
Care Insurance Care Supreme
The Care Insurance Care Supreme plan is a health insurance policy that is offered by Care Health Insurance Company Limited.
This plan provides extensive coverage and is at a competitive price compared to other plans available in today's market. One major benefit is that you can accumulate a No Claim Bonus of up to 600% of the sum insured under the policy. However there are some downsides as well. Under the policy, there is no monthly premium payment option and our research indicates a significantly higher number of complaints regarding claim settlements and policy purchases, suggesting a poor track record in both service areas for the insurer.
What are the benefits offered by the Care Insurance Care Supreme plan?
- Inpatient hospitalisation coverage: The Care Insurance Care Supreme plan provides coverage for inpatient hospitalisation expenses. These are expenses you incur when you are admitted to the hospital for more than 24 hours such as room and board charges, nursing fees, medical practitioner charges, prescription medication costs, ICU expenses, etc.
- Pre-hospitalisation coverage: Pre-hospitalisation expenses are the medical costs you incur before being admitted to the hospital. They include the cost of lab tests, consultations, checkups, medical reports, etc. It is important to note that these expenses will only be covered if they are related to the medical condition that leads to hospitalisation and approved as part of the inpatient hospitalisation expenses. Care Insurance Care Supreme plan offers coverage for pre-hospitalisation expenses for 60 days prior to hospitalisation up to the sum insured.
- Post-hospitalisation coverage: After you get discharged from the hospital, you may face additional medical expenses known as post-hospitalisation costs. These can include expenses associated with physician consultations, medical check-ups, rehabilitation programs, physical therapy, and other medical treatments. To be eligible for coverage, these expenses must be directly related to your initial hospitalisation and your claim must be approved as part of the inpatient hospitalisation coverage. The Care Insurance Care Supreme plan offers coverage for post-hospitalization expenses incurred 180 days after hospitalisation up to the sum insured.
- Daycare treatment coverage: As medical technology continues to advance, many medical procedures that previously required prolonged hospitalisation can now be completed in less than 24 hours. These procedures are commonly known as daycare treatments. The Care Insurance Care Supreme plan covers all daycare treatments, without imposing any limits.
- Domiciliary treatment coverage: Domiciliary treatments are the treatments for illnesses or injuries which need immediate care in a hospital but can be administered at home, if the patient is very ill or injured and cannot be moved safely to a hospital, or there are no beds available in the vicinity. The Care Insurance Care Supreme plan provides coverage for domiciliary treatment expenses, except for 12 specific illnesses up to the sum insured.
- Organ donor coverage: The Care Insurance Care Supreme plan provides coverage for expenses related to harvesting the organ up to the sum insured in the event of an organ transplant surgery, where the insured is the recipient.
- Modern treatment coverage: The world of medicine has seen remarkable advances in recent years. New treatment options like stem cell therapy and radio surgeries offer hope to those battling various medical conditions. The Care Insurance Care Supreme plan recognizes the importance of these modern treatments and provides coverage for related expenses up to the sum insured without placing a cap.
- Non-medical expenses coverage: Non-medical expenses include costs related to consumables such as nebulization kits, gloves, oxygen masks, and other similar items. The Care Insurance Care Supreme plan provides coverage for non-medical expenses if you opt for an add-on.
- No Claim Bonus: The Care Insurance Care Supreme plan provides you with a No-Claim Bonus as a reward if you don’t file any claims in a policy year. You will receive 50% of the sum insured as No Claim Bonus. Your accumulated bonus will remain intact if you make a claim during a policy year. Under the plan, you can accumulate a maximum bonus of up to 100% of the total sum insured.
- Super No Claim Bonus: The Care Insurance Care Supreme plan offers a Super No Claim Bonus, which is an enhanced version of the No Claim Bonus. Like the regular bonus, if you don’t file a claim during a policy year, you can receive a bonus of 100% (if you opt for an add-on). You can keep the accumulated bonus intact regardless of any claims made (if you opt for an add-on). Under the policy, you can accumulate a maximum bonus of up to 500% of the sum insured.
- Restoration Benefit: The Restoration Benefit replenishes your sum insured if it gets exhausted in a policy year. It kicks in only when the sum insured and the No-Claim Bonus are partially utilised during the policy year, and it restores the entire amount. The Restoration Benefit applies to both related and unrelated illnesses, and you can make use of this benefit an unlimited number of times in a policy year. You can refill your sum insured after the first paid claim.
