Care Health Insurance

Care - Care Heart

Care Heart policy is a heart insurance plan that offers coverage for pre-existing heart illnesses. A specific heart insurance product, it serves as an ideal health insurance for cardiac patients i.e. those with pre - existing heart ailments.

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Fast changing lifestyles and food habits have contributed to an increase in heart-related ailments significantly over the past 20-25 years and what is more important to note is that Heart Diseases or CVD are no longer prevalent in senior citizens. Even younger persons are being treated for various heart ailments. Heart disease has a lot of attention now but you still need to be alert and make the right choices so that expenses and costs don’t cripple your family’s financial security in the long run. If you are thinking of getting health insurance or upgrading your existing one, coverage for heart-related treatments is an important consideration factor and this plan Care Heart from Care Health is an ideal plan to take care of financial burdens at difficult times.

Care Health Insurance Review

Care Health Insurance
Sum Insured
4 lacs - 600 lacs
Claims Incurred Ratio *
59.00%
Tenure Options
1, 2, 3 years
Claims Settlement Ratio **
86.63%
List of Network Hospitals
19,000+ hospitals
Number of Policies issued *
1,178,380
Maximum Family Floater Coverage
Self, Spouse + dependent children + dependent parents
Number of Lives Covered *
7,342,207
* As per IRDAI report for 2020-21   |  ** As per NL25 data published on the Insurance Company website

Care Health Insurance - Care Heart plan - review

  • Key features
  • Eligibility
  • Coverages
  • Benefit description

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

Benefit Description

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

Care health insurance FAQ's

Care has an extensive network of 7400+ network hospitals across India and this number has been growing steadily over the years. Hence it is important while seeking treatment following a sickness or an accident to ideally get admitted to a network hospital. One can get the hospital closest to them by going through the Care network hospital list available on Care health insurance.

Yes, Care Health offers Cashless treatment for inpatient hospitalisation of the insured. The important criteria to avail of the cashless facility is to seek admission into one of Care’s network hospitals across the country. Subject to the claim being admissible under the policy, Care will offer cashless settlement upto the policy limits of the insured’s policy.

Care Health offers a free look period to review it’s policy terms and conditions. In case one is not satisfied with the same, one can request for cancellation of their policy during this period. The insured will be charged the pro-rated premium for the period during which your policy was in-force, the cost of pre-policy health check-up, if any, and the stamp duty. The balance premium would be refunded.
Also, one can request for cancellation of your policy at any time during the policy period post the free look period. In this case, the refund of the premium amount is as per the short scale grid, which is shared as part of the Policy Terms and Conditions sent as part of the policy kit. However, in case you of any claim being reported with Care, the insured will not be entitled to any refund of premium on cancellation of the policy.

Brochure

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Policy wordings

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2025
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