Care Insurance Care Freedom

Care Insurance Care Freedom is a health insurance policy offered by Care Health Insurance Company Limited.

Enter the world of peace of mind with Care Insurance's Care Freedom Plan. This health insurance policy serves as a reliable safeguard, covering hospitalisation expenses. What sets it apart is its unique focus on pre-existing diseases, a feature often overlooked by many plans in the market. This plan promises to alleviate financial stress in medical emergencies, ensuring your savings and healthcare are protected. As per our research, it is a cost-effective option, too!

But, like every policy comes with its cons, with the Care Freedom Plan, you don't have the option to pay the premiums on a monthly basis and every time you make a claim, you'll have to bear a certain % of the approved claim amount. It does not offer comprehensive coverage and the plan applies sub-limits on core benefits, such as domiciliary hospitalisation costs and common treatments like cataract and joint replacement, which could result in significant expenses being incurred by you.  Additionally, our research shows that the insurer has received a higher number of complaints related to claim settlements and policy purchases, suggesting a poor track record in terms of both purchase and claim services.

What are the benefits offered by Care Insurance Care Freedom?

• Inpatient hospitalisation coverage: The Care Insurance Care Freedom plan provides coverage for the expenses related to inpatient hospitalisation. These expenses refer to the costs that arise when you are admitted to a hospital for a duration exceeding 24 hours, such as the costs of your hospital room, nursing care, consultations, prescription medications, ICU charges, and any other relevant expenses.
• Pre-hospitalisation coverage: Before you are admitted to the hospital, you may incur certain medical expenses. These costs, called pre-hospitalisation charges, include fees for consultations, laboratory tests, checkups, and medical reports, among other things. Please note that the insurance company will only cover your expenses if they are directly related to the medical condition that leads to your hospitalisation and the claim is approved as part of your inpatient hospitalisation expenses. The Care Insurance Care Freedom Plan covers 10% of payable hospitalisation expenses, which implies that the rest will have to be borne by you. This will be covered for a period of 30 days before your hospitalisation.
• Post-hospitalisation coverage: After your discharge from the hospital, you may incur certain medical costs known as post-hospitalisation expenses. These costs include consultation expenses, check-up expenses, medical tests expenses, etc. To ensure your expenses are covered, they need to be directly related to your hospital stay and approved as part of your inpatient hospitalisation coverage. The Care Insurance Care Freedom Plan covers 10% of payable hospitalisation expenses, which implies that the rest will have to be borne by you. This will be covered for a period of 30 days after your hospitalisation.
• Daycare treatment coverage: A daycare treatment is a medical procedure or surgery that traditionally required an extended hospital stay but can now be completed within 24 hours due to advancements in medical technology.  With the Care Insurance Care Freedom Plan, you can enjoy coverage for 541 daycare treatments without any limit.
• Domiciliary treatment coverage: Domiciliary treatments refer to medical treatments for illnesses or injuries that require immediate attention in a hospital but are administered at home because the patient is very ill or injured and cannot be transported safely to a hospital, or because there are no hospital beds available in the patient's immediate vicinity. With the Care Insurance Care Freedom, only 10% of the sum insured will be covered by the insurer and they extend this coverage to 13 treatments. Also, it is important to note that pre and post hospitalisation expenses will not be covered by the insurer in such a condition of home treatment.
• Organ donor coverage: The Care Insurance Care Freedom plan provides no coverage for organ donor expenses. All costs associated with this process of an organ transplant will have to be an out-of-pocket expense.
• Modern treatment coverage: The relentless progress in medical technology has granted access to groundbreaking treatments that were once unimaginable. Treatments like stem cell therapy, radio surgery, etc. are now available, offering targeted solutions for conditions that were previously deemed untreatable. The Care Insurance Care Freedom plan is tailored to keep up with these developments and covers the expenses associated with these modern treatments without any limit.
• Non-medical expenses coverage: The Care Insurance Care Freedom plan also covers non-medical expenses, but this has a limit of up to 1,000/- per day. These non-medical expenses refer to the cost of consumables, such as gloves, nebulization kits, oxygen masks, and other items necessary for treatment. Note that the cost of consumables will not be covered during the first 3 consecutive days of hospitalisation and for hospital stays lasting beyond 7 days.
• No Claim Bonus: No-Claim Bonus is a reward given by the insurance company if no claim is made during the policy period.  The Care Insurance Care Freedom plan does not offer a No-Claim Bonus.
• Super No-Claim Bonus: The Super No Claim Bonus is an upgraded version of the No Claim Bonus, and it operates in a similar manner. The Care Insurance Care Freedom plan does not offer this in its policy.
• Restoration benefit: The restoration benefit is a feature that restores your sum insured after you have used it up during a policy year. With the Care Insurance Care Freedom plan, you can enjoy this benefit for unrelated illnesses. This feature is activated when your sum insured has been fully used up. The refill can be utilised once in a policy year and no more than that.

