

To acquire the Care Enhance Health Insurance Plan, you'll need to submit several documents:

  • A completed Application Form.
  • Proof of identity, such as an Aadhar card, Passport, Voter ID, or Driver's license.
  • Proof of age, such as a Birth Certificate, School Leaving Certificate, or Passport.
  • Proof of address, such as Utility Bills, Rental Agreement, or Aadhar Card.
  • Passport-sized Photographs.
  • In some cases, pre-policy health check-up reports may be required.
  • Any additional documents requested by your insurer.

How to Buy a Care Enhance Health Insurance Plan?

Buying the Care Enhance Health Insurance Plan through InsuranceDekho is a straightforward process. Follow the steps outlined below:

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 Enhance" 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 for Care Enhance Insurance Plan

You can claim the Care Enhance Health Insurance plan through two methods:

Cashless Claim

  • Visit a hospital affiliated with Care Health Insurance.
  • Provide your Care Enhance plan details and necessary information.
  • Submit the required documents, and the insurance company will approve the expenses.
  • Following the review, the insurance company will directly settle the hospital bill.

Reimbursement Claim

  • Choose a nearby hospital in the Care Health Insurance network.
  • Settle your medical bills at the hospital.
  • Request a reimbursement claim on the insurance company's website.
  • Submit the Care Enhance claim form and all relevant plan information.
  • After the insurance company verifies your claim, they will reimburse you for the medical expenses.

Frequently Asked Questions

1. What are the key variants of Care Enhance Health Insurance?

A. Care Enhance Health Insurance offers two variants i.e. Enhance 1 and Enhance 2. Each variant varies in coverage benefits, sum insured, and deductible options.

2. Is there an age limit for pre-policy medical check-ups?

A. If the combined deductible and sum insured are below Rs. 40 lakh and the insured individual is under 50 years old, there is no requirement for pre-policy medical check-ups.

3. What is the Enhance Anywhere feature?

A. The Enhance Anywhere feature allows access to selected medical treatments globally, ensuring you can receive medical care anywhere in the world.

4. What riders are available with Care Enhance Health Insurance?

A. Care Enhance offers additional riders like Everyday Care, providing access to health portals, free health helpline, etc, whereas, the Expert Opinion rider offers extra medical opinions for major illnesses diagnosed during the policy term.

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Key Inclusions and Exclusions of the Plan

What's Included

  • In-patient hospitalisation expenses
  • Pre-hospitalisation and post-hospitalisation expenses
  • Health check-up
  • Organ donor expenses
  • Daycare treatment

What's Not Included

  • Expenses incurred on spectacles, contact lenses, dental treatment
  • Congenital disease
  • Expenses incurred on treatment for AIDS
  • Pregnancy/childbirth, abortion, miscarriage, and other treatment expenses
  • Treatments and tests related to infertility and IVF

6003 Care Cashless Network Hospitals in India

Choose Care Health Insurance Critical Illness Plan

Add-ons to Enhance Benefits

  • Everyday care

    Under this add-on benefit, Care Health Insurance covers you for everyday care services such as health portal, free health helpline, health and wellness offers, maximum 4 consultations of doctors for the same illness in a policy year, etc.
  • Expert opinion

    This add-on covers you for additional medical opinion in relation to a major illness that you have been diagnosed with, during a policy term. The medical opinion shall be arranged for some specific illnesses such as cancer, multiple sclerosis, end stage renal failure, benign brain tumor, etc.

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 Enhance Health Insurance Plan

  • What are the deductible options under Care Enhance policy?

    Care Enhance 1 policy comes with deductible options ranging between Rs. 1 lakh and Rs. 10 lakh and Care Enhance 2 policy comes with deductible options of Rs. 5 lakh, Rs. 10 lakh, Rs. 15 lakh, and Rs. 20 lakh. 

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

    Yes. If you enroll under Care Enhance policy at the age of 61 years or more, you will be required to pay 20% of the claim amount and the rest will be borne by the insurance company.   

  • What is the minimum entry age to be covered under Care Enhance policy?

    If purchased on an individual basis, the minimum entry age for adults for Care Enhance policy is 18 years and for children, it is 5 years to 24 years. Whereas if purchased on a floater basis, then the minimum entry age for adults is 18 years and for children, it is 1 day to 24 years with at least one member aged 18 years or more.  

  • What are the waiting periods under Care Enhance policy?

    Care Enhance policy comes with an initial waiting period of 30 days. Whereas the waiting period for some specific illnesses is 2 years, and for pre-existing illnesses, it is 4 years. 

     

  • What is the room category that I will be covered for under the Care Enhance policy?

    Under Care Enhance 1, you will be covered for a single private room with AC. whereas in Enhance 2, you will be covered for a single private room with AC, and you can upgrade to next level. 

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