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Care Advantage Health Insurance Plan
24,800+ Network Hospitals
Incurred claim ratio 53.82%
Sum insured Up to 6 CR
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Home > Health Insurance > Care Health Insurance > Care Advantage Health Insurance Plan
What is the Care Advantage Policy?
The Care Advantage health insurance policy provides a comprehensive range of coverage options, with sum insured amounts reaching up to 6 crore rupees. With sum insured options starting from 25 lakh rupees and going as high as 2, 3 and 6 crores, the policy aims to alleviate the financial strain of costly medical treatments. This extensive coverage ensures that both you and your family can receive high-quality medical care without being burdened by financial concerns.
Care Advantage provides extensive coverage for major medical expenses such as pre and post-hospitalization costs, in-patient care, daycare treatments, ambulance cover and AYUSH treatment. This makes it an ideal insurance solution for both large and small families with customisable benefits and various optional covers. You can learn about its policy features and ways to enhance its coverage through optional benefits.
Care Advantage Policy Specifications
KEY FEATURES | ₹25L / 50L / 1Cr | ₹2/ 3/ 6Cr |
In-Patient Hospitalization | Up to SI | Up to SI |
Daycare Treatment | Up to SI | Up to SI |
Pre-hospitalization* | 60 Days | 60 Days |
Post-hospitalization* | 180 days | 180 days |
Ambulance Cover | Up to SI | Up to SI |
Organ Donor Cover | Up to SI | Up to SI |
No Claims Bonus (NCB) | check | check |
Automatic Recharge | Up to SI (Once in a Policy Year) | Up to SI (Once in a Policy Year) |
Unlimited E-Consultations* | check | check |
AYUSH Treatment | Up to SI | Up to SI |
Global Coverage** | Optional Basis | Inclusive Basis |
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that provides all the necessary coverage benefits you need at affordable premiums.
Coverage Benefits of the Care Advantage Plan
Care Advantage is a comprehensive health insurance plan designed to provide extensive coverage for individuals and families. With high-sum insured options ranging from 25 lakh to 6 crore rupees, the plan aims to cater to diverse medical needs and financial capabilities.
| Benefits | Coverage |
In-patient Hospitalization | Covers hospital expenses for at least 24 hours, includes room, nursing, ICU, doctors, surgeons, anaesthesia, blood oxygen and operation theatre charges |
Daycare Treatments | Covers 540+ medical procedures that need less than 24 hours in the hospital, like cataract surgery, chemotherapy, dialysis etc |
Pre-hospitalization Expenses | Covers medical expenses before hospitalization |
Post-hospitalization Expenses | Covers medical expenses up to 60 days after leaving the hospital. Includes consultations, medications and tests |
No Claim Bonus (NCB) | Rewards claim-free years with a gradually increasing sum insured of up to 50% higher |
Automatic Recharge of the Sum Insured | The sum insured is automatically restored once per policy year for multiple claims within the same period |
Annual Health Check-up | Policyholders can get a free annual health check-up |
Cashless Hospitalization | Helps with cashless treatment at hospitals. No need to pay upfront |
Additional Covers | Offers add-on covers like maternity, newborn baby, critical illness, personal accident to enhance coverage |
High Sum Insured Options | Flexible sum insured options available to meet various financial requirements |
No Sub-limits | No restrictions on room rent, ICU charges or surgeries |
Co-payment Waiver | Waives co-pay for young policyholders |
Organ Donor Cover | Covers organ donation expenses |
Ambulance Cover | Includes ambulance costs for emergencies |
Air Ambulance Cover | Covers air ambulance services up to a limit |
COVID-19 Coverage | COVID-19 treatment is covered with certain conditions |
Care Advantage Health Insurance Inclusions
- Hospitalization expenses for in-patients
- Costs for daycare
- Cost of ambulance
- Cost of organ donation
- Before and after hospital expenses
Waiting periods
- Pre-existing disease waiting period is 4 years
- The initial waiting period is 30 days
- The specific ailments waiting period is 2 years
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Care Health Insurance Claim Process
Care Health prioritizes your health and aims to alleviate stress during unexpected medical situations. This guide will simplify the process of filing claims under your insurance plan, whether it is for emergency hospitalization, planned procedures or selecting between cashless and reimbursement options.
Timely Intimation is Key
- Contact the helpline number within 24 hours of hospitalization for efficient claim processing.
- Notify the Care office 48 hours before a planned procedure for pre-authorization and smoother claim settlement.
Choosing Your Claim Path: Cashless or Reimbursement
- For cashless claims at in-network hospitals, request pre-authorization at the insurance/TPA desk. They will handle the paperwork while you focus on recovery.
- For non-network hospitals or upfront payments, submit the claim form and required documents for reimbursement.
Claim Approval Process
- Complete the pre-authorization form at the hospital's insurance/TPA desk and submit it to Care via fax.
