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Care Senior Health Plan

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What is the Care Senior Health Plan?

Ageing can lead to various health problems that require extensive Insured care and can even lead to hospitalisation if not treated properly. The increased cost of healthcare and medical inflation can significantly impact your finances, especially during retirement. However, opting for the Care Senior Citizen health insurance plan can provide financial security and ensure that you receive the best possible Insurable care when you need it the most. Care Senior Health Plan by Care Health Insurance is a comprehensive health insurance plan with a sum insured specifically designed for individuals aged 60 and above.

The plan provides comprehensive Insurance protection for elderly individuals against sudden medical expenses, ensuring access to top-notch medical facilities without financial burden. With an affordable premium, senior citizens can select insured sums based on their healthcare requirements without straining their finances, particularly post-retirement. This policy can be bought without a pre-policy medical checkup, although a tele-underwriter may inquire about any pre-existing medical conditions. Noteworthy elements of the Care Senior plan include annual health checkups, cashless hospitalisation, coverage for pre-existing conditions and more than 541 daycare treatments.
 

Care Senior Health Plan Specifications

KEY FEATURES

₹3L

₹5L, 7L, 10L

In-Patient Hospitalization

Up to the Sum Insured

Up to the Sum Insured

Daycare

Up to the Sum Insured

Up to the Sum Insured

Pre-hospitalization*

30 Days

30 Days

Post-hospitalization*

60 days

60 days

Daily Allowance

₹500 per day

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Ambulance Cover

Up to ₹1,500 per hospitalization

Up to ₹2,000 per hospitalization

Organ Donor

Up to ₹50,000

Up to ₹1 Lac

Domiciliary Hospitalization

Up to 10% of the Sum Insured

Up to 10% of the Sum Insured

Automatic Recharge

Second Opinion

Alternate Treatment

Up to ₹15,000

Up to ₹20,000

No Claim Bonus

Annual Health Check-up

Room Rent

Up to 1% of Sum Insured per daySum Insuredngle Private Room (Max. Up to 1% of Sum Insured per day)

ICU Charges

Up to 2% of Sum Insured per dayUp to 2% of Sum Insured per day

Tenure

1 Yr/2 Yrs/3 Yrs1 Yr/2 Yrs/3 Yrs

Treatment of Cataract

Up to ₹20,000 per eyeUp to ₹30,000 per eye

Treatment of Total Knee Replacement

Up to ₹80,000 per kneeUp to ₹1 Lac per knee

Treatment for Ailments like Hernia Surgery, etc.

Up to ₹50,000Up to ₹65,000

Treatment for Ailments like Cancer Surgery, Bone Fractures, etc.

Up to ₹2 LakhUp to ₹2.5 Lakh

Choose the Best Health Insurance Plan

that provides all the necessary coverage benefits you need at affordable premiums.

Coverage Benefits of Care Senior Health Plan

The primary coverage in Care Health for Senior Citizens is specifically tailored to address the unique healthcare needs of elderly individuals, who are at high risk for age-related illnesses. As a result, the coverage includes a wide range of services and treatments that cater to the specific health concerns of seniors, ensuring they have access to the care they need as they age. 

BenefitsCoverage

In-patient Hospitalization

The plan covers hospital expenses for stays over 24 hours.

Pre and Post Hospitalization Expenses

30 days pre-hospitalization and 60 days post-hospitalization are covered for full medical expense reimbursement.

Day-Care Treatment

Hospitals cover 541 procedures with stays of less than 24 hours.

Domiciliary Hospitalization

Insured can get 10% coverage for home treatment if the hospital stay is over 3 days.

Alternative Treatment

The insured can use AYUSH treatment with a limit of 15,000 or 20,000 rupees based on the sum insured.

Care Senior Health Plan Inclusions

  • Room charges are limited to 1% of the sum insured and ICU charges are limited to 2% of the sum insured
  • Ambulance charges are covered up to 1500 or 2000 rupees, depending on the sum insured
  • Transplantation expenses are covered up to 50,000 or 1,00,000 rupees based on the chosen sum insured.
  • Optional Add-on Cover: 

- Reduced wait for pre-existing conditions from 48 to 24 months
- 20% co-payment waived
- Coverage for 3 benefits claim protected

Waiting periods

  • 30-day waiting period for all illnesses except accidents
  • 48-month wait for pre-existing conditions
  • 24-month waiting period for specific diseases

Health Insurance Calculator

Health Insurance Calculator


Care Senior Health Plan 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
 

  1. Complete the pre-authorization form at the hospital's insurance/TPA desk and submit it to Care via fax.
  2. Your request will be reviewed and an approval letter will be sent to you.
  3. 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

Step 01

Filled and signed claim form with name, policy number, illness details and address.

Step 02

Include all medical test reports and relevant documentation.

Step 03

Original hospital bills, discharge summaries and payment receipts are crucial for claim verification.

