Care Senior Plan
Care Plan
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Care Senior Health Insurance

Care Senior Health Insurance is a comprehensive health plan that comes with a list of health care benefits to provide ease to the senior citizens in their retirement age. The plan makes sure that no senior citizen is left hanging in time of a medical emergency.

To understand this health policy in a better way, let us move forward into details.

Eligibility:

Minimum entry age

61 years

Maximum entry age

Lifelong

Sum insured

Rs.3, 5, 7, 10 lakhs

Policy tenure options

1/2/3 years

**Last Updated on 14-12-2020

Coverage:

This dedicated health plan covers most of the expenses for the diseases that may arise in older age. Have a look at the below table for the details.

Parameters

Coverage

Day care treatments

Up to sum insured, 541 procedures

Pre-hospitalization expenses

30 days

Post-hospitalization expenses

60 days

In-patient hospitalization

Up to sum insured

Room eligibility

Yes

ICU charges

2% sum insured per day

Ambulance cover

Up to Rs.2000 per hospitalization

Domiciliary hospitalization

Up to 10% of the sum insured, covered following 3 days

Annual health check-up

Yes, all members

Automatic recharge of sum insured

Yes, up to the sum insured (once in a policy year)

Organ donor cover

Up to Rs.1,00,000

Second opinion

Yes

Alternative treatments

Up to Rs.20,000

**Last Updated on 14-12-2020

What are the key features of the Care Senior Health Insurance?

The major features of this medical policy are listed below.

  • The plan can be purchased on an individual and family floater basis.
  • No pre-policy medical check-up is required to avail of this policy.
  • Grab a chance to save tax on up to Rs.75,000 premium under Section 80D of the Income Tax Act, 1961.
  • Automatic recharge of sum insured.
  • Get OPD cover on certain grounds.
  • Up to 150% increase in sum insured with No Claim Bonus and No Claim Bonus Super.

What are the benefits of Care Senior Health Insurance?

The plan offers you several benefits that are listed below.

In-patient hospitalization -In case of hospitalization for at least 24 hours, the company compensates for nursing expenses, room charges, intensive care unit charges, doctor's fee, surgeon's fee, blood, anesthesia, oxygen, operation theater charges, etc.

In the case of hospitalization for less than 24 hours, the company pays for the medical expenses for a day care treatment where you don't have to stay hospitalized for 24 hours or more.

Pre-hospitalization expenses - This medical policy covers the relevant medical expenses such as investigative tests, routine medications, and many more up to 30 days before the hospitalization.

Post-hospitalization expenses - Under this policy, relevant medical expenses such as doctor's fees, medications, etc. are covered up to 60 days after the discharge from the hospital.

Emergency ambulance cover - If an emergency arises and you need to hurry to the hospital, your ambulance costs are compensated up to Rs.2000 per hospitalization.

Organ Donor Expenses - The plan covers (up to Rs.1 lakh) the medical and surgical expenses of the organ donor while having a major organ transplant.

Domiciliary hospitalization - In any case, if the hospitalization is not possible, the company pays (up to 10% of SI) for the expenses of treatments at home for a period exceeding 3 consecutive days.

Alternative treatment - This facility is only provided when the hospitalization exceeds more than 24 hours. Coverage up to Rs.20,000 is provided by the plan.

Automatic recharge - If the policyholder ever runs out of health coverage due to claims made, this health policy will reinstate the entire sum insured amount of the policy.

Second opinion - If the insured feels uncertain of his/her diagnosis, (s)he can go for a second opinion arranged by the company for a specific critical illness.

Lifelong renewability - If you are 61 years old or more, the company provides you an option to choose for co-payment of 20% per claim (over & above any other co-payment, if any), which is applicable for you. The insurer will pay the rest of the amount.

Which add-ons are available under Care Senior Health Insurance?

You will come across several useful add-ons under the umbrella of protection of this plan. Some of them are listed below.

Reduction in PED - This optional coverage helps you to reduce the applicable PED waiting period from 48 months to 24 months.

Co-payment waiver - If the insured is 61 years of age or above, by opting for this add-on, (s)he can get rid of the 20% co-payment condition. The insurer will pay medical expenses incurred for hospitalization (subject to policy terms and conditions).

No Claim Bonus Super - The insured can increase the sum insured amount by 50 % for every claim-free year up to a maximum of 100%.

