A top-up plan based on Policy Deductible principle
Care Enhance is a super top-up health insurance plan that provides extra health insurance coverage to you and your family. It is an ideal choice for those who already have another mediclaim policy or a limited self-financing capacity as this plan covers the expenses over or above their existing coverage. Care Enhance plan works on the Policy Deductible principle and offers flexible choices of deductible with a wide range of SI options.
Have a look at how Care Enhance works:
Suppose you have an insurance cover of 4 lakhs but you think it is not sufficient to meet the expensive medical treatments due to the increasing inflation. In this scenario, you can buy a Care Enhance super top-up plan of 15 lakhs with a deductible of 4 lakhs (i.e. your existing cover). Now, this top-up cover pays for your healthcare expenses up to 15 lakhs if the medical bills cross 4 lakhs. Understand with an example below:
Sum Insured
5 Lakhs
5 Lakhs
5 Lakhs
Deductible
1 Lakh
2 Lakhs
3 Lakhs
Claim Amount
50K
2.5 Lakhs
3 Lakhs
Payable Amount
NA
50K
NA
Care Enhance Plan Specifications
Care Enhance is a super top-up plan based on the principle of policy deductible. To get a better idea about the Care health insurance super top up plan, look below at its specifications and the eligibility criteria.
Variant
Care Enhance Plan 1, Care Enhance Plan 2
Sum Insured
Plan 1: Sum Insured: 1 to 30L, Deductible: 1 to 10L Plan 2: Sum Insured: 30 - 55L, Deductible: 5 - 20L
Age Eligibility
Adult: 18 to No age limit, Child: 1 day (floater), 5 years (individual) to 24 Years
Plan Type
Top-up for Individual & Family floater
Policy Term
1 | 2 | 3 Years
Initial Waiting Period
30 Days
*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
Read more specifications in the brochure.
Choose your Care Enhance Plan
In-patient & Out-patient coverage
Room Rent
Single Private AC room
ICU Charges
Covered up to SI
Pre-Hospitalization
Covered up to 30 days
Post-Hospitalization
Covered up to 60 days
Domiciliary Hospitalization
Not Covered
Daycare Treatment
Covered
OPD Charges
Not Covered
Coverage Terms
COVID-19 Treatment
Covered
Cataract
Not Covered
No Claim Bonus
Not available
Automatic Restoration
Not available
Daily Hospital Cash
Not available
Organ Donor
Covered up to SI
Maternity Cover
Not Covered
New Born Baby Cover
Not Covered
Alternative Treatments
AYUSH Treatment
Covered
IVF Treatment
Not Covered
Modern Treatment
Covered
Emergency Coverage
Ambulance
Not available
Air Ambulance
Not available
Compassionate Travel
Not available
Global Coverage
Not available
Wellness Programmes
E-Consultation
Not available
Health Check-Up
Covered
Second Medical Opinion
Available as a rider
Vaccination
Not Covered
Limitations
Co-payment
20% of the claim amount
Sub-limits
Not Applicable
In-patient & Out-patient coverage
Room Rent
Single Private AC room
ICU Charges
Covered up to SI
Pre-Hospitalization
Covered up to 30 days
Post-Hospitalization
Covered up to 60 days
Domiciliary Hospitalization
Not Covered
Daycare Treatment
Covered
OPD Charges
Not Covered
Coverage Terms
COVID-19 Treatment
Covered
Cataract
Not Covered
No Claim Bonus
Not available
Automatic Restoration
Not available
Daily Hospital Cash
Not available
Organ Donor
Covered up to SI
Maternity Cover
Not Covered
New Born Baby Cover
Not Covered
Alternative Treatments
AYUSH Treatment
Covered
IVF Treatment
Not Covered
Modern Treatment
Covered
Emergency Coverage
Ambulance
Not available
Air Ambulance
Not available
Compassionate Travel
Not available
Global Coverage
Available
Wellness Programmes
E-Consultation
Not available
Health Check-Up
Covered
Second Medical Opinion
Available as a rider
Vaccination
Not Covered
Limitations
Co-payment
20% of the claim amount
Sub-limits
Not Applicable
What is Room Rent?
Room rent limit is the maximum amount of bed charge that you can claim if you are hospitalized.
