• All Day Care Treatments Covered
• Coverage for In-patient Care up to SI
• Advance technology methods covered up to 100% of Sum insured
• Ayush Treatment Covered up to SI
• Coverage for treatment expenses at home up to 100% of Sum Insured under - Domiciliary Hospitalization
• Organ Donor Covered up to SI
• Up to 60 days pre hospitalization and 90 days post hospitalization coverage
• Same Wait Period for New born^^
• Any mode of transport is covered up to SI under Ambulance Cover
• Tax Benefits under Section 80D of IT Act 1961^###

^{*This is an Optional Benefit (Premium Payback) that is pre-added in the sales proposition. Available on payment of additional premium. In case no hospitalisation related claim is made for the preceding 5 consecutive Policy Years, then 1st Policy Year premium of base plan shall be refunded in every block of 5 years subject to subsequent renewal of Policy. Base premium is the premium excluding optional benefits and taxes. ^^This is an optional benefit available on payment of additional premium. #Provided no hospitalisation related claim has been made in 7 preceding Policy Years. Waiting Period shall be waived off for this additional Sum Insured. If there is an increase in Sum Insured, the original Sum Insured at the Policy's inception will be considered and in case of decrease in sum insured, the reduced sum insured will be considered. **This is an optional benefit (wellness benefit) that is pre-added in the sales proposition. Available on payment of additional premium. ##This is an optional benefit that is pre-added in the sales proposition. Available on payment of additional premium with multi tenure policies and only one claim is payable in the entire policy term under this benefit. ^Discounts on premium are available only for the first 3 years - 30% discount in first year, 20% discount in second year and 10% discount in 3rd year. ^^If added in the policy within 90 days of birth.  ###As per section 80D of Income Tax Act, an Adult (aged between 18 & 60 years) can save tax on a premium paid by him/her up to ₹ 25,000 for his & his  family’s policy & up to ₹ 50,000 for his/her senior citizen parents (aged 60 years & above). Tax Benefits under the policy will be as per the prevailing Income Tax laws and are subject to amendments from time to time. For tax related queries, contact your independent tax advisor.}

• Entry Age – Minimum - Adult: 18 Years, Child: 91 Days
• Entry Age – Maximum - Adult: Lifelong, Child: 24 Years
• Exit Age - Adult: Lifelong, Child: 25 Years
• Lifelong Renewability
• Cover Type - Individual: max up to 6 persons | Floater: max up to 2A2C
• Tenure Options - 5 Years
•  ICU Charges - Up to SI
• Waiting period
  • Initial waiting period - 30 days  for any illness (except accidental injury)
  • Named ailment waiting period - 24 months of continued coverage
  • Pre-existing disease waiting period - 36 months of continued coverage

Key Exclusions

• Any item or condition or treatment specified in List of Non-Medical Items.
• Taking part or is supposed to participate in a naval, military, air force operation or aviation in a professional or semi-professional nature.
• Treatment taken from anyone who is not a Medical Practitioner or from a Medical Practitioner who is practicing outside the discipline for which he is licensed or any kind of self-medication.
• Charges incurred in connection with routine eye examinations and ear examinations, dentures, artificial teeth and all other similar external appliances and / or devices whether for diagnosis or treatment
• Alopecia wigs and/or toupee and all hair or hair fall treatment and products.
• War (whether declared or not) and war like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.
• Act of self-destruction or self-inflicted Injury, attempted suicide or suicide while sane or insane or Illness or Injury attributable to consumption, use, misuse or abuse of tobacco, intoxicating drugs, alcohol or hallucinogens.

For complete exclusions please refer to the product Policy Terms and Conditions.

Re-imbursement Claim Process

• You can register your claim online by scanning & uploading the claim documents at the Care Health Insurance ‘Self-Help Portal’ Link- https://www.careinsurance.com/self-help-portal.html or download the Care Health-Customer App to be able to do the same.
• As per the product you are insured with, download the re-imbursement claim form & submit online- https://www.careinsurance.com/health-insurance-claim-forms.html or download the Care Health-Customer App to be able to do the same.
• Upload a personalized name printed cancelled cheque in name of employee for corporate policy and in name of proposer for individual policy.
• In event of employee’s/proposer’s demise – cancelled personalized cheque (name printed) of nominee, ID proof of nominee & legal heir certificate.
• You are requested to scan & upload the following documents received from your hospital. Also submit additional documents, if any.
  • Original discharge summary
  • Original final hospital bill with item wise break-up
  • Original paid receipt against the final hospital bill
  • For Accidental cases
    1. MLC/FIR copy (if applicable)
    2. Alcohol history (if applicable)
  • Investigation reports (like X-Ray/MRI/CT Scan etc)
  • Attested copy of indoor case papers
  • In case of implant surgery, invoice & sticker
  • For all claims amounting Rs.1 lakh or above please provide copy of any one of these KYC documents (Aadhaar Card, Passport, Driving Licence Voter ID, etc). Please ensure that the address on KYC documents is matching with the Policy address.

Cashless Claim Process

1. To locate the nearest cashless network visit https://www.careinsurance.com/health-plan-certified-network-hospitals.html or download the Care Health-Customer App by clicking here https://bit.ly/3iI2ZfJ.
2. Contact hospital insurance help-desk or billing counter with a copy of patient’s medical ID card, e-health card, pre-authorization form along with valid Govt. ID proof. You can easily access your e-card anytime, anywhere by downloading the Care Health-Customer App.
3. Submitted documents are shared by the billing counter/TPA desk with us, seeking pre-authorization approval.
4. In case any information is incomplete/ missing; we may contact hospital for the same.
5. Pre-authorization decision will be given by us post review as per policy terms and conditions.
6. Post treatment discharge summary and other related documents are submitted by the hospital/TPA to us for final approval.
7. We assess the bills basis the sum insured and plan terms & conditions to settle the bill directly with the hospital.