Care Health Insurance Company (Formerly known as Religare Care Health Insurance Company Limited) is a part of Religare Group established in July 2012. It is a direct subsidiary company of Religare Enterprises Limited. Care Health is a leading player in the health insurance industry of India.
It is a specialised health insurance provider offering a suite of insurance solutions in the retail segment. Its plans include International Travel Insurance, Health Insurance, Personal Accident, Critical Illness and Top-up coverage along with Group Health Insurance for Corporates and Companies.
Claim settlement ratio 100%
NCB* 50%, up to 100% of SI*
PED Waiting# 48 months
Network Hospital 22900+
Paybima's Right Advisor = Expert Solutions
| Claim Settlement Ratio | 100% for F.Y 21-22 |
| Claims Settled | 38 lacs+ claims settled |
| Networked Hospitals | 22900+ Cashless healthcare providers |
| Grievance Ratio | 37 less grievance ratio per 10,000 claims. |
Care Health Insurance has been bestowed with various awards and accolades ever since its inception. A few of its achievements are as follows:
Some of the coverage benefits that are found across most Care health insurance plans are as follows:
| Coverage benefit | Meaning |
| Hospitalisation cover | Hospitalisation cover is designed to cover your medical expenses that are incurred on an inpatient basis, i.e. when you are hospitalised for 24 hours or more. The cover includes room rent, nurse’s fee, doctor’s fee, treatment costs, and the like |
| Pre hospitalisation cover | If you incur medical expenses before you are hospitalised, such expenses can be claimed as pre hospitalisation expenses. These expenses are covered up to a specific number of days before hospitalisation |
| Post hospitalisation cover | If you incur medical costs after you are discharged from the hospital, such costs can be claimed under this benefit. Costs up to a specific number of days after hospitalisation are covered |
| Daycare treatments | Treatments that involve only a few hours of hospitalisation are called daycare treatments. Such treatments are also covered under Care health insurance plans |
| Organ donor expenses | If you are receiving an organ from a donor for undergoing an organ transplant surgery, the cost of the donor’s hospitalisation and organ harvesting would be covered |
| AYUSH coverage | AYUSH stands for Ayurveda, Unani, Siddha and Homeopathy. These are non-allopathic treatments that are covered under many Care health insurance plans |
| Free health check-ups | Care Health Insurance Company promotes healthy living for its customers. As such, its health plans allow free check-ups to monitor your health at regular intervals |
| Domiciliary treatments | Domiciliary treatments are those which are taken at your own home. These treatments are covered if there are no hospital beds or if you cannot be moved to the hospital. |
Care Health Insurance offers comprehensive health insurance plans. However, in some cases, the claim is not payable. Such cases fall under policy exclusions. Each policy has a list of exclusions which can be found in the policy wordings. However, some commonly found exclusions include the following –
Care Health Insurance offers a wide range of health insurance policies. Some of the best policies, available at PayBima, are as follows –
Care is the company’s most popular health plan which offers a comprehensive scope of protection. The policy has many salient features which are as follows –
If you opt for sum insured levels of Rs.50 lakhs and above, you can get an inbuilt maternity coverage under the policy. The coverage would cover the expenses of pregnancy and childbirth.
If you use your sum insured on a claim and if there is an unrelated second claim, the policy restores the sum insured so that the second claim can be paid. This benefit helps in the case of multiple claims within the same policy year and ensures that you have sufficient coverage when needed
There is no upper entry age. Individuals of all ages can buy the plan for their coverage needs.
You can avail of a free second opinion from Care’s team of medical experts. Such a second opinion is available under all variants of the plan and allows you to consult another specialist, free of cost, in severe illnesses.
Care with NCB is nothing but the aforementioned Care plan with the added coverage of the Super No Claim Bonus. Let’s understand the salient features of this version of the plan –
The plan has a unique super no-claim bonus feature. Under this feature, if you don’t claim in one policy year, you get a no-claim bonus of 50% of the base sum insured. Thereafter, if no claim is made in the second successive year, another 50% increase in the sum insured is allowed. This doubles the base sum insured within 2 years without any claim.
Besides the super no claim bonus, you continue to earn a 10% increase in the sum insured as the no claim bonus if you don’t make a claim. This increase is allowed up to a maximum of 50% of the base sum insured.
When you combine the super no claim bonus and the no claim bonus features, you get a high sum insured. Together with the super no claim bonus, your sum insured becomes 220% after two successive claim-free years. This is free of cost and you don’t have to pay the premium for the increase in the sum insured.
