Ultimate Care Health Insurance Plan

4.5

Paybima Rating

Purchasing a health insurance plan is a necessity in today's time. However, many of us, especially the ones who are young and healthy, feel that a health insurance plan should do more than just cover hospital expenses. This is where the Ultimate Care Health Insurance plan comes into play, offering coverage for medical needs while also providing rewards for staying healthy, including money-back benefits and loyalty rewards.

Sounds interesting, right? Care Health Insurance Company offers a plan tailored to meet the needs of every individual. The Ultimate Care plan offers multiple impressive benefits and exciting returns that you won't want to miss. Let's explore.

Highlights of Ultimate Care Plan

Sum insured up to ₹1 crore.

The Infinity bonus increases coverage by 100% of the base sum insured.

Money-back and loyalty benefits.

Tenure multiplier for enhanced sum insured benefits.

Get all your insurance related queries answered

Care Health Ultimate Care: Highlights

Let’s take a detailed look at the plan highlights for a better understanding:

Particulars	Details
Plan Name	Ultimate Care
Insurance Company	Care Health Insurance
Sum Insured Options	Available Options: 5 Lakhs 7 Lakhs 10 Lakhs 15 Lakhs 20 Lakhs 25 Lakhs 50 Lakhs 1 Crore
Add-Ons	Available Options: Infinity Bonus Annual Health Check-Up Instant Cover Claim Shield Unlimited E-Consultation OPD Benefits PED Wait Period Modification
Waiting Period	Initial Waiting Period: 30 days Named Ailment Waiting Period: 24 months Pre-Existing Diseases Waiting Period: 36 months
Claim Settlement Ratio	92.77% (as released by IRDA in 2025)
Network Hospitals	21700+

Wish to Enhance Coverage? Take a Look at the Riders Available

To enhance protection under the Ultimate Care plan, you can opt for riders to add to your existing plan. Take a look at the riders available for you:

Riders	Details
Infinity Bonus	Under this, the insured can get 100% of the sum insured. Here’s what you need to know: 100% of SI is added every year to your base coverage, irrespective of claims made. This is available unlimited times.
Annual Health Check-Up	Under this, every insured member under the policy is entitled to one free annual health check-up.
Instant Cover	Under this rider, the insured can waive off the waiting period for pre-existing conditions like diabetes, obesity, asthma, etc. Note: The waiver off can be done only after the completion of the initial 30-day waiting period.
Claim Shield	Under this rider, the insurance company offers coverage for non-payable items, such as masks and gloves. Note: You can refer to the policy document for a detailed list of non-payable items
PED Wait Period Modifications	Under this rider, the insured can reduce the waiting period for pre-existing diseases to one or two years. Note: This rider is available only for specified pre-existing diseases.
OPD Benefits	Under this rider, the insured can get the following OPD benefits: 4 physical consultations with a general physician for every insured member in one policy year. 4 physical consultations with specialist doctors for every insured member in one policy year. The maximum coverage limit is ₹500 per consultation.
Unlimited E-Consultations	Under this rider, the insured can get access to unlimited e-consultations with general physicians. This is easily available through the Care Health Mobile App.

Features and Benefits of Care Health Ultimate Care

Care Health Ultimate Care is a comprehensive health insurance plan designed to provide coverage for medical needs while also offering exciting rewards for making healthy lifestyle choices every day. Let’s take a look at the features and benefits of the Ultimate Care plan:

Coverage for Medical Needs

The plan offers comprehensive coverage that addresses all the medical needs of the insured. From hospitalisation expenses to domiciliary treatment expenses, the plan steps in to settle the bills.

Exciting Rewards

Imagine taking steps for your health and then getting rewarded not just with good health but also monetary benefits. Sounds exciting, right? The policy offers:

Money Back: This offers a complete refund of the first year's base premium after five consecutive years with no claims.
Loyalty Boost: This offers an additional sum insured equivalent to the first policy year’s sum insured for seven consecutive years, provided there are no claims.
Wellness Discount: Provides up to 30% discount on premium renewals with healthy days programs through the Care Health Mobile App.

Enhanced Protection with Add-Ons

Worried about the base coverage not being enough for all your medical needs? Worry no more, because the plan has a long list of add-ons or riders that you can add to your existing policy to enhance protection according to the medical needs of you and your family.

