Religare Care Freedom Health Insurance Plan

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Health issues are on a rise and if you do not have health insurance policy handy, then get ready to pay hefty hospital bills. For any injury or health ailment, you would need to pay the bill from your own pocket. Taking into consideration the exorbitant medical expenses it might drain down all your savings in one go. This is where the role of a health insurance policy comes into play. It offers the required support at the time of an unforeseen financial medical urgency arising due to an illness or injury.

Religare care freedom plan offers you the required flexibility and freedom to enjoy your life in a carefree manner. It gives you the required financial cushion to deal with a medical emergency. The plan does not require pre-medical screening and pre-existing diseases are also covered after a waiting period of 2 years.

Features of Religare Care Freedom Plan

  • Lifelong renewability
  • Minimum entry age is 18 years
  • The plan is available in both individual and family floater option
  • 30 days of grace period from the expiry date
  • An initial waiting period of 30 days from any illness
  • Pre-existing illnesses are covered after 2-years
  • Online tracking of claims
  • Online purchase and renewal facility

Benefits of Religare Car Freedom Plan

  • Companion Benefit is also provided if the hospitalization exceeds 10 days
  • Expenses incurred on the dialysis procedure are also recompensed
  • Domiciliary hospitalization expenses are also covered
  • Annual health check-up facility can be extended to cover cardiac health and diabetes health check-up expenses
  • The premium that you pay offers tax exemption benefits under Section 80C of the IT Act, 1961.

Minimum Entry Age for Care Freedom Pan 1

  • Adult - 18 Years
  • Child – from 90 Days onwards

Minimum Entry Age for Care Freedom Plan – 2

  • For individuals, it is 46 years
  • Minimum entry age in floater plan is 46 years for the eldest member
  • For others, it is 18 years
  • For children, it is 90 days onwards

Sum assured limit

  • Care Freedom Pan – 1: INR 3lakh/5lakh
  • Care Freedom Pan – 2: INR 3lakh/5lakh/7lakh/10lakh

Inclusions of Religare Care Freedom

  • Sum insured option - 3 lakhs, 5 lakhs, and 7/10 lakhs
  • Minimum entry age is 46 years and there is no cap on maximum age
  • Can be both floater and individual plan ( can include up to 6 family members)
  • 30 days of the initial waiting period from the policy inception date
  • In-patient Care (room charges, surgeon fees, ICU, nursing expenses, anesthesia, blood, etc.) up to the sum assured limit
  • Daycare treatment for selected treatments up to the sum assured limit
  • Annual health check-ups including - blood sugar, a blood test with ESR, lipid profile, urine routine, urine culture, KFT/kidney functioning test, Liver functioning test, etc.
  • Pre and post hospitalization expenses to be reimbursed up to 10% of total payable hospitalization expenses
  • Consumable allowance paid in a lump sum  for each day of hospitalization ( covered after 3 days of hospitalization for a maximum of 7 days)
  • Domiciliary hospitalization expenses covered up to the sum assured limit after 3 days of treatment at home.
  • Dialysis covers up to Rs. 1000 per visit for consecutive 2 years
  • Policy tenure can be 1 to 3 years
  • Sub-limits applicable ( check policy documents for the same)
  • Ambulance expenses cover up to Rs. 1000 per hospitalization
  • Companion benefits for hospitalization exceeding more than 10 days
  • 100% reinstatement of sum insured on exhaustion of sum assured

Exclusions of Religare Care Freedom

There are various medical expenses that the policy covers, but the list of the policy exclusions is listed below:

  • Any pre-existing health condition is not covered until the completion of 2 years from the policy commencement date.
  • OPD expenses
  • The policy shall not cover any disease or illness that was not contracted during the initial 30 days of the policy issuance date ( except for accidental cases)
  • Hospitalization required due to suicidal attempt or self-inflicted injuries
  • Medical expenses attributable to an overdose of drugs or alcohol
  • Congenital diseases
  • Cost of spectacles and contact lenses
  • Cost of dental treatment that does not require hospitalization
  • Hospitalization required for AIDS treatment
  • Health complications resulting due to miscarriage, childbirth, pregnancy, and abortion
  • Expenses incurred on some specific treatments such as joint replacement, non-infective arthritis, etc. are recompenses only after completion of 2 consecutive policy years
  • Infertility related treatment and medical expenses

Plan Variants

Sum Assured

Plan 1: INR 3 Lakh

Plan 1: INR 5 Lakh

Plan 2: INR 7/10 Lakh

In-patient Hospitalization

Up to the SI limit

Up to the SI limit

Up to the SI limit

Day Care procedures (for specific diseases)

Up to the SI limit

Up to the SI limit

Up to the SI limit

Consumable Allowance (after 3 days of hospitalization for a maximum of 7 days)

 INR 750 per day

 INR 1,000 per day

INR 1,000 per day

Annual Health Check-up Facility

Yearly

Yearly

Yearly

Reinstatement of Sum Insured (upon exhaustion of SI)