Under plans that have a sum insured of Rs.50 lakhs and above, you can avail of international coverage through the Care Anywhere benefit. This allows wider coverage and is beneficial.
There are a variety of add-ons available with the policy which you can add by paying additional premiums to enhance the scope of coverage.
The Care Freedom plan doubles up as a policy for individuals suffering from diabetes, hypertension or BMI issues. The salient features of the policy are as follows –
There are two plan variants available under the policy. The first one is a basic health plan available for adults as well as children. The second variant, however, is available only to adults aged 46 years and above and is designed to cover their health needs.
If you suffer a big claim and the sum insured is used up, the plan restores the sum insured back to its original amount so that if you suffer another claim, the plan would be able to cover it too.
Hospitalisation results in various non-medical costs too that are not covered under the health insurance policy. As such, the plan allows you a daily allowance for each day of hospitalisation so that you can meet such non-medical expenses
Every time you visit a hospital to get dialysis, the medical costs incurred would be covered under the policy. Coverage is allowed up to Rs.1000/sitting for a maximum of 24 consecutive months.
If your hospitalisation exceeds 10 days, the plan offers a lump sum companion benefit to help you meet the additional costs that you might have incurred due to such prolonged hospitalisation.
A super top-up health insurance policy, Care Enhance allows you to enhance your existing health insurance coverage without burning your pockets. The salient features of the policy are as follows –
The plan offers a wide range of coverage and deductible options so that you can choose the amount that you want and which matches your needs. You can, thus, customize the plan as per your coverage needs.
Under the second plan variant coverage for international treatments is allowed if taken in an emergency. So, you can expand the geographical scope of coverage with the policy and avail of treatments anywhere.
The policy offers an add-on benefit wherein you can avail of an expert’s medical opinion if required. This coverage is available at an additional premium.
| Features | Care | Care with NCB | Care Freedom | Care Enhance |
| Inpatient hospitalisation | Covered | Covered | Covered | Covered |
| Pre and post-hospitalisation | 30 and 60 days respectively | 30 and 60 days respectively | Up to 7.5% or 10% of the sum insured | 30 and 60 days respectively |
| Daycare procedures | Covered | Covered | Covered | Covered |
| AYUSH cover | Available | Available | Not available | Not available |
| Donor expenses | Covered Up to Rs.50,000 to Rs.3 lakhs | Covered Up to Rs.50,000 to Rs.3 lakhs | Not available | Covered Up to the sum insured |
| Sum insured recharge | Available Up to 100% of the base sum insured | Available Up to 100% of the base sum insured | Available Up to 100% of the base sum insured | Not available |
| Domiciliary hospitalisation | Covered Up to 10% of the sum insured | Covered Up to 10% of the sum insured | Covered Up to 10% of the sum insured | Not available |
| Ambulance cover | Covered Up to Rs.1500 to Rs.3000 | Covered Up to Rs.1500 to Rs.3000 | Covered Up to Rs.1000 | Not available |
| Daily allowance | Only for sum insured up to Rs.4 lakhs at Rs.500/day | Only for sum insured up to Rs.4 lakhs at Rs.500/day | Available Rs.750 to Rs.1000 per day | Not available |
| Health check-ups | Annually | Annually | Annually | Annually |
| Second opinion | Available | Available | Available | Available As an add-on |
| No Claim Bonus | 10% of the sum insured up to a maximum of 50% | 10% of the sum insured up to a maximum of 50% | Not available | Not available |
| Super No Claim Bonus | Not available | Available 50% increase after each claim-free year up to a maximum of 100% | Not available | Not available |
| Care Anywhere | Available if the sum insured is Rs.50 lakhs and above | Available if the sum insured is Rs.50 lakhs and above | Not available | Yes Under the second variant only |
| Maternity cover | Available if the sum insured is Rs.50 lakhs and above | Available if the sum insured is Rs.50 lakhs and above | Not available | Not available |
| Entry age | Minimum – 5 years onwards Dependent children – 3 months onwards on a floater basis | Minimum – 5 years onwards Dependent children – 3 months onwards on a floater basis | Adults – 18 years or 46 years depending on plan variant Children – 90 days onwards | Adults – 18 years onwards Children – individual basis – 5 years to 24 years Floater basis – 1 day to 24 years |
| Sum insured | Rs.3 lakhs, Rs.4 lakhs, Rs.5 lakhs, Rs.7 lakhs, Rs.10 lakhs, Rs.15 lakhs, Rs.20 lakhs, Rs.25 lakhs, Rs.30 lakhs, Rs.40 lakhs, Rs.50 lakhs, Rs.60 lakhs or Rs.75 lakhs | Rs.3 lakhs, Rs.4 lakhs, Rs.5 lakhs, Rs.7 lakhs, Rs.10 lakhs, Rs.15 lakhs, Rs.20 lakhs, Rs.25 lakhs, Rs.30 lakhs, Rs.40 lakhs, Rs.50 lakhs, Rs.60 lakhs or Rs.75 lakhs | Rs.3 lakhs, Rs.5 lakhs, Rs.7 lakhs or Rs.10 lakhs | Rs.1 lakh to Rs.10 lakhs, Rs.15 lakhs and Rs.20 lakhs Deductible – Rs.1 lakh to Rs.30 lakhs, Rs.35 lakhs, Rs.40 lakhs, Rs.45 lakhs, Rs.50 lakhs, Rs.55 lakhs |
| Term of the plan | 1, 2 or 3 years | |||
| Premium payment frequency | In one lump sum
Annually Half-yearly Quarterly Monthly |
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| Pre-existing waiting period | 4 years | 4 years | 2 years | 4 years |
Care Health Insurance plans are available offline as well as online. You can buy a Care Health Plan online by following a smooth process through PayBima.com. The process to buy a Care Health Plan through PayBima is as follows:
Begin the process by visiting PayBima’s official website or just click on www.paybima.com and click on ‘Health Insurance.’
