Religare Care Health Insurance Plan

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*savings provided by insurer

Religare offers this Comprehensive medical insurance policy named as Religare Care. The plan is designed to offer financial protection to you and your family members in case of a medical emergency. With Religare Care, you can be sure of getting the best medical treatment in India and overseas and focus on your recovery in a worry-free manner.

Key Features of Religare Care Health Insurance Plan

With Religare Care, you can avail the following unique medical benefits:

  • 92% Claim settlement ratio( as per the insurer’s website)
  • Cashless treatment in more than 5420 network hospitals
  • Annual medical check-up facility for all the insured members
  • In-house claim settlement
  • Up to 150% of No Claim Discount with NCB Super
  • Automatic recharge of the sum insured
  • 12 critical illnesses are covered under the Global plan variant
  • Various riders benefit to meet your health concerns

Religare Care Super Saver Plan Table

Features/ Plan (SI)

Care 3 ( 4 Lakh ) 
Super Saver

Care 4 (5,7,10 Lakh) 
Elite

Pre-hospitalization Charges

30 days

30 days

Inpatient Hospitalization Charges

Up to SI

Up to SI

Post-hospitalization Charges

60 days

60 days

ICU Charges

2 percent of SI /day

No sub-limit

Day Care Medical Treatment/Surgery

Covered

Covered

Daily Case Allowance

INR 500 per day for a max. of 5 days

-

Room Rent Charges

1% of SI per day

Private Room ( Single)

Ambulance Cover

Up to INR 1,500 per hospitalization

Up to INR 2,000 per hospitalization

Deductible in Policy Period

INR 10,000

Not applicable

Domiciliary Hospitalization

Up to 10% of SI

Up to 10% of SI

No Claim Discount

Included

Included

Health Check-up

Covered

Covered

Recharge of Sum Insured

Included

Included

Second Medical opinion

Covered

Covered

Organ Donor Expenses

INR 50,000

INR 100,000

Alternative Medical Treatments

Up to 15,000

Up to 20,000

 

Religare Care Elite Plan Table

Features/ Plan (SI)

Care 4 (5,7,10 Lacs) 
Elite

Care 5 (15,20,25,30,40 Lacs)
Elite Plus

Pre-hospitalization Charges

30 days

30 days

Inpatient Hospitalization Charges

Up to SI

Up to SI

Post-hospitalization Charges

60 days

60 days

Alternative Medical Treatments

Up to Rs.20,000

Up to Rs.30,000

Room Rent Charges

Private Room ( Single)

Private Room ( Single)

ICU charges

No Limit

No Limit

Ambulance Cover

Up to INR 2,000 per hospitalization

Up to INR 2,500 per hospitalization

Organ Donor Expenses

Rs.100,000

Rs.200,000

Health Check-up

Covered

Covered

Day Care Medical Treatment/Surgery

Covered

Covered

No Claim Discount

Included

Included

Recharge of Sum Insured

Included

Included

Second Medical opinion

Covered

Covered

Domiciliary hospitalization

Up to 10% of SI

Up to 10% of SI

 

Religare Care Elite Plus Plan Table

Features/ Plan (SI)

Care 4 (5,7,10 Lacs) 
Elite

Care 5 (15,20,25,30,40 Lacs)
Elite Plus

Pre-hospitalization Charges

30 days

30 days

Inpatient Hospitalization Charges

Up to SI

Up to SI

Post-hospitalization Charges

60 days

60 days

Day Care Medical Treatment/Surgery

Covered

Covered

Room Rent Charges

Private Room ( Single)

Private Room ( Single)
(upgradable to next level)

ICU charges

No Limit

No Limit

Ambulance Cover

Up to INR 2,000 per hospitalization

Up to INR 2,500 per hospitalization

Domiciliary hospitalization

Up to 10% of SI

Up to 10% of SI

Health Check-up

Covered

Covered

Recharge of Sum Insured

Included

Included

No Claim Discount

Included

Included

Organ Donor Expenses

INR 100,000

INR 200,000

Second Medical opinion

Covered

Covered

Alternative Medical Treatments

Up to INR 20,000

Up to INR 30,000

 

Religare Care Global Plan Table

Features/ Plan (SI)

Care 6 (50,60,75 Lacs)
Global

Care 7 (1,2,3,6 Cr)
Global Plus

Pre-hospitalization Charges

30 days

30 days

Inpatient Hospitalization Charges

Up to SI

Up to SI

Post-hospitalization Charges

60 days

60 days

Recharge of Sum Insured

Included

Included

Room Rent Charges

Private Room ( Single)
(upgradable to next level)

Private Room ( Single)
(upgradable to next level)

Organ Donor Expenses

INR 3 lakh

INR 5 lakh

Ambulance Cover

Up to INR 3,000 per hospitalization

Up to INR 3,000 per hospitalization

Domiciliary hospitalization

Up to 10% of SI

Up to 10% of SI

Day Care Medical Treatment/Surgery

Up to SI

Up to SI

Health Check-up

Covered

Covered

ICU charges

No Limit

-

No Claim Discount

Included

Included

Alternative Medical Treatments

up to INR 40,000

up to INR 50,000

Second Medical opinion

Covered

Covered

Maternity Expenses

up to INR 100,000

up to INR 200,000

Care Anywhere

Covered

Covered

Vaccination Cover

-

up to INR 10,000

Overseas Coverage: (excluding the USA) Coverage outside USA & India- 45 days during a single trip; up to a maximum of 90 days on a cumulative basis during a policy term

 

Up to SI for hospitalization/medical expenses. Maternity expenses up to the specified limit with a co-payment of 10% per claim

Special Add-on Benefits:

   

Global Coverage – The scope of geographical coverage/ Global Coverage is extended to the United States of America as well