Please note that the limits and conditions mentioned in the above benefits and features are for Rs. 10 Lakhs sum insured.
Care Insurance Care Supreme: Financial Limits
- Room rent limit: The maximum/highest amount that your insurance provider will pay for your hospital room is the room rent limit. As long as you choose a room that falls within this limit, you will not have to worry about any additional expenses. However, if you opt for a room that is above your eligibility, you will be subject to a proportional deduction. This means that you will have to pay a proportionate portion of the bill rather than just the difference in room rent. Care Insurance Care Supreme plan offers you the flexibility to choose any type of room without having to worry about limits.
- ICU rent limit: The Care Insurance Care Supreme plan provides coverage for expenses incurred during an ICU stay without placing any cap. This ensures that you receive the best possible medical care without any financial burden.
- Copayment: A copay is a percentage of the approved claim amount you need to pay from your end before your insurer covers the rest of the amount. The Care Insurance Care Supreme plan does not have a copayment limit.
- Deductible: Deductible is a certain amount you need to pay out of your own pockets before insurance coverage kicks in to cover your medical expenses. Care Insurance Care Supreme plan doesn’t have a deductible.
- Limits on surgeries/treatments: Some health insurance policies cover certain medical procedures or treatments up to a certain limit while others may not. The Care Insurance Care Supreme plan covers important procedures such as cataract treatment and joint replacement surgery up to the sum insured. This means that you can receive the medical treatments you need without worrying about any limits.
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 Supreme: Waiting Periods & Exclusions
👉Waiting period
Health insurance policies have waiting periods during which certain medical conditions or illnesses are not covered. Once this waiting period is completed, you can make a claim for those specific health issues. Here are the types of waiting periods -
- Initial waiting period: The Care Insurance Care Supreme plan has an initial waiting period of 30 days for all medical conditions except in case of accidents. During this period, you will not be able to make claims for hospitalisation expenses, except in the event of an accident.
- Waiting period for pre-existing diseases: Such existing diseases refer to any medical illness or condition that you experienced in the last 36 months before applying for a health insurance policy. Under the Care Insurance Care Supreme plan, pre-existing diseases have a 12-month waiting period (if you opt for an add-on). During this waiting period, you won't be able to claim any medical expenses related to your pre-existing disease.
- Waiting period for specific diseases: Care Insurance Care Supreme policy includes waiting periods for certain medical conditions other than for your pre-existing diseases. These waiting periods are determined by the insurer and are not dependent on your current health status. The Care Insurance Care Supreme plan imposes a fixed waiting period of 24 months for specific diseases.
👉Exclusions
There are certain medical conditions or situations that are not covered by health insurance policies, referred to as exclusions. These exclusions may include -
- Standard permanent exclusions: Health insurance providers in India are required to adhere to a standardised list of "permanent exclusions" established by the Insurance Regulatory and Development Authority of India (IRDAI). Here are some of them -
- Monitoring hospitalisation: When you are admitted to the hospital solely for observation or monitoring purposes.
- Rest, rehabilitation, and respite: Admission to a facility for rest or respite where active medical treatment is not provided.
- Weight control procedures: Any surgical or medical procedures aimed at controlling weight or addressing obesity.
- Gender change treatment: Medical interventions to alter the body's characteristics to match the opposite gender.
- Plastic/cosmetic surgery: Surgical or medical procedures for modifying appearance or body characteristics.
- Hazardous or adventure sports: Medical expenses incurred while participating professionally in activities like mountaineering, river rafting, scuba diving, horse racing, etc.
- Legal violations: Expenses related to treating a person who has committed or attempted to commit a criminal act.
- Excluded providers: Treatment from medical practitioners or hospitals not covered by the insurance company.
- Narcotics: Costs related to treating addictive conditions like alcohol addiction, drug usage, etc.
- Domestic establishments: Expenses incurred in health spas, nursing homes, or similar places arranged for domestic reasons.
- Non-prescription supplements: Vitamins, minerals, and other dietary supplements not prescribed by a medical practitioner.
- Refractive error: Expenses linked with correcting refractive errors up to 7.5 diopters for improved eyesight.