Step 04

Attach pharmacy bills and corresponding prescriptions for medication used during treatment.

Step 05

Include police FIR and post-mortem report (if applicable) for accident claims.
 

Claim Intimation Made Easy with Claim Genie

Step 01

Open the Care Health Customer App on your smartphone

Step 02

Find and click “Claim Genie” and then “Claim Intimation” on the home screen

Step 03

Choose between “Emergency” or “Planned” when asked to choose a claim type.

Step 04

Enter claim details for the insured member.

Step 05

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

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Care Senior Health Plan Contact Details

You may contact Care Health Insurance using the below-mentioned information if you have any queries about Care Health Insurance plans:

Phone: 1800-102-4499 (Sales) or WhatsApp: 8860402452 (Services)

Download the Mobile App for easy policy management.

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
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium
ICICI Elevate Health Insurance Policy Individual & Family Floater ₹2 Lakh - ₹6 Crore 18-65 years
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium
IFFCO Tokio Family Health Protector Policy Individual & Family Floater ₹2 Lakh - ₹6 Crore 18-65 years
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium
Niva Bupa Aspire Policy Individual & Family Floater ₹2 Lakh - ₹6 Crore 18-65 years
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium
Arogya Supreme Policy Individual & Family Floater ₹2 Lakh - ₹6 Crore 18-65 years
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium
TATA AIG Medicare Lite Policy Individual & Family Floater ₹2 Lakh - ₹6 Crore 18-65 years
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium

Frequently Asked Questions (FAQs)

A.

Care Senior Health Plan, provided by Care Health Insurance, is a comprehensive health insurance plan tailored for individuals aged 60 and above. It covers a broad spectrum of medical expenses, such as hospitalization costs, ambulance charges, pre and post-hospitalization care and more.

A.

The plan is designed to provide seniors with the financial security they need to cover unexpected medical expenses, offering them peace of mind. This is especially beneficial for seniors who may be living on a fixed income and want to ensure they have access to necessary medical care without fearing the cost.

A.

There is a minimum age requirement of 60 years old to enrol in Care Senior, but there is no upper age limit.

A.

It is important to carefully review the policy document to understand any sub-limits on specific benefits such as room rent, doctor fees or certain procedures. Some plans may have restrictions in place and being aware of these limitations can help you make informed decisions about your coverage.

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Care Senior plans generally include coverage for hospitalization in India. However, it is important to check if there are any specific exclusions for international treatment, especially if you anticipate the need for medical care overseas.

A.

There is typically a grace period of 15 to 30 days to pay your premium before your coverage lapses. The exact grace period offered by your plan can be found in your policy details.

A.

Cancellation of the Care Senior Health plan is an option but it could result in losing accrued benefits or facing penalties. Carefully check your plan’s terms for more information.

A.

The process for making a claim will differ based on your insurance provider. Typically, you will have to get in touch with your insurer and provide the required paperwork, like medical bills and physician’s assessments. Certain plans may provide cashless claims at affiliated hospitals, making the procedure more straightforward.

A.

It is important to know that Care Senior plans cover hospitalization expenses for treating chronic conditions after the waiting period for pre-existing conditions. Just keep in mind that certain plans may have limitations for specific chronic illnesses. Understanding these details is crucial before enrolling.

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Care Senior plans are generally designed as individual policies, tailored to the needs of the individual enrolling. While Care Health Insurance may offer separate plans for family coverage, these are not typically included as part of the core Care Senior product.

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It is important to thoroughly compare plans from different insurers. Utilize online comparison tools or seek guidance from licensed insurance agents who represent multiple companies. Pay attention to factors such as coverage details, claim settlement ratios, network hospitals and customer service reputation.

A.

Care Senior provides continuous coverage, requiring policy renewal and timely payments. Regardless of any deterioration in health, coverage eligibility remains intact as per the plan’s terms, except for any pre-existing condition waiting periods.

A.

Some Senior Care plans provide more extensive coverage and higher insurance amounts for specific medical procedures, which can be beneficial for seniors with a larger healthcare budget. However, these plans usually have higher premium costs to match the increased coverage.

A.

Care Senior plans mainly cover hospitalization and related medical expenses but may not include long-term care services such as nursing homes. Insurers might provide separate long-term care insurance but it is usually not part of the standard Care Senior product.

A.

The Insurance Regulatory and Development Authority of India (IRDAI) has put in place a system to safeguard policyholders in the event of an insurance company’s departure from the market. In such a scenario, your policy would be transferred to another insurance provider, ensuring that your coverage remains uninterrupted.

A.

Consider speaking with a licensed insurance agent representing Care Health Insurance for personalized advice and further clarification. They can provide detailed information about the plan, address your specific questions and assist in selecting the most suitable coverage option based on your health requirements and budget.

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