 

Up to SI for hospitalization/medical expenses. Maternity expenses up to the specified limit with a co-payment of 10% per claim

 

Inclusions of Religare Care Health Insurance Plan

  • 30-days pre-hospitalization charges are covered
  • Ambulance expenses are also covered under this plan
  • In-patient hospitalization expenses are also covered
  • Hospitalization for a minimum of 24 hours including room rent charges, intensive care unit charges, nursing expenses, doctor and surgeon's fee, blood, anesthesia, operation theater, and oxygen charges.
  • It covers medical treatment requiring hospitalization for less than 24 hours such as day care treatments that do not require hospitalization for more than 24 hours. Religare care covers more than 540-day care procedures.
  • Room Rent expense
  • ICU Charges are also covered
  • 60-day post-hospitalization expenses
  • Annual medical check-up
  • Reassurance of second medical opinion
  • No Upper Age Limit to purchase the policy
  • Domiciliary hospitalization
  • Organ donor expenses
  • Alternate medical treatments are also covered

Add-on Covers in Religare Care Health Insurance Plan

No Claim Bonus Super- It is an optional cover that will further enhance your sum assured amount for claim-free years. NCB can vary from 50% to 100%. So, in total with No-Claim-Bonus & No-Claim-Bonus, you can enhance your sum insured up to 150% in five years.

Overseas Health Cover- There are no boundaries when it comes to quality healthcare. If you need to undergo medical treatment overseas, then you can avail cashless medical treatment overseas in the listed network hospitals.

Automatic Reinstatement- You should not run out of coverage anytime during your policy period that is why it is important to have this additional coverage as your sum insured will be reinstated upon exhaustion of the sum insured. There is no limit as you can avail this benefit for unlimited number of times.

Everyday Care- Without health insurance place, people tend to avoid getting hospitalized for a medical condition. However, it is really fortunate to evade doctor consultations in a few months. But for all the OPD consultations, you can get 1% of your sum insured towards diagnostic procedures and doctor consultations.

You can avail this using a cashless health card. You just need to pay an additional premium to avail this benefit and the premium that you pay is eligible for tax-saving.

Air Ambulance Cover- This add-on benefit proves to be useful when the treatment is suggested miles away from your city. With Air Ambulance add-on cover you can be sure that you will always have access to the best medical treatment. It proves to be really useful when you have suggested a medical treatment in some other city or state.

Religare Care Health Insurance Exclusions

The policy does not cover the following medical expenses under any of the plan variants:

  • Expenses incurred on the treatment of congenital diseases are not paid by the insurer
  • Hospitalization required due to self-inflicted injuries and suicidal attempts are not covered
  • Hospitalization required for treatment of HIV and AIDS
  • Medical treatment/hospitalization required due to an overdose of drugs and alcohol or intoxications are not recompensed
  • Any disease/illness/surgery that has been diagnosed or has given symptoms within 30 days of the policy commencement date
  • Hospitalization traceable to childbirth/pregnancy, abortion, miscarriage, and its complications
  • Medical tests and hospitalization pertaining to infertility and in vitro fertilization
  • War, strike, nuclear weapons, and riots induced hospitalization.

Religare Care Health Insurance Terms and Conditions

  • Minimum entry age is 91 days
  • There is no limit on Maximum entry age
  • The plan offers lifetime renewability benefit
  • There are 30 days of the waiting period for illness except for injuries
  • The waiting period of pre-existing illnesses is 4-years. After completion of the 4-years of the policy term, you can file a claim for the medical expenses incurred on a pre-existing illness
  • At the time of Religare care policy renewal, you can increase your sum insured amount
  • There is a grace period of 30 days from the policy expiry date. In case you miss renewing your health plan, you can utilize this time to do so.
  • The cost of premium while renewing the policy is subjected to change as per the IRDA guidelines and approval.
  • If the age of the insured members is lesser than 61 years thane there is no co-payment. If the age of the eldest insured members s more than 61 years then 20% co-pay is applicable. This means that you will pay 20% of the medical expenses and the rest will be paid by the insurer. 

Religare Care Health Insurance Claim Process

Before filing a claim it is always better if you know the process that follows for hospitalization, OPD, and everyday care.

The Claims Process for Hospitalization is Listed Below:

Emergency hospitalization treatment requires you to inform within 24 hours of getting hospitalized

If it is a planned hospitalization you can inform the insurer 48 hours before the hospitalization

For Cashless Claims

  • Request for pre-authorization
  • Submit the pre-authorization form at the hospital’s TPA desk and fax it to Religare
  • The claim management team will send the approval letter
  • Either the insured or the hospital can respond to the any queries that were raised by the claim management team
  • In case your cashless claim is rejected you may start with the treatment and file a fresh claim for reimbursement

For Reimbursement Claims

  • Submit the claim form and all the required documents as per the policy terms and conditions
  • You will get an approval letter from the Religare’s claim management team
  • You would need to address all the queries related to your claim request and treatment
  • The insurance company will inform you for approval or rejection (along with the reason for rejection)

Procedure for Everyday Care

  • Check the list of Everyday Care network centers online on their website
  • Visit the OPD service provider and take your Everyday Care Card
  • You would also need an original copy of a government photo id proof
  • The service provider will deduct 80 percent from the Everyday Care Card and you would need to pay 20% of the co-payment
  • You will also get an email and SMS notification of the services availed

OPD Care Claims Procedure

  • Download the claim form from the insurer’s site
  • Attach the original bills and invoices and send your claim application at the insurer’s official address
  • For the seamless settlement of claims, you can submit your claim application along with your NEFT details
  • Most of the claims are settled within 15 days from the date of receipt of all the documents
Written By: PolicyBazaar - Updated: 25 June 2019