Care Heart Plan
Overview
Care Health Insurance (CHI) is a specialized Health Insurer offering health insurance services to employees of corporates, individual customers and for financial inclusion as well. With CHI’s operating philosophy being based on the principal tenet of ‘consumer-centricity’, the company has consistently invested in the effective application of technology to deliver excellence in customer servicing, product innovation and value-for-money services. Care Health Insurance currently offers products in the retail segment for Health Insurance, Critical Illness, Personal Accident, Top-up Coverage, International Travel Insurance and Maternity along with Group Health Insurance and Group Personal Accident Insurance for corporates. The organization has been adjudged the ‘Best Health Insurance Company’ at the ABP News-BFSI Awards & ‘Best Claims Service Leader of the Year – Insurance India Summit & Awards. Care Health Insurance has also received the ‘Editor’s Choice Award for Best Product Innovation’ at Finnoviti and was conferred the ‘Best Medical Insurance Product Award’ at The FICCI Healthcare Awards. Best Health Insurance Company - ABP News – BFSI Awards 2015, Best Claims Service Leader of the Year - Insurance India Summit & Awards 2018, Best Product Innovation - Editor’s Choice Award Finnoviti 2013, Best Medical Insurance Product - FICCI Healthcare Awards 2015
Highlights For
Care Heart
Restore Benefit
Cardiac Health Check up
Modern Treatments
Home Care
Features
Sub-limits
Room Rent
Room rent for in-patient hospitalisation
ICU Charges
Charges for ICU hospitalisation
Co pay
% of the claim that the policyholder needs to pay out-of-pocket
Health Check up
Free annual health check-up for all insured members according to the list of tests specfied in the policy document.
Ambulance
Transportation of the patient to the hospital and back home
Organ Donor
The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.
Modern Treatments
All advanced treatment with upgrade in technology.
Pre-Hospitalisation : 30 Days
The amount of expenses incurred during this period prior to hospitalisation such as diagnostic tests, doctor fees, medicines, etc. for investigiation purpose are also payable by the insurer
Post Hospitalisation : 60 Days
The amount of expenses incurred during this period after discharge from hospitalisation for the purpose of recovery such as follow-up tests, doctor fees, medicines, etc. are also payable by the insurer
Pre existing Disease cover : Pre-existing diseases covered after 24 months of renewal.
Coverage for all Pre-Existing Diseases covered after a certain specified waiting period with continuous renewal.
Waiting Period- Initial : 30 Days
No claims are accepted within this period except due to accidents/ injury.
Waiting Period- Specific : 2 years
Listed specific illness
Waiting Period- PED : 2 years
No pre-existing ailment related claims are accepted within this period.
Room Rent : 3 Lakh: Upto 1% of SI per day 5 lakh-10 lakh: single private room
Room rent for in-patient hospitalisation
ICU Charges : 3 Lakh: Upto 2% of SI per day 5 lakh - 10 lakh: No limit
Charges for ICU hospitalisation
Co pay : 20% Co-payment if the entry age 70 years or less than 70 years 30% Co-payment if the entry is 71 years and above
% of the claim that the policyholder needs to pay out-of-pocket
Restore Benefit/ Recharge/ Refill : 100% automatic recharge once in the policy year
If the sum insured is exhausted due to hospitalisation expenses of one or more members, there is an automatic restoration of the sum insured for related or unrelated ailments.
Health Check up : Annually
Free annual health check-up for all insured members according to the list of tests specfied in the policy document.
No Claim Bonus : 10% increase in Upto Sum Insuredper Policy Year for claim-free years, up to a maximum of 50% of the Sum Insured. A 10% decrease in Upto Sum Insuredper Policy Year if a claim has been paid, applicable only to the No Claim Bonus accrued Sum Insured.
% of the sum insured that rises every claim free year.
Video/telephone consultation : No
E-consultation with expert doctors empanelled with the insurer for a second opinion.
Domiciliary hospitalization : Upto 100% of Sum Insured covered after 3 days
Home care treatment where there are no beds in the hospital or paitient is not in a condition to be moved to the hospital, This treatment is provided under the supervision of a registered medical practitioner.
Ambulance : 3 lakh - 5 lakh: Up to Rs 2,000 per Hospitalization 7 lakh - 10 lakh: Up to Rs 3,000 per Hospitalization
Transportation of the patient to the hospital and back home
Convalescence benefit : No
A specific fixed amount of money paid as a recovery benefit for extended hospitalisation.
Bariatric cover : No
Expenses related to obesity-related conditions such as high BP, sleep apnea, arthiritis asthma, etc.
Daycare : Upto Upto Sum Insured
Covers in-patient hospitalisation expenses where the stay is <24 hours under a specified list of treatments
AYUSH : Upto 25% of sum insured
Alternative treatment coverage such as ayurvedic, unani, sidha and homeopathy which leads to hospitalisation.
Congenital Coverage : No
Covers medical expenses related to diagnosis and treatment of heriditary and internal congenital ailments/ conditions/ traits that exist from birth.
Health Management/ Wellness : No
Benefits provided for staying fit and managing health
Maternity Benefit : No
All expenses related to childbirth or legal medical termination of pregnancy, usually upto a specified limit.