Care - Care Heart

Care Health Insurance - Care Heart plan - review

• Key features of Care Heart insurance policy

  Some of the key features of this plan include:
  
  • Room Rent :Upto 1% of Sum Insured for a Private Single A/c Room
  • Co-pay :Co-pay upto 20% co-pay for claims
  • Restoration Benefit: NIL Restoration Benefit
  • No upper limit on entry age
  • Enrols for who have undergone heart surgery in last 7 years
  • Only 2 years wait period for pre-existing ailments
  • No pre-policy medical check-up
  • 540+ Day Care Treatments
  • Covers Alternative Treatments

• Care Health insurance - Care Heart plan – eligibility

  Entry Age – Minimum	18 Years
  Entry Age – Maximum	Lifelong
  Exit age	No Exit age
  Policy Term	1/2/3 Years
  How can You cover Yourself	Individual basis (maximum up to 6 Persons having same/different Sum Insured) or Floater basis
  Cover Type	Individual: Maximum up to 6 Persons. Floater : 2A (Self and Spouse)
  Who are covered (Relationship with	1. Individual: Self, Legally married spouse, son, daughter, father, mother, brother, sister, mother-in-law, father-in law, grandmother, grandfather, grandson, granddaughter, uncle, aunt, nephew, niece, employee or any other relationship having an insurable interest. Family Floater: Self, Legally married spouse, son, daughter, father, mother, employee and his/her dependents (Legally married Spouse, Children & Parents) or any other relationship having an insurable interest
  Eligibility Criteria	Person/either one Person in case of a Floater Policy with 2 Adults, who have been diagnosed with a cardiac ailment/disorder in the past and undergone a Cardiac surgical intervention or procedure for the same

• Coverages under Care Heart insurance plan

  Sum Insured (all figs in ₹ INR)	2,00,000	3,00,000	4,00,000	5,00,000	7,00,000	10,00,000
  Deductible	No deductible/10K/25K/50K/1L/2L/3L
  Pre Policy Issuance Health Check-up	None
  Benefits
  Inpatient Treatment	Upto Sum Insured
  Day Care Treatment	Upto Sum Insured
  Pre / Post Hospitalisation Coverage	Pre-Hospitalization for 30 days & Post-Hospitalization for 60 days; Maximum upto 5% of SI
  Alternate Treatment	Upto 25% of Sum Insured
  Ambulance Cover	Upto 2,000				Upto 3,000
  Domiciliary Hospitalisation	up to 100% of Sum Insured covered after 3 days
  Automatic Recharge	100% of original SI upon exhaustion of SI
  No Claim Bonus (NCB)	10% increase in SI per Policy Year in case of claim-free year; Max upto 50% of SI (10% decrease in SI per Policy Year in case a claim has been paid; Such decrease is only in SI accrued as NCB)
  Waiting Periods
  Initial Waiting Period	30 days
  Specific Waiting Period	24 month
  Pre Existing Diseases	24 months
  Co Pay	20% / 30% per claim
  Sublimits
  Room Rent / Category	Upto 1% SI per day			Single Private Room
  ICU Charges	Upto 2% SI per day			No Limit
  Cataract Treatment Expenses	Upto 20,000 per Eye			Upto 30,000 per Eye
  Knee Replacement Treatment	Upto 70,000 per knee	Upto 80,000 per knee		Upto 1,00,000 per knee	Upto 1,20,000 per knee
  Treatment for each and every Ailment / Procedure mentioned below:- i. Surgery for treatment of all types of Hernia ii. Hysterectomyiii. Surgeries for Benign Prostate Hypertrophy (BPH) iv. Surgical treatment of stones of renal system.	Upto 35,000	Upto 50,000	Upto 55,000	Upto 65,000	Upto 80,000
  Treatment for each and every Ailment / Procedure mentioned below:- i. Treatment Cerebrovascular disorders ii. Treatments/Surgeries for Cancer, iii. Treatment of other renal complications and Disorders iv. Treatment for breakage of bones	Upto 1,50,000	Upto 2,00,000	Upto 2,25,000	Upto 2,50,000	Upto 3,00,000
  Optional Covers
  OPD Care	Up to 2k/3k/5k/7k/10k/15k/20k/25k for consultations/diagnostics/pharmacy; Max. up to 50% of covered amount for diagnostics.
  International Second Opinion	Once per Major Illness / Injury per policy year
  Home Care	Up to Rs.1,000 per day; Max. 7 days per occurrence & Max. 45 days per policy year per Insured Person; Covered after a deductible of 1 day				Up to Rs.2,000 per day; Max. 7 days per occurrence & Max. 45 days per policy year per Insured Person; Covered after a deductible of 1 day
  Active Health Check Up	3 times a year
  Heart Health Check Up	Annually

• Comprehensive coverage for hospitalization expenses

  The main feature of Care Heart is to cover expenses that will be incurred during hospitalization. One can use the cashless facility or get the costs reimbursed. It is always good to have a breakdown on what is covered for e.g. expenses include room charges and nursing expenses, amongst others apart from main treatment charges. One also gets adequate coverage for day care treatment.
  
  Pre - hospitalization and post - hospitalization benefits Medical expenses are not just restricted to the hospitalization costs, so with Care Heart the insured is covered for pre-hospitalization and post-hospitalization expenses as well. All one needs to do is just focus on your treatment and recovery – the insured are covered for 30 days preceding the hospitalization and 60 days after discharge.
  
  Coverage for alternate treatments Our health insurance for cardiac patients accommodates alternative medicine so the insured can get coverage for supplementary Ayurveda or Unani treatments.
  
  Ambulance expenses Coverage for Ambulance expenses is a built-in feature of the plan.
  
  Domiciliary hospitalization coverage Illness does not necessarily mean hospitalization – in some cases, the insured will be recommended domiciliary care. This usually happens when the patient is too sick to be transferred, so to avoid the additional stress of transference, home based care is recommended. Care Heart covers domiciliary treatment expenses as well.
  
  Automatic recharge facility Our cardiac health insurance has an automatic re-charge feature so the sum insured once exhausted is automatically topped-up on the policy.
  
  Get no claims bonus If one has not made a claim for an entire policy year, your Sum Insured is increased by 10% over the previous year Sum.
  
  Cardiac health check-up Care Heart includes an annual check-up for insured members, at no extra cost, which assesses comprehensive cardiac and other related parameters. Staying informed is the best way to stay healthy.
  
  Optional cover for OPD expenses This covers OPD expenses which include pharmacy, diagnostics, and consultation costs. The diagnostics cover will be 50% of the total coverage for OPD care.
  
  International Second Opinion Care Heart gives the insured the freedom to go ahead and take an International Second Opinion at no extra cost specially arranged by us.
  
  Home Care Option Health treatment doesn’t end at discharge and the insured may need a detailed home care routine that involves registered professionals and specific treatments. Care Heart gets the insured ahead on the road to recovery with its Home Care option. This benefit needs to be utilized within 30 days of discharge and this form of treatment should be recommended by a medical practitioner.
  
  Active health check-up Active health check-ups are also integral to maintaining health of the insured patient. There certain tests that are indispensable and Care Heart has that covered. This includes coverage for tests like lipid profile, fasting and PP blood sugar test, and blood pressure test up to three times a policy year