RELIGARE CARE FREEDOM

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Religare Care Freedom


About Religare Health Insurance Company : Religare Health Insurance is a standalone medical health insurance provider which incorporates three entities: Religare Enterprises Limited, a leading group of financial services that is based out of India, Union Bank of India & Corporation Bank. Religare Health Insurance offers health insurance and other products.

Religare Health Insurance Co. Ltd. is an Indian health insurance organization founded with the aid of Religare Enterprises Ltd. (REL), Union Bank of India & Corporation Bank.

Incepted in July'12, Religare Health Insurance has made tremendous progress in a short span of time, and is already working out of 54 offices with 1200 people, servicing more than 2.6 million customers lives across 300 locations.

Religare Care Freedom


The Religare Care Freedom plan gives most suitable and flexible coverage options. Also, you don't need to go through the hassles of undergoing medical checkup for the issuance of the policy.

The most important aspect of our life revolve around our health and finances, and whether our finances will be capable of keeping up with healthcare treatment costs.

The Religare Care Freedom policy aims to offer you with the freedom and versatility to live life to the fullest and have a monetary cushion to fall back on if you need health insurance. It doesn’t require any pre-medical check-up for every age and sum assured.

Highlights of Religare Care Freedom


Entry level age is ninety days with upper limit of 24 years

Waiting period of 2 year for pre-existing diseases

Covers pre-existing diseases

Get an annual health check-up for insured participants - irrespective of claims records

Ease of cashless treatment & fast settlement of claims

Get automatic coverage recharge if claim amount exhausts your sum assured at no extra price

Cashless Hospitalization time period options of 1, 2 or 3 years

Free look period of 15 days from the receipt of policy documents

Tax benefit on premium paid under section 80D of the income Tax Act, 1961

Avail a discount on your premium in case you opt for a 2-yr coverage term or a 3-year coverage time period.

Sub-Limits  
Sum Insured 3 Lacs 5 Lacs 7 lac/10 lac
Room Rent/Room Category Twin Sharing Room subject to a maximum of 1% of SI per day Twin Sharing Room Single Private Room
ICU Charges Upto 2% of SI per day No Limit No Limit
Treatment of Cataract Upto 20,000 per eye Upto 30,000 per eye Upto 30,000 per eye
Co-payment* 20% / 30% per claim 20% / 30% per claim 20% Beyond 70 years of age: increase in co-payment by 10% per claim (optional, though mandatory for first time entrants)
Treatment for each and every Ailment/Procedure mentioned below:-
i. Surgery for treatment of all types of Hernia
ii. Hysterectomy
iii. Surgeries for Benign Prostate Hypertrophy (BPH)
iv. Surgical treatment of stones of renal systembr
Treatment of Total Knee Replacement Upto Rs. 50,000 Upto Rs. 65,000 Upto Rs. 80,000
Treatment for each and every Ailment/Procedure mentioned below:-
i. Treatment of Cerebrovascular and Cardiovascular disorders
ii. Treatment/Surgeries for Cancer
iii. Treatment of other renal complications and disorders
iv. Treatment for breakage of bones
Upto Rs.80,000 per knee Upto Rs.1,00,000 per knee Upto Rs. 1,20,000 per knee
Treatment for each and every Ailment/Procedure mentioned below:-
i. Treatment of Cerebrovascular and Cardiovascular disorders
ii. Treatment/Surgeries for Cancer
iii. Treatment of other renal complications and disorders
iv. Treatment for breakage of bones
Upto Rs.2,00,000 Upto Rs.2,50,000 Upto 3,00,000

* The applicable Co-payment will increase by 10% per claim in the policy year following the insured person (Or eldest insured person in the case of floater cover) attaining age 71. If an insured person (Or eldest insured person in the case of floater cover) attaining age 71 during the policy period. Additional 10% Co-payment will be applicable to the policy only at the time of subsequent renewal. However, if the age of the insured person or the eldest person (in case of floater) at the time of issue of the first policy with the company is 70yrs or below, then the insured person has an option to waive the condition for the additional 10% Co- payment upon payment of extra premium in the regard.

What does the plan cover?


Inpatient care: Hospitalization expenses along with room rent, nursing costs, ICU expenses, health care provider's prices, doctor's expenses, anesthesia, blood, oxygen, operation theater prices and so forth.

Day care treatment: Clinical expenes incurred if hospitalization is much less than 24 hours.

Pre and post hospitalization: Medical costs incurred 30 days prior to hospitalization can be included. Charges incurred as much as 60 days after being discharged from the hospital together with visits to clinidoctors, treatment, etc. are covered.

Ambulance Prices: fees of Ambulance transport is covered under the policy.

Daily Allowance: Out-of-pocket spending together with transportation, and many others. Lump sum quantity for each completed day of hospitalization is paid as per day allowance.

Organ Donor cover: the policy provides cover to a organ donor for expenses incurred during the transplant process.

Domiciliary Hospitalization: For a treatment requiring hospitalization but being treated at home, the same will be covered for a period extending 3 days.