Fill in all the required details to enable PayBima to calculate the premium based on your eligibility and coverage requirements. Details such as your name, age, lifestyle habits, gender, location, sum insured, and the number of dependents are required to be provided. Also, provide your contact details to get personalized consultation on the phone to guide you to buy the best health insurance at a reasonable price.
A list of available plans will be displayed after the submission of your details. Care Health Insurance plans would also be on the list. You can select the best plan after comparing the available plans.
After finalising the policy, provide your details in the proposal form. Fill out the form correctly and submit it online.
The policy is issued instantly after online payment of the premium, in case there are no adverse declarations about medical history and lifestyle habits in the proposal form.
You might be required to undergo medical screening before issuance of the plan based on your age, lifestyle habits, gender, coverage and pre-existing illness. You can avail of the check-up facility at any of the networked hospitals of the insurance company.
Besides buying, you can also renew your health insurance plan through PayBima. Simply click on www.paybima.com to visit the website and renew your plan. To enjoy uninterrupted coverage and lifelong renewals renew the policy within the due date.
You can renew your Care Health Insurance plan by providing your policy number and other policy details. You can also check all the plan details at the time of care health insurance renewal and make changes to your policy if required. The policy will be renewed within minutes after the online care health insurance payment. You can contact PayBima at 1800 267 67 67 to renew your plan or send a mail to PayBima care@mahindra.com.
Care Health Insurance provides two options to claim on your health insurance policy. The first is the reimbursement mode in which you have to initially pay the hospital bills and then get them reimbursed. The second is cashless claim settlement wherein the company will directly pay the bills on your behalf.
The following steps should be taken for a cashless claim in your Care Health Insurance plan:
1. Admission to a network hospital
For a cashless claim settlement, get admitted to a hospital with which the insurance company has a tie-up. You will first have to locate your nearest network hospital. You can locate the nearest network hospital by visiting the official website of the insurance company or by calling the customer helpline. Show your ID proof and health card to the hospital and get admitted.
2. Pre-authorisation claim form
A pre-authorisation claim form is to be submitted for cashless claim approval. The form is needed at least 48 hours before planned hospitalisation. In case of emergency admission, you can submit the form within 24 hours. The form can be taken from the TPA desk of the hospital or can also be downloaded online and submitted to the insurance company.
3. Approvals
The claims management team of Care Health Insurance will send an approval letter to the network hospital based on the pre-authorisation claim form. Once the approval letter is received cashless treatment would be allowed.
4. Reimbursement Claim
If you get admitted to a non-networked hospital or if your cashless claim is rejected by the claim management team, then your claim will be handled on a reimbursement basis. You will have to submit the claim form along with relevant documents. Once approved, all the bills will be reimbursed by the insurer.
You can seek the help of PayBima’s executives for easy settlement of your health insurance plan. Just call at 1800 267 67 67 or mail at paybima.care@mahindra.com and we will guide you through your claim process and its settlement.
Documents required for successful claim settlement of Care Health Insurance Plans are as follows:
Care Health Insurance plans are quite comprehensive and are well-customized as per individual requirements. Other highlights include the following:
* NCB will increase by 5% for each claim free year up to a maximum of 50% if the policy is renewed without break
# Ailments diagnosed within 48 months before policy issuance date or any medical treatment received within 48 months before the issue date of policy