- Your request will be reviewed and an approval letter will be sent to you.
- Prompt responses from you or the hospital will speed up the claim assessment process.
Care Health Insurance Claim Process Through Claim Genie
At Care Health, accessibility and hassle-free claim processes are the top priorities. With “Claim Genie” integrated into their Care Health Customer App, you can conveniently handle all your health insurance needs. The user-friendly app allows for claim intimation, online form submission, document uploads and real-time claim status tracking.
Make sure you have all the necessary documents ready for a quick claim settlement, whether you are opting for the cashless or reimbursement method. Having the right paperwork in order will help expedite the process and ensure that you receive timely compensation for your claim.
Required Documents for a Smooth Claim Experience
Filled and signed claim form with name, policy number, illness details and address.
Include all medical test reports and relevant documentation.
Original hospital bills, discharge summaries and payment receipts are crucial for claim verification.
Attach pharmacy bills and corresponding prescriptions for medication used during treatment.
Include police FIR and post-mortem report (if applicable) for accident claims.
Claim Intimation Made Easy with Claim Genie
Open the Care Health Customer App on your smartphone
Find and click “Claim Genie” and then “Claim Intimation” on the home screen
Choose between “Emergency” or “Planned” when asked to choose a claim type.
Enter claim details for the insured member.
Upload your medical documents for your claim.
Track Your Claim Status with Ease
To ensure absolute transparency, you have the power to monitor the progress of your claim at any given moment. All you need to do is access the app’s homepage and click on the “Claim Tracking” option. This section provides you with a comprehensive overview of all your active claims. By selecting the “Track Cliam” feature for the specific claim you wish to keep tabs on, you will instantly presented with the most up-to-date status update. Moreover, the app grants you the ability to effortlessly download vital documents, ranging from query and settlement letters to approval notices.
Other Insurance Plans
Individual And Family Health Insurance Plan
Coverage Benefits
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Eligibility Criteria
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Coverage Benefits
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Eligibility Criteria
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Coverage Benefits
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Eligibility Criteria
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Coverage Benefits
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Eligibility Criteria
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Coverage Benefits
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Eligibility Criteria
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Coverage Benefits
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Eligibility Criteria
- Extensive network hospitals
- Customizable coverage options
- Wellness programs
Care Health Insurance Contact Details
You may contact Care Health Insurance using the below-mentioned information if you have any queries about Care Health Insurance plans:
Care Health Insurance Limited, 5th Floor, 19, Chawla House,
Nehru Place, New Delhi-110019
1800-102-6655/1800-102-4488 (Toll-free)
Best Health Insurance Plans In India
When it comes to the best health insurance, there is no “one-size-fits-all” policy. It is like choosing a Netflix or OTT plan - different plans offer different benefits and have different costs. However, this age is designed to meet the diverse needs of most users, making it a versatile and comprehensive health insurance comparison page.
It is essential to conduct a thorough comparison to find the policy that best suits your needs. We have created a comprehensive table of how some of the top mediclaim policies in India compare to others in the industry.
| Insurance Provider | Plan Name | Coverage Type | Sum Insured Range | Age Limit (Adults) | Important Parameters | |
|---|---|---|---|---|---|---|
| Care Advantage Health Insurance Plan | Individual & Family Floater | ₹2 Lakh - ₹6 Crore | 18-65 years |
|
Check Premium |
Frequently Asked Questions (FAQs)
Maternity expenses typically fall outside the scope of most standard health insurance plans, including Care Advantage. Nevertheless, there Care Health Insurance offers a different insurance plan specifically tailored for maternity care.
Dental and eye check-ups are typically not covered by most insurance plans although certain plans might offer protection for accidental dental injuries or specific eye surgeries. It is important to review the policy details for more information.
The No Claim Bonus (NCB) is a discount offered by Care Advantage to policyholders who have consecutive claim-free years. The NCB can reach up to 50% of the sum insured and it is applied to the premium for the following year. This means that if no claims are made during the policy term, policyholders can enjoy a discounted premium.
You can file a claim with Care Health Insurance either through cashless hospitalization at a network hospital or through reimbursement by submitting necessary documents after hospitalization. Care Health Insurance has specific guidelines for both processes.
The required documents for a claim usually consist of a claim form, discharge summary, medical bills, prescriptions and other relevant medical reports. The specific list of documents needed may vary.
The claim settlement ratio is a crucial factor in assessing the efficiency of an insurance company’s claim handling. In this case, it is important to check the latest claim settlement ratio of Care Health Insurance to evaluate its performance.
Submit a portability request to the new insurer within the specified timeframe provided by Care Advantage guidelines.
You can easily access a list of network hospitals by visiting the insurer’s website or contacting their customer care.
You can cancel the policy by sending a written request to the insurer. Keep in mind that there may be certain conditions and refund policies to consider.
Policyholders are entitled to transparent and precise policy information, prompt claim resolution and customer support accessibility.