Annual Health Checkup: The coverage can pay for annual health check-up of the insured. Medical tests covered within the health check-up are as follows:

Complete Blood with ECR

Urine routine

Blood sugar

Lipid Profile

Kidney checkup

ECG

Recharge of Sum assured: If the Sum assured in the coverage is exhausted because of claims made, then the company reinstates the entire sum assured inside the policy year. This reinstated amount may be used for other claims, now not associated with the infection / harm for which the claim has already been made during the ongoing year.

Plan Option   (In Rs.)
Features (Sum Insured ) 3 Lacs 5 Lacs 7 Lac / 10 Lac
In patient care Upto Sum Insured Upto Sum Insured Upto Sum Insured
Day Care Treatment (for selected ailments) Upto Sum Insured Upto Sum Insured Upto Sum Insured
Recharge of Sum Insured 100% Original SI Upon exhaustion of SI 100% Original SI Upon exhaustion of SI 100% Original SI Upon exhaustion of SI
Annual Health Check-up Annually Annually Annually
Consumable Allowance(Max. 7 days per Hospitalization covered after 3 days) Rs. 750 Per Day Rs. 1000 Per Day Rs. 1000 Per Day
Pre-hospitalization expenses (valid till 30 days beyond the Policy End Date) Upto 7.5% payable Hospitalization expenses Upto 10% payable Hospitalization expenses Upto 10% of payable Hospitalization expenses
Companion Benefit(If Hospitalization exceeds 10 days) 10,000 15,000 15,000
Post-hospitalization expenses (valid till 30 days beyond the Policy End Date) Upto 7.5% payable Hospitalization expenses Upto 10% payable Hospitalization expenses Upto 10% payable Hospitalization expenses
Ambulance Cover Upto Rs. 1,000 per Hospitalization Upto Rs. 1,000 per Hospitalization Upto Rs. 1,000 per Hospitalization
Domiciliary Hospitalization Upto 10% of Sum Insured covered after 3 days Upto 10% of Sum Insured covered after 3 days Upto 10% of Sum Insured covered after 3 days
Dialysis Cover Upto Rs. 1,000 per sitting limited upto 24 consecutive months Upto Rs. 1,000 per sitting limited upto 24 consecutive months Upto Rs. 1,000 per sitting limited upto 24 consecutive months
Tenure 1 Year/2 Years/3 Years 1 Year/2 Years/3 Years 1 Year/2 Years/3 Years

What isn't covered?


Prices existing diseases or injurys are not covered for the first 24 months

Self-inflicted injury. For e.g. - An attempt to commit suicide.

Clinical fees incurred for treatment of AIDS

Non-allopathic remedy

Fee of spectacles/contact lenses, dental treatment

Arthritis

Alcohol and drug abuse

Allergies

All Psychiatrist and Psychosomatic disorder

Hypertension

Bronchitis

Claim Process


Claims method for cashless treatment:

1. Filling up of the pre-authorization form, the necessary details will be checked by the healthcare provider and the TPA

2. Upon submission of the pre-authorization form, all communications will be taken care of through Religare referring to the settlement of the invoice

3. If in case some fees aren't included or are not covered by the policy, the same will be communicated to the insured before or after hospitalisation.

Reimbursement


In case one has to get admitted to a health facility that isn't always within the panel of networked hospitals of Religare or the pre-authorization form has been rejected, one should record a claim for reimbursement of charges. The method for the claim and vital factors to consider are mentioned underneath-

1. In case of an emergency admission, Religare has to be informed within 24 hours. If the hospitalization is pre-planned, the intimation must be executed 48 hours earlier .

2. The information required at some point of this procedure could be the following -

- Policyholder's name

- Claimant's name and customer id

- Information of the health center/ clinic/ hospital

- Information of diagnosis and treatment

- An approximation of the claim amount

- Date of admission

Documents Required:


The claim form may be downloaded from Religare's website and together with the completed form, the following files need to be provided -

1. The authentic copy of the claim form, duly filled and signed

2. Government authorized valid identity proof

3. Referral letter from a medical practitioner advising hospitalization

4. Letter from scientific practitioner detailing the list of tests, medications and consultations if any

5. Copies of bills, receipts and discharge card from the clinic or the medical practitioner

6. Original copies of bills or receipts from pharmacies or druggists concerned

7. Copies of tests and reports along with their receipts

8. FIR copy, post mortem report if applicable

FAQs


Q1. I need to increase/ decrease the sum insured of my health policy?
Please observe that the increase / decrease of the sum insured isn't allowed all through the policy tenure. It may be achieved at the time of renewal, pertaining to the terms and conditions of the policy coverage and underwriter’s review.

Q2. What is a Health Card?
You will get the same along the policy. It looks a lot like an identity card. It can be used for cashless hospitalization but please note that this is not a debit/credit card

Q3. I want to add/remove extra family members in my existing coverage?
Please notice that the addition or removal of a member isn't allowed in the course of the policy tenure. It could be accomplished at the time of renewal subject to the policy terms. But you may buy a new policy for the extra member.

Q4. What is Co-pay?
Co-pay is that part of your claim amount, which you have to bear. For instance, in case of co-pay of 20% and claim of Rs. 10,000, the insurer will pay you Rs. 8,000 (80% of 10K) and you will bear 20% (Rs. 2,000).

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