Common Room categories covered under room rent are:
Private Single AC Room
Twin Sharing
General Ward
Coverage status under Care Enhance Plan?
Under this plan, a policyholder can get coverage for a Single Private AC room. The room type can be upgraded to the next level if you select any of the SI options under Care Enhance 2.
What are ICU Charges?
It is a special department in the hospitals where patients with serious medical conditions are treated.
Coverage status under Care Enhance Plan?
ICU charges are covered up to the sum insured amount you select.
What is Pre Hospitalization?
Medical expenses incurred before the hospitalization of the policyholder.
Coverage status under Care Enhance Plan?
This plan covers medical expenses of up to 30 days before your hospitalization.
What is Post Hospitalization?
Medical expenses incurred after the discharge of the policyholder from the hospital.
Coverage status under Care Enhance Plan?
This plan covers medical expenses of up to 60 days after you get discharged from the hospital.
What is Domiciliary Hospitalization?
Home hospitalization arrangement for the insured person due to unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get the financial coverage.
Coverage status under Care Enhance Plan?
Not covered
What is Daycare Treatment?
Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.
Coverage status under Care Enhance Plan?
This plan covers all day care treatments.
What are OPD charges?
The cost of doctor consultation and prescribed medical tests that may not require hospitalization.
Coverage status under Care Enhance Plan?
Not covered
What is COVID-19 Treatment?
COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. approved Centre.
Coverage status under Care Enhance Plan?
Covered as per policy terms & conditions.
What is Cataract Treatment?
A common eye condition in which your vision gets blurred.
Coverage status under Care Enhance Plan?
Not covered
What is a No-Claim Bonus?
For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as a no-claim bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain percentage that varies from plan to plan.
Coverage status under Care Enhance Plan?
Not available
What is Automatic Restoration?
Automatic restoration is a benefit in which an insurance company restores the sum insured amount completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from plan to plan.
Coverage status under Care Enhance Plan?
Not available
What is Daily Hospital Cash?
It is a cash amount that you receive each day during the time of hospitalization.
Coverage status under Care Enhance Plan?
Not available
What is an Organ Donor Cover?
It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body.
Coverage status under Care Enhance Plan?
This plan covers organ donor expenses up to your selected sum insured.
What is a Maternity Cover?
It refers to the cover that includes expenses for normal and c-section procedures deliveries.
Coverage status under Care Enhance Plan?
Care Enhance does not include Maternity cover.
*It is generally not covered under most health insurance plans as pregnancy is a planned condition.
What is a New Born Baby Cover?
It takes care of the medical expenses that arise due to the hospitalization of the newborn baby in case of unforeseen circumstances. Some of the common treatments that are covered under the new born cover and these common treatments can vary from plan to plan:
Congenital anomaly (conditions since birth)
Acute condition
Chronic condition
Premature delivery
Birth asphyxia
Day care treatment
Coverage status under Care Enhance Plan?
Not covered
What is AYUSH Treatment?
Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.
Coverage status under Care Enhance Plan?
AYUSH treatments are covered under this plan.
What is IVF Treatment?
In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:
Full infertility
No fertility
Infertility diagnosis
Infertility diagnosis and limited fertility treatment
Medication (which may or may not include fertility drug prescriptions)
Coverage status under Care Enhance Plan?
Not covered
What is a Modern Treatment?
Medical treatments that demand the use of modern technology such as robotic surgeries, stem cell therapy, etc.
Coverage status under Care Enhance Plan?
This plan offers coverage for modern treatments like robotic surgeries, etc.
What is an Ambulance Cover?
An ambulance is used to move the patient from home to hospital, transfer to another hospital, and take them for different tests outside the hospitals.
Coverage status under Care Enhance Plan?
This plan does not cover Ambulance charges.
What is an Air Ambulance?
Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.
Coverage status under Care Enhance Plan?
Not available
What is Compassionate Travel?
Refers to the traveling expenses of a family member of the insured person in case the policyholders get admitted to a hospital outside his/her residential city.
Coverage status under Care Enhance Plan?
The policy does not cover compassionate travel expenses.
What is Global Coverage?
Any kind of medical/health emergency when you are outside of India.