- Unproven treatments: Surgeries, medical procedures, or treatments that lack proven effectiveness.
- Birth control, sterility, infertility: Expenses related to contraception, sterilisation, artificial insemination, and advanced reproductive technologies such as IVF, GIFT, ICSI, ZIFT, gestational surrogacy, etc.
- Maternity Expenses: Costs associated with pre/post-natal care, childbirth and its related hospitalisation, etc.
- Additional permanent exclusions: Apart from the pre-approved permanent exclusions by the IRDAI, insurance providers can also apply "permanent exclusions'' to particular medical conditions or circumstances at their discretion. Insurance companies may permanently exclude medical conditions that they consider risky from coverage. However, they are bound to exclude only those conditions that are listed by the IRDAI and not beyond that.
- Non-standard exclusions (Specific exclusions): Apart from the permanent exclusions, insurers also apply specific exclusions based on its terms and conditions It is essential to note that these exclusions may vary across different insurance providers. Listed below are some of the specific exclusions of the Care Insurance Care Supreme plan -
- Injury or illness resulting from participation in professional or semi-professional naval, military, or air force operations or aviation, whether direct or indirect.
- Costs of external durable equipment used for diagnosis or treatment unless necessitated due to an accident.
- Expenses associated with hair fall treatments and products.
- Screening, counselling, or treatment for external birth illnesses, defects, or anomalies.
- Circumcision expenses, unless deemed medically necessary for treating a disease or injury.
- Expenses associated with preventive care, vaccination, inoculation, immunisation (except post-animal bite treatment) and tonics, except those incurred under the "Annual Health Check-up" benefit.
- Ventilator for a patient in a vegetative state (brain dead) with no chance of recovery.
- Injury or illness caused due to civil war, terrorism, war, or warlike operations, whether direct or indirect.
- Expenses associated with treatment for intentional self-inflicted injury or attempted suicide by any means.
- Injury or illness due to nuclear, chemical, or biological attacks or weapons.
- Abuse of stimulants or depressants that damage intellectual abilities unless prescribed by a medical practitioner.
- Treatment received in a clinic, rest home, sanatorium, nursing home, or other similar institution
- Hormone replacement therapy
What to expect in terms of claims experience if you buy from Care Health Insurance?
- Speed of claims: Care Insurance Health Insurance Company has settled 100% of claims within 30 days. This means you can rest assured that your claims will be processed quickly.
- Claim-related complaints: Based on our research, it appears that Care Insurance Health Insurance Company has a higher rate of complaints regarding claim settlements at 0.39%. This suggests that their service still needs improvement for better customer satisfaction.
- Claims incurred ratio: Claims incurred ratio is an important metric for assessing an insurer's financial stability. It is the proportion of total claims paid out against total premiums received in a fiscal year. In this regard, Care Insurance Health Insurance Company stands out with claims incurred ratio of 57.69%.
- Claim settlement ratio: It is known as the ratio of total claims settled against the total number of claims received during a fiscal year. Care Insurance Health Insurance Company has a claim settlement ratio of 90.50%.
- Network hospitals: Care Insurance Health Insurance Company has over 24,800+ hospitals in their network. This means you have access to a wide range of healthcare providers with the convenience of cashless treatments.
How is the customer service of Care Health Insurance?
- Policy purchase-related complaints: Based on our research, Care Insurance Health Insurance Company has a post-sales service record with a comparatively high complaint rate of 0.01%. This shows the company's is yet to improve their customer service.
- Response on Toll-Free: In our research, we have observed that the toll-free customer service number of Care Insurance Health Insurance Company is average than other insurance providers.
- Response on Twitter: Based on our research, the response time of Care Insurance Health Insurance Company on Twitter is also average than that of other insurance companies.
About Care Health Insurance Company Limited
Care Health Insurance was formerly known as Religare Health Insurance Company Limited. It is a dedicated health insurance provider in India that offers a range of products in the retail segment, including health insurance, top-up, personal accident insurance, maternity insurance, international travel insurance, and critical illness insurance. They also offer group health insurance and group personal accident insurance for corporations as well. Founded in 2012, the company is headquartered in Gurugram, Haryana, and is led by CEO and MD Mr. Anuj Gulati.