100% of the original Sum Insured

100% of the original Sum Insured

100% of the original Sum Insured

Companion Benefit(after 10 days of hospitalization)

 INR 10,000

  INR 15,000

  INR 15,000

Pre-hospitalization payable expenses ( up to 30 days)

Up to 7.5%

Up to 10%

Up to 10%

Post-hospitalization payable expenses

Up to 7.5%

Up to 10%

Up to 10%

Domiciliary Hospitalization Expenses

Up to 10% of SI (provided after 3 days)

Up to 10% of SI (provided after 3 days)

Up to 10% of SI (provided after 3 days)

Emergency Ambulance Expenses

Up to  INR 1,000 for each Hospitalization

Up to  INR 1,000 for each Hospitalization

Up to  INR 1,000 for each Hospitalization

Tenure

One/two/three years

One/two/three years

One/two/three years

Dialysis Expenses

Up to  INR 1,000 per sitting ( For a maximum of 24 continuous months)

Up to  INR 1,000 per sitting ( For a maximum of 24 continuous months)

Up to  INR 1,000 per sitting ( For a maximum of 24 continuous months)

 

Applicable Sub-limits in the Plan

Sub-limits

 

 

 

Sum Insured

3 Lakh

5 Lakh

7 Lakh/ 10 Lakh

Applicable Co-pay

20 to 30 percent per claim

20 to 30 percent per claim

20 percent for members above 70 years of age

 

Room Category

Twin Sharing Room

Twin Sharing Room

Single Private Room

Room Expenses

Up to 1% of Sum Insured per day

-

-

ICU Expenses

Up to 2% of Sum Insured per day

No limit

No limit

 Total Knee  Replacement Cover

Up to  INR 80,000 (per knee)

Up to  INR 100,000 (per knee)

Up to  INR 120,000 (per knee)

Treatment of Cataract Treatment

Up to  INR 20,000 per eye

Up to  INR 30,000 per eye

Up to  INR 30,000 per eye

For all the treatments/procedures given below:-

  • Cardiovascular and Cerebrovascular treatments
  • Cancer treatment and surgeries
  • Renal disorder and complications
  • Bone breakage treatment

Up to  INR 200,000

Up to  INR 250,000

Up to  INR 300,000

For all the treatments/procedures given below:-

  • Hernia operation/surgery
  • Renal surgeries/stone treatment surgery
  • Hysterectomy
  • Benign Prostate Surgeries
  • Hypertrophy

Up to  INR 50,000

Up to  INR 65,000

Up to  INR 80,000

 

Religare Care Freedom Claim Process

Claim Intimation

In case of an unforeseen hospitalization, make sure that you inform the insurer within 24-hours of hospitalization. And if it is planned, you would need to inform the Religare claim team at their registered email id or over a call, at least 48 hours before getting hospitalized.

Initiating Pre-Authorization Procedure

  • A pre-authorization form is easily available at the hospital's TPA desk/insurance, or you can easily download the form online
  • Enter your personal details in the first section of the form and submit the pre-authorization signed form at the hospital’s TPA’s desk to fill up the rest of the details
  • The concerned hospital will fax the pre-authorization form to the insure

Processing a request for Pre-Authorization

  • Reliance has an in-house medical team who will review the submitted documents as per your case
  • Once the pre-authorization request is approved, the insurer will inform both the insured  and the hospital
  • If more information is required from your end then the hospital will inform you the same. To speed up the process, then you would need to submit the documents with the required information at the earliest.
  • In case the pre-authorization request is disapproved, you would need to file a reimbursement claim request. In that case, the hospital bills shall be paid by you and the insurer will reimburse the expenses.

Reimbursement Claim Procedure

Claim Intimation

Just like the cashless procedure, timely notifying your insurer is a pre-requisite. All the emergency hospitalizations require you need to inform the insurer within 24 hours of your hospital admission. In case of planned hospitalization, you need to inform the insurer at least 48 hours before your admission. At the time of claim intimation, the insurer will seek the following information-

  • Name of the insured
  • Details of the hospital
  • Customer ID and Claimant's ID
  • Treatment and diagnosis details
  • Estimated claim amount
  • Hospital admission Date

The insurer will provide you with a reference ID for all the future communications related to your claim,

Note: The Claim form can be downloaded from their website.

Documents Required for Religare Care Freedom Health Insurance Claims

Religare Care Freedom medical insurance claim form is easily downloadable online from the insurer’s website. To settle the process you would need to furnish all the documents together with a duly-filled claim form in the stipulated time:

  • Original claim form to be duly completed and signed
  • Valid photo-id proof
  • Referral letter from the treating doctor recommending hospitalization/specific treatment
  • A prescription from the medical practitioner suggesting diagnostic tests/medicines/consultation
  • Original bills, discharge card and receipts
  • FIR, final police report, if applicable
  • Pharmacy/Chemist original bills
  • Original diagnostic/ pathological/ radiology tests reports
  • Post mortem report ( as per the case)
  • All the payment receipts
  • Any other documents as required by the Insurer

For any additional documents, you can check with the insurance provider at the time of claim.