Please remember that the limitations and conditions mentioned in the benefits above apply to a sum insured of Rs. 10 lakhs. 

Care Insurance Care Freedom: Financial Limits

• Room rent limit: The room rent limit is the maximum amount that your insurance provider will cover for your hospital room expenses. When you choose a room within this limit, you won't have to pay any extra charges. But if you decide to go for a pricier room, you'll be responsible for a proportionate portion of the total hospital bill, not just the room rent difference. With the Care Insurance Care Freedom plan, you have a cap on your room rent limit which is equivalent to a single private AC room.
• ICU rent limit: It is the maximum amount that your plan will pay for your stay in the intensive care unit at the hospital. In the Care Insurance Care Freedom plan, there is no limit on the ICU rent. This means that the plan will cover the entire cost of your ICU stay up to the sum insured.
• Co-payment: A co-payment, or co-pay, is a portion of the approved claim amount that you are responsible for paying out of pocket. Once this payment is made, the insurer will cover the remaining expenses. The Care Insurance Care Freedom plan has a co-payment clause of 20% in its policy. 
• Deductible: A deductible refers to a specific amount that you need to pay out of pocket before your insurance coverage kicks in to cover the remaining costs. There is no deductible in the Care Insurance Care Freedom plan.
• Limits on surgeries/treatments: This refers to the maximum amount that the health insurance policy will cover for specific medical procedures or treatments. Some plans have predetermined limits on the amount they’ll cover for certain procedures, while others do not. There are some limits when it comes to the Care Insurance Care Freedom plan. Here, cataract treatments are covered up to 30,000/- per eye per policy year and joint replacement surgeries are covered up to 1,20,000/- per knee per policy year.

Please note that the above financial limits are taken for a 30-year-old individual opting for a sum insured of Rs. 10 Lakhs.

Care Insurance Care Freedom: Waiting Periods & Exclusions

👉Waiting period

A waiting period is a specific time frame during which certain illnesses and medical conditions are not immediately covered after obtaining a health insurance policy. Claims for these specific conditions can only be made once the waiting period has passed. Here are some of the types of waiting periods 

• Initial waiting period: There is an initial waiting period of 30 days for all medical conditions, with the exception of accidents. During this time, you will not be eligible to make a claim for any hospitalisation, except in cases of accidents.
• Waiting period for pre-existing conditions: A pre-existing condition refers to any medical condition or illness you experienced within the 36 months before purchasing a health insurance policy. In the Care Insurance Care Freedom plan, there is a waiting period of 24 months for pre-existing conditions. During this waiting period, you will not be eligible to make any claims for costs associated with your pre-existing disease.
• Waiting period for specific diseases: In addition to pre-existing conditions, insurers maintain a list of particular medical conditions or illnesses which entail waiting periods, regardless of whether you have experienced those diseases previously or not. The waiting period is determined by the insurer and is not dependent on your current state of health. The Care Freedom plan has a waiting period of 24 months for specific diseases.

👉Exclusions

Health insurance policies do not provide coverage for specific medical conditions or situations. These are referred to as exclusions. Here are some of the types of exclusions -

• Standard Permanent Exclusions: All insurance providers are required to adhere to the ‘standard permanent exclusions’ established by IRDAI. These include -

1. Investigation and evaluation: Hospital admission for observation or monitoring.
2. Rest, rehabilitation, and respite care: Admission to a facility for bed rest without active treatment. 
3. Obesity/weight control: Treatment or surgery related to weight control or obesity.
4. Gender reassignment: Treatments aimed at altering the body’s characteristics to match the opposite sex. 
5. Plastic/Cosmetic surgery: Treatment or surgery intended to modify body characteristics or appearance.
6. Profession in hazardous or adventure sports: Treatment costs incurred resulting from participating in adventurous activities such as river rafting, mountaineering, scuba diving, etc. as a professional.  
7. Breach of law: Expenses incurred in treating a person who has committed or attempted to commit a criminal act.
8. Excluded providers: Treatment received from medical practitioners or hospitals excluded by the insurance company.
9. Narcotics: Treating addiction to substances such as alcohol, drugs, etc.
10. Treatments in establishments that are for domestic purposes: Expenses incurred due to the treatment received in health spas, nursing homes, or similar establishments arranged entirely or partially for domestic reasons. 
11. Dietary supplements, substances purchased without subscription: Vitamins, minerals, etc., that a medical practitioner does not prescribe.
12. Refractive error: Expenses associated with correcting refractive errors of up to 7.5 dioptres to improve eyesight.
13. Unproven treatments: Surgeries, medical procedures, or treatments that are not proven to be effective.
14. Expenses related to birth control, sterility, and infertility: Contraception, sterilisation, artificial insemination, and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc. 
15. Maternity expenses: Pre/post-natal costs and any childbirth-related hospitalisation expenses, etc. 