OPD care - Through this optional cover, one can claim an amount equivalent to his/her bills at the time of reimbursement. Coverage amount ranges between Rs.5,000-50,000.

What are the exclusions of Care Senior Health Insurance?

The major exclusions are as follows.

  • Treatment expenses of self-inflicted injuries.
  • Problems arising from taking any intoxicating substances.
  • Pregnancy or maternity-related expenses.
  • Internal congenital diseases.
  • Tests and treatment relating to infertility and in vitro fertilization.
  • Hospitalization due to war or due to a nuclear, chemical, or biological weapon and radiation of any kind.

How to buy Care Senior Health Insurance Online?

Follow the below-mentioned steps to buy this plan easily and smoothly.

  • Go to the official website of Care Health Insurance.
  • Go to the 'Health Insurance' tab and click on 'Care Senior'.
  • Enter your 'Mobile Number' and 'Email Id' and click on 'Get Quote'.
  • Fill in the required information and check the premium details.
  • Pay the premium online and the policy document will be shared on your email address.

For more information about this plan, please get in touch with the customer service team of PolicyX.com at 1800-4200-269.

What is the claim process of Care Senior Health Insurance?

To make things simpler and structured for its customers, Care Health Insurance has listed two ways of filing a claim-

  1. Cashless Claim
  2. Reimbursement Claim

Both the claim processes are discussed here with proper steps. Have a look.

Cashless Claim:

  • Authorization - Before availing treatment and/or incurring medical expenses at a network hospital, the insured/ his or her representative must inform the company.
  • Emergency Hospitalization - In case of emergency hospitalization, the insured/ his or her representative gets 24 hours to intimate the company about such hospitalization.
  • Planned Hospitalization - In the case of planned hospitalization, the insured/insured's representative needs to intimate such admission 48 hours before hospitalization.
  • Send the form - Complete the pre-authorization form available at the hospital's insurance/TPA Desk or download it via the company's website. The hospital will send the form to the company for verification.
  • Approval - The specialist from the company will reflect on your claim and if satisfied, the approval letter will be sent by the claim management team to avail of the treatment.
  • Query - The hospital or the insured has to answer the queries raised by the claim management team.
  • Rejection - If your claim gets rejected, you may initiate the treatment and file for a reimbursement claim.

Note: For a cashless claim, you have to get admitted to one of the authorized network hospitals of the company and the insurer will directly pay the hospital.

Reimbursement Claim:

  • Emergency Hospitalization - In case of emergency hospitalization, the insured/ his or her representative gets 24 hours to intimate the company about such hospitalization.
  • Planned Hospitalization - In the case of planned hospitalization, the insured/insured's representative needs to intimate such admission 48 hours before hospitalization.
  • Submission - Submit the claim form along with all the required and correct documents like medical certificate issued by the doctor, discharge papers, duly filled form, and more to the below company's address.

Care Health Insurance Limited(formerly known as Religare Health Insurance Company Limited),

Unit No. 604 - 607, 6th Floor, Tower C, Unitech Cyber Park,

Sector-39, Gurugram-122001 (Haryana).

  • Approval - The specialist from the company will reflect on your claim and if satisfied, the approval letter will be sent by the claim management team.
  • Rejection - In case of rejection of the claim, the company will directly communicate with you with the details and reasons.

Note: For the reimbursement claim, you can get admitted to any hospital according to your convenience and the amount will be paid by you.

FAQs:

1. How to calculate Care Senior Health Insurance Premium?

The premium is a pre-decided amount of money that a policy taker has to pay for a specified period, against the coverage. The amount of premium of Care Senior plan is subjected to the age of the person, the sum insured, pre-existing diseases, policy term, etc.

2. What is the waiting period under Care Senior Health Insurance?

It's divided into three parts-

  • 30 days for any illness except injury.
  • 2 years of continuous coverage for named ailments.
  • 4 years of continuous coverage for pre-existing conditions.

3. What is the grace period under Care Senior Health Insurance?

30 days is the grace period.

4. I am 67 years old. Can I buy the Care for Senior Citizen Plan?

Yes, of course. There is no maximum entry age for this policy.

5. How many cashless healthcare providers are associated with Care Health Insurance?

There are 11000+ healthcare providers.

Last updated on 15-01-2021