Care Ultimate Care Plan

Exclusion of Care Ultimate Care Plan may differ from one plan to another. Some of the inclusions that are common under all the policies are given below:

1. Obesity and weight-control treatments
2. Dietary supplements and substances
3. Treatment for alcohol or drug addiction
4. Non-allopathic treatments
5. Treatments for injuries due to participation in adventure sports
6. Cosmetic surgeries
7. Self-inflicted injuries or attempt to suicide
8. Unproven treatments

Optional Cover of Care Ultimate Care Plan may differ from one plan to another. Some of the inclusions that are common under all the policies are given below:

1. Premium Payback

   It refunds the base premium amount of the first policy year to the policyholder after every 5 consecutive claim-free years.
2. Infinity Bonus

   It increases your coverage amount by 100% of the base sum insured on every renewal irrespective of whether you file a claim or not.
3. Instant Cover

   It covers pre-existing asthma, diabetes, obesity, hypertension, coronary artery disease, hyperlipidemia and hyperthyroidism from the 31st day of the policy.
4. Tenure Multiplier

   It allows the policyholder to combine the annual sum insured across the policy tenure in a multi-year health insurance policy for a single claim. This benefit is available once in the entire policy tenure.
5. Unlimited Care

   It covers hospitalization expenses without any restriction on the sum insured amount once in the lifetime of the policy.
6. Unlimited Automatic Recharge Booster

   It automatically restores the coverage amount by 100% of the sum insured for the first claim in the lifetime of the policy.
7. Premium Freeze

   It freezes the policy premium as per the entry age of the policyholder unless a claim is raised.
8. Maternity Cover

   It covers maternity expenses incurred during pregnancy and childbirth, including pre-natal and post-natal expenses. Moreover, it accumulates the maternity coverage amount for up to 3 times, provided no pregnancy-related claims have been filed.
9. OPD Care

   It reimburses the medical expenses incurred for doctor consultations, pharmacy and diagnostic examinations on an outpatient department (OPD) basis.
10. Newborn Baby Cover

    It pays for the hospitalization expenses incurred for the treatment of the newborn baby within the first 90 days of its birth.
11. Claim Shield

    It pays for the cost of non-medical items, such as oxygen masks, IV injection charges, gauze, cotton, etc., availed during in-patient hospitalization.
12. Plus Benefit

    It provides an additional coverage amount of 20%/ 50%/ 100%/ 500% of the sum insured from day 1 of the policy, which will get activated once the base sum insured is completely exhausted.
13. Inflation Shield

    It increases the sum insured of the policy based on the inflation rate of the previous year.
14. Annual Health Check-up

    It covers the cost of preventive health check-ups once every year incurred by each insured member.
15. Cover Pause

    It allows the policyholder to pause policy coverage for up to 30 days once a year in case he/she is travelling abroad. The policy tenure will be extended by the number of days it was paused under this benefit.
16. Outpatient Consultations

    It pays for the medical expenses incurred on availing OPD consultations with general physicians and specialists.
17. Outpatient Dental and Vision Care

    It covers the cost of OPD dental consultations and treatments along with OPD consultations and diagnostic tests for vision care.
18. OPD Diagnostics

    It pays for the OPD expenses incurred on diagnostic tests prescribed by a qualified doctor.
19. OPD Pharmacy

    It covers the medical expenses incurred on buying medicines on an OPD basis.
20. Unlimited E-consultations

    It allows the insured to avail e-consultations from general physicians/specialists within the insurer’s network unlimited times a year.
21. Physical Consultations with General Physicians

    It pays for a maximum of 4 OPD physical consultations with a general physician availed by each insured member during the policy year.
22. Physical Consultations with Specialist Doctors

    It covers the cost of 4 OPD physical consultations with specialist doctors availed by each insured member in a policy year.
23. Women Care

    It pays for the OPD expenses incurred on mammography and the screening for PCOD/PCOS and cervical cancer on a cashless basis.
24. Mental Health Wellbeing

    It covers the cost of OPD consultations, counselling and rehabilitation for acute depression, anxiety, Post-traumatic Stress Disorder (PTSD) and Obsessive Compulsive Disorder (OCD).
25. Newborn External Congenital Disease/Defects

    It pays for the treatment cost of medically diagnosed external congenital disease/defects