• Additional permanent exclusions: Insurance providers have the authority to apply additional exclusions for particular medical conditions or circumstances besides the standard permanent exclusions. If you have certain diseases or severe medical conditions that insurers consider risky to cover, they may permanently exclude them from your policy. 

However, you need to note that the health insurers are restricted to a list of illnesses defined by the Insurance Regulatory and Development Authority of India (IRDAI) for which they can apply a permanent exclusion. They cannot impose permanent exclusions to illnesses or diseases beyond this list.

• Non-standard exclusions (Specific exclusions): These are specific exclusions that go beyond the standard permanent exclusions outlined by the IRDAI. These exclusions differ across insurance companies and depend on the policy’s terms and conditions. Here are some of the specific exclusions listed under the Care Insurance Care Freedom plan -

1. Treatment for any sexually transmitted disease other than HIV
2. Prosthesis or external equipment of any kind like wheelchairs, walkers, crutches, etc.
3. Expenses related to screening, counselling or treatment of external birth defects
4. Circumcision unless necessary due to an accident or for treating a disease
5. Expenses related to preventive care, vaccination, inoculation, immunisation (except post-animal bite treatment) and tonics
6. Use of a ventilator for a patient in a vegetative state (brain dead) without any chances of recovery
7. Expenses related to treatment or surgery to remove an organ from a donor
8. Expenses related to Ayush treatments or non-allopathic or alternative treatment
9. Injury or disease due to war, invasion, act of foreign enemy, and warlike operations
10. Treatment-related to intentionally self-inflicted Injury or attempted suicide by any means
11. Injury or illness due to nuclear, chemical or biological attack or weapons
12. Abuse of stimulants or depressants that impair intellectual abilities, unless prescribed by a medical practitioner
13. Multifocal lens implantation for cataract

What to expect in terms of claims experience if you buy from Care Health Insurance Company Limited?

• Speed of claims: Care Health Insurance Company has settled 100% of its claims within 30 days. This assures you of a smooth and timely claim settlement experience.
• Claim-related complaints: As per our research, we found that Care Health Insurance Company has a higher complaint rate as compared to other insurers, accounting for 0.39%.
• Claims incurred ratio: The claims incurred ratio is a measure of an insurer's financial performance. It shows the total claims paid out in relation to the premiums received in a specific fiscal year. Care Health Insurance Company has a claims incurred ratio of 57.69%.
• Claim settlement ratio: Care Health Insurance Company’s claim settlement ratio stands at 90.50%. This figure reflects the proportion of total claims received to those successfully settled by the company in a specific fiscal year.
• Network hospitals: Care Health Insurance Company provides access to an extensive network of 24,800+ hospitals. This kind of reach is rare amongst insurers and is definitely a plus. This broad network allows customers to receive cashless treatment without any financial worry.

How is the customer service of Care Health Insurance Company Limited?

• Policy purchase-related complaints: Based on our research, Care Health Insurance Company has received 0.01% of complaints related to its after-sales service, which is significantly higher than other insurance companies. 
• Response on Toll-Free: Our research suggests that Care Health Insurance Company's response time on their toll-free is average, as compared to other insurers. 
• Response on Twitter: As per our research, Care Health Insurance Company has an average response time on Twitter, as compared to others.

About Care Health Insurance Company Limited

Care Health Insurance (formerly known as Religare Health Insurance Company Limited) is a specialised health insurance company in India. The company provides Health Insurance, Top-up Coverage, Personal Accident, Maternity, International Travel Insurance, and Critical Illness products in the retail segment, as well as Group Health Insurance and Group Personal Accident Insurance for corporations, etc. It was founded in 2012 and is headquartered in Gurugram, Haryana. Mr Anuj Gulati is the company's CEO and MD.