Promised Discounts

In addition to offering comprehensive coverage and multiple add-ons, the policy has multiple discounts that will get you on board to purchase the policy:
Welcome Discount: Offers up to 30% off premiums for new policyholders.

Quick Claim Settlement

Care Health Insurance company comes with a promise to ensure quick and seamless claim settlement for every coverage. With a claim settlement ratio of 92.77%, you can be assured of getting your claims settled without any hassle.

Care Health Ultimate Care: Eligibility Criteria

To purchase the Ultimate Care plan, you must meet the eligibility criteria. Take a look at the eligibility criteria:

The individual's age must be 18 years or older.
The minimum entry age for an adult is 18 years, and for a child, it is 91 days.
The maximum entry age for a child is 24 years, and there is no age limit for adults.
The exit age for a child is 25 years, and there is no age limit for adults.

Care Health Ultimate Care: What is Covered?

Understanding the coverage under a health insurance plan is crucial to ensure that your medical needs are covered. Let's take a quick look at the Ultimate Care plan coverages:

Pre- and Post-Hospitalisation Cost

Expenses such as medications, tests, diagnosis, and post-treatment care can quickly drain your finances. Taking care of the expenses incurred on pre- and post-hospitalisation needs is covered under the plan. Ensure that you check the policy document to determine the pre- and post-hospitalisation days for which coverage is provided.

Day Care Treatment

Daycare treatments are those treatments that require hospitalisation for less than 24 hours.

In-Patient Cover

The policy offers coverage for expenses incurred on inpatient hospitalisation. The policy covers expenses up to the sum insured amount.

AYUSH Treatment

AYUSH treatment encompasses Ayurveda, Yoga, Unani, Siddha, and Homoeopathy. Any expenses incurred on such treatment at AYUSH hospitals or other authorised medical centres are covered.

Unlimited Automatic Recharge

Under the policy, the insured can enjoy unlimited automatic recharge of the sum insured for unrelated or subsequent claims.

Ambulance Cover

Expenses incurred for ambulance services from a hospital or a registered ambulance service, provided in emergency situations, are covered.

Other Coverages

Apart from the above-mentioned base coverages, there are certain other benefits also that the insured gets to enjoy, including:

Health Services

Under this, the insured gains access to health portals for E-consultations, healthy tips, reminders, and more, as well as exciting offers on consultations and other services.

Medi Voucher

The insured gets two pharmacy vouchers worth ₹250.

ICU and Room Charges

ICU and room charges up to the sum insured are provided.

Care Health Ultimate Care: What is Not Covered?

Remember that the Ultimate Care plan has certain exclusions that you must be mindful of before purchasing the plan:

Self-Inflicted Injuries

Expenses incurred on any self-inflicted injuries are not covered. Additionally, injuries sustained due to attempted suicide are also not covered.

Specific Expenses

Expenses incurred for treatment related to alcohol or drug consumption are not covered.

Congenital Diseases

Expenses incurred for the treatment of congenital diseases are not covered. These are diseases that a person is born with.

Infertility Related Treatments

Expenses incurred on infertility-related tests, in-vitro fertilisation, tests and infertility treatment are also not covered.

Pregnancy-Related Treatments

Expenses incurred on situations related to pregnancy, childbirth, abortion, miscarriage and related consequences, etc, are not covered.

Our verdict

Purchasing health insurance, such as the Ultimate Care plan, is an investment you make today to safeguard the future medical needs of you and your loved ones. In addition to offering comprehensive coverage, the plan promises several exciting rewards and benefits for those who take good care of their health. What’s better than a healthy lifestyle and getting rewards?<br><br>If you haven’t already purchased a health insurance plan, then take this as a sign and head to the Paybima portal for a seamless purchase.

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Claims Experience

Claims Experience Rating 4.4

% of claims settled in less than 30 days
Reflects on the speed of settling valid claims

98.61%

% of Complaints received on overall claims
% customers unhappy with claims experience

0.24%

Claims Incurred Ratio

72.71%

Claim Settlement Ratio (No. of claims)
What % of the claims received were paid?

90.24%

No. of Cashless Hospitals

11,000+

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Disclaimer

10% Cumulative Bonus (CB) will be applied on the Base Sum Insured for each claim free Year, which can go up to a maximum of 100% of the Base Sum Insured.
# Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with the insurer.

(For Detailed Information Refer to the Policy Wording)