Care Senior Health Advantage Plan

Care Senior Health Advantage Plan

Care Senior Health Advantage is a senior citizen health insurance plan with no maximum entry age limit. It provides day 1 coverage for pre-existing diseases (PED), including asthma, hyperlipidemia, diabetes and hypertension, with the Instant Cover. It also comes with disease management programs for hypertension, asthma, diabetes and hyperlipidemia patients.

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This Care health insurance policy offers unlimited restoration of the sum insured for the same and unrelated illnesses with the Unlimited Automatic Recharge benefit. It also comes with OPD cover, annual health check-ups, companion benefit, No Claim Bonus Super, unlimited e-consultations, etc.

Care Senior Health Advantage Plan: Key Highlights

Benefits of Care Senior Health Advantage Plan

Take a look at the Care Senior Advantage plan benefits:

1. Day 1 Coverage for Listed Pre-existing Diseases

   Policyholders can avail day 1 coverage for pre-existing asthma, diabetes, hyperlipidemia, and hypertension with the Instant Cover benefit. However, this benefit is available as an optional cover.

2. Unlimited Recharge of Sum Insured

   This health insurance policy automatically recharges the sum insured amount once a year for both related and unrelated illnesses in case of exhaustion. It also comes with an Unlimited Automatic Recharge option that recharges the sum insured unlimited times a year on the payment of an additional premium.

3. Annual Health Check-ups

   Care Health Insurance provides coverage for preventive health check-ups from day 1 of the policy at any of its network provider once a year.

4. Unlimited E-consultations

   Policyholders can avail unlimited e-consultations from any general physician under the network of the insurance company.

5. Disease Management Programs

   This mediclaim policy comes with disease management programs for people suffering from diabetes, hyperlipidemia, asthma and hypertension that covers the cost of doctor consultations, listed diagnostic tests and medicines. However, this benefit is available as an optional cover.

6. No Claim Bonus Super

   A No Claim Bonus (NCB) of 25% of the sum insured for up to 100% is granted to the policyholder on every claim-free year. It can also be increased to an NCB of 50% of the sum insured per claim-free year if the policyholder opts for the No Claim Bonus Super benefit on the payment of an additional premium.

7. Value-Added Services

   Policyholders can avail discounts on OPD treatments, diagnostic tests, and pharmacy at the network healthcare centres as other value-added services.

8. Tax Benefits

   Care Senior Health Advantage premiums can be claimed for tax savings under Section 80D, Income Tax Act.

Care Senior Health Advantage Plan Eligibility Criteria

Check out the eligibility criteria to purchase a Care Senior Health Advantage plan:

Inclusions of Care Senior Health Advantage Plan

The following coverage are included in the Care Senior Health Advantage plan:

• In-patient Care – It pays for the healthcare expenses incurred during hospitalization of 24 hours or more.
• Day Care Treatments – It covers the cost of all day care treatments that do not require 24 hours of hospitalization.
• Advance Technology Methods – It pays for the medical expenses incurred on obtaining 12 modern treatments, including stem cell therapy, deep brain stimulation, robotic surgeries, and oral chemotherapy.
• Domiciliary Hospitalization – It covers the cost of obtaining medically necessary treatment at home for more than 3 days on the recommendation of the doctor in case hospitalization is not possible.
• Organ Donor Cover – It pays for the hospitalization expenses of the donor incurred while donating the organ for the transplant surgery of the insured.
• AYUSH Treatment – It covers the in-patient hospitalization expenses of obtaining treatment through Ayurveda, Unani, Homeopathy and Siddha at an AYUSH hospital or healthcare centre.
• Pre-Hospitalization Medical Expenses – It pays for the medical costs incurred for up to 60 days before getting admitted to the hospital.
• Post-Hospitalization Medical Expenses – It covers the medical costs incurred for up to 90 days after being discharged from the hospital.
• Road Ambulance Cover – It pays for the charges of obtaining road ambulance services to transport the insured to a hospital or from one hospital to another.
• Unlimited E-consultations – It covers the cost of availing unlimited teleconsultations from general physicians under the insurer's network via audio, video, chat or email.

Optional Covers:

• Room Rent and ICU Modification – It allows policyholders to modify their room rent and ICU limits.
• Sub-limit on Advance Technology Methods – It levies a sub-limit on advance technology methods by changing its existing coverage limit.
• Unlimited Automatic Recharge – It upgrades the recharge benefit by restoring the sum insured amount unlimited times in a policy year for the same and unrelated illness in case of exhaustion.
• OPD Care – It covers the OPD expenses incurred on diagnostic tests, medicines and medical devices.
• OPD Consultation & Therapy Expenses – It pays for doctor consultations and prescribed therapies obtained on an outpatient department basis.
• Sub-limit on Specified Diseases – It levies sub-limits on listed diseases and procedures, including cancer, cataract treatment, cardiovascular diseases, etc.
• Voluntary Co-payment – It enables policyholders to opt for a voluntary co-payment of 10%, 20%, 30%, 40% or 50%. However, the opted co-payment will increase by 10% if the insured is more than 70 years old.
• No Claim Bonus Super – It enhances the no claim bonus to 50% of the sum insured payable at every claim-free year for up to a maximum of 100%.
• Additional Sum Insured for Accidental Hospitalization – It provides an additional coverage amount of up to 100% of the sum insured or ₹75 lakh, in case the insured is admitted under in-patient care due to an accident.
• Additional Sum Insured for Defined Critical Illnesses – It pays an additional sum insured of up to 100% or ₹25 lakh, if the insured is undergoing in-patient treatment or day care treatment due to 11 listed critical illnesses.
• Air Ambulance Cover – It covers the medical expenses incurred on obtaining air ambulance services in India to transport the insured on the recommendation of the treating doctor.
• Smart Select – It reduces the policy premium if the insured promises to obtain medical treatment at listed hospitals only. However, if the insured avails treatment at any other hospital, then an additional co-payment of 20% is applicable.
• Increase in PED Waiting Period – It increases the pre-existing disease (PED) waiting period from 1 year to 2 or 3 years.
• Instant Cover – It removes the PED waiting period for diabetes, asthma, hypertension and hyperlipidemia and provides coverage from day 1.
• Termination of Automatic Recharge Coverage – It terminates the automatic recharge benefit, leading to no restoration of the sum insured.
• Modification of No Claim Bonus – It modifies the no claim bonus to 10% of the sum insured for every claim-free year for a maximum of 50%.
• Disease Management Programs – It allows policyholders to opt for a disease management program for asthma, hypertension, diabetes and hyperlipidemia that covers the cost of doctor consultations, pharmacy and listed diagnostic tests.
• Modification of Pre-Hospitalization and Post-Hospitalization Medical Expenses – It reduces the pre-hospitalization coverage from 60 days to 30 days and post-hospitalization expenses coverage from 90 days to 60 days.
• Companion Benefit – It pays a lump sum amount once a year if the insured is hospitalized for more than 10 consecutive days.
• Sub-limit on Hospitalization-related Expenses – It levies a sub-limit on expenses related to in-patient hospitalization, including surgeon, specialist, anaesthetist, consultant and doctor's fees.

Exclusions of Care Senior Health Advantage Plan

Care Senior Health Advantage comes with the following exclusions:

• Maternity expenses
• Obesity and weight-control treatments
• Dietary supplements and substances
• Cost of consumables
• Treatment for alcohol or drug addiction
• Injuries due to participation in hazardous or adventure sports
• Sterility and infertility
• Cosmetic or plastic surgery
• External congenital defects
• Unproven treatments
• Self-inflicted injuries

Care Senior Health Advantage Plan: FAQs