Coverage status under Care Enhance Plan?
Global coverage is available under Care Enhance 2 as Enhance Anywhere option.
What is E-Consultation?
If a policy offers E-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.
Coverage status under Care Enhance Plan?
Not available
What is a Health Checkup?
A facility where the policyholder can avail free health check-ups after fulfilling the company's policies.
Coverage status under Care Enhance Plan?
The plan offers annual health check ups for adult members under the policy.
What is a Second Medical Opinion?
If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company’s network of medical practitioners.
Coverage status under Care Enhance Plan?
This option is available under this plan as a rider. You can avail of the benefit of expert opinion by paying an additional amount for this rider.
What is Vaccination cover?
Coverage against the expenses incurred on vaccinations is provided by the insurance companies.
Coverage status under Care Enhance Plan?
Not available
What is Co-payment?
In the co-payment clause, policyholders have to pay a portion of the medical expense on their own and the insurer will pay the rest of the amount.
Coverage status under Care Enhance Plan?
20% of co-payment applies to policyholders who are above 60 years of age.
What is the Sub limit?
Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder.
Coverage status under Care Enhance Plan?
No sub-limits defined
Care Enhance Riders
Care health insurance super to up plan offers 1 additional rider along with its basic coverage that can be availed of at an additional cost to seek expert opinion. Read the details below:
Expert Opinion
Get expert opinion for specified illnesses.
Expert Opinion
The company will arrange a specialist medical professional, allowing you to seek an expert opinion regarding specified major illnesses.
Care Health Insurance Network Hospital List
Care Health Insurance promises a wide Network of cashless Hospitals across India. A well connected network of over 19000+ cashless hospitals, Care Health Insurance ensures that you are medically secured, irrespective of the city you reside in
The following diseases or health conditions are not included in this health insurance plan:
Injuries resulting from a suicide attempt
Hospitalization due to alcohol, and drug abuse
Cost of spectacles, contact lenses, and dental treatment
Treatment of AIDS
Congenital Disease
Non-allopathic treatment
Treatments related to infertility and in-vitro fertilization
Treatment arises due to pregnancy and childbirth, miscarriage, abortion, and its consequences
Coverage after Waiting Period
Some treatments are covered after a defined waiting period under this plan. To know more, read below:
Pre-Existing Diseases after 4 years
Specific ailment after 2 years
Care Enhance Premium
PolicyX.com aims at making the premium calculation of a top-up plan simpler for you. Therefore, we have calculated two samples of annual premiums for 1 year policy term based on the same sum insured with different deductible amounts. Find sample premiums of both plan variants below:
Individual Plan Premium
Age Group
Sum Insured
Deductible
Sample Annual Premium (1A)
25 - 35 years
6 Lakhs
2 Lakhs
3794
25 - 35 years
6 Lakhs
3 Lakhs
3086
*The premium calculated in the table is inclusive of 18% GST.
Family Floater Premium
Age Group
Sum Insured
Deductible
Sample Annual Premium (2A+1C)
45 - 55 years
20 Lakhs
5 Lakhs
15606
45 - 55 years
20 Lakhs
10 Lakhs
11537
*The premium calculated in the table is inclusive of 18% GST.
Explore Care Health Insurance
Know more about Care Health Insurance plans, claim process, buying process, and contact details of the company by clicking on the sections below:
1. What do you mean by deductible in super top-up health insurance?
A deductible is an amount that policyholders need to pay for their medical expenses before using the top-up sum insured amount.
2. When does the Super Top-up Policy activate?
Super Top-up Policy activates when the medical expenses cross the deductible chosen in the plan.
3. Did Care Enhance cover pre-existing diseases?
There is a 4 year waiting period for pre-existing diseases from the date of policy inception.
4. Is there any co-payment clause under the Care Enhance policy?
Yes, you have to bear the 20% of co-pay on your medical expenses if your age is 61 years or above.
Read Reviews & Ratings
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Delhi
September 14, 2022
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Delhi
May 25, 2022
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Rajkot
February 17, 2022
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Dehradun
August 16, 2021
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Guwahati
August 16, 2021
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Ahmedabad
August 6, 2021
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Pune
August 6, 2021
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Chandigarh
August 6, 2021
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