About Care Advantage Health Insurance
Care Advantage Health Insurance is a Rs 1 crore health insurance policy that offers comprehensive coverage to individuals and families. The policy is designed to meet the healthcare needs of the insured against emergency planned and emergency medical expenses. It comes with no sub-limits and also offers a co-payment waiver as an optional cover.
Care Advantage Health Insurance: Key Highlights
| Categories | Specifications |
|---|---|
| Sum Insured | ₹25 lakh to 1 crore |
| Pre-policy Medical Check-up | Not required up to 50 years |
| Pre-existing Diseases Waiting Period | 3 years |
| Specific Ailments Waiting Period | 2 years |
or select from popular citiessSearch Care Advantage Cashless Network Hospital list
Key Benefits of Care Advantage Health Insurance
Care Advantage Health Insurance Inclusions, Exclusions & Optional Cover
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In-patient Hospitalization ExpensesIt covers the medical expenses incurred on hospitalization of at least 24 hours, including room rent, doctor’s fee, nursing charges, etc.
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Day Care ProceduresIt covers the cost of day care procedures/ treatments that requires less than 24 hours of hospitalization.
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Pre-hospitalization ExpensesIt pays for the medical expenses incurred for up to 30 days before getting admitted to the hospital.
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Post-hospitalization ExpensesIt covers the medical expenses incurred for up to 60 days after getting discharged from the hospital.
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Ambulance ChargesIt pays the cost of ambulance services used to transport the insured to a hospital during a medical emergency.
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Organ Donor ExpensesIt covers the cost of harvesting the organ from a donor for the treatment of the insured.
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Self-inflicted InjuryIt does not cover costs to treat injuries from suicide attempts or intentional self-harm.
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Cosmetic or Plastic SurgeryIt excludes expenses incurred on cosmetic surgeries done to change appearance unless medically necessary.
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External Congenital DiseasesIt does not pay for the treatment of the removal of physical abnormalities present from birth.
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Maternity ExpensesIt does not cover childbirth-related costs and treatment of the newborn baby.
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Treatment for Addictive SubstancesIt excludes expenses incurred on the treatment for alcoholism, drugs and other addictive substances.
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Unproven TreatmentsIt does not cover the costs of unproven treatments that are not supported by medical documentation.
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Unlimited Automatic RechargeIt ensures that the sum insured amount is recharged an unlimited number of times in a policy year in case it gets exhausted after a claim.
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No Claim Bonus SuperIt ensures that the policyholder gets a No Claim Bonus of 50% for up to a maximum of 100% on every claim-free year.
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Air Ambulance CoverIt covers the cost of availing air ambulance services for up to a maximum of Rs 5 lakh.
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Smart SelectIt provides a premium discount of 15% to the policyholder. However, a co-payment of 20% will apply in case the treatment is taken at a non-network hospital of the insurance company.
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Reduction in PED Waiting PeriodIt reduces the waiting period for the coverage of pre-existing diseases from 48 months to 24 months.
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Co-payment WaiverIt ensures that policyholders above 60 years do not have to pay any co-payment while raising a claim.
In case of emergency we are just a call away. Take care of your family, we will do the rest. Our claim specialists will reach your location & complete the formalties from filing the claim to documentation to coordinating with insurer, TPA & hospital. Available in New Delhi and 114+ cities View cities list ›Policybazaar Claim Process
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Care Advantage Health Insurance: FAQs
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Q: Does Care Advantage plan cover COVID-19?
Ans: Yes. The Care Advantage policy covers the COVID-19 treatment expenses.
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Q: Can I get any discount on the premium of my Care Advantage policy?
Ans: If you opt for the Smart Select cover or the deductible option, then you will get a discount on your Care Advantage policy.
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Q: Does Care Advantage offer a Rs 25 lakh sum insured?
Ans: Yes. The Care Advantage plan offers a Rs 25 lakh sum insured option.
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Q. What is the advantage of selecting a policy with a duration of more than 1 year?
Ans: If one buys Aditya Birla Health Insurance for more than a year, one can save 7.5 % and 10% on the 2 and 3 years premium, respectively.
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Q. How is an Individual cover different from a Floater cover?
Ans: In an Individual cover, coverage is offered to each individual in the family separately. In a Family Floater health insurance plan, each family member is covered based on a floater sum insured.
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Q. How is an Individual cover different from a Floater cover?
Ans: In an Individual cover, coverage is offered to each individual in the family separately. In a Family Floater health insurance plan, each family member is covered based on a floater sum insured.
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Q. What is a waiver of a mandatory co-pay cover?
Ans: This benefit is covered on payment of an additional premium. Therefore, any mandatory co-payment that is applicable under the Aditya Birla Activ Health Essential Plan will be waived off.
Care Health offers two types of claim settlements – cashless and reimbursement. Follow the steps to raise a claim:
- Find the nearest network hospital of Care Health
- Get admitted to the hospital
- Notify the insurance company about the hospitalization
- In case of pre-planned hospitalization, intimate the insurer before hospital admission.
- Fill up the pre-authorization form and submit it to the hospital staff
- The pre-authorization form will be sent to Care Health for approval.
- Once approved, obtain medical treatment.
- At the time of discharge, sign all the medical documents.
- Pay for the items/services not covered under the Care Health policy
- The network hospital will send the hospital bill to Care Health.
- After review, the insurance company will pay the bill amount directly to the network hospital.
- Inform the insurance company about the hospitalization
- In case of planned hospitalization, notify the insurer before hospital admission.
- Receive medical treatment
- At the time of discharge, pay the entire hospital bill in full.
- Collect all the medical documents, bills and payment receipts
Our Claim specialists in below cities will reach your hospital or home in 30 minutes to support your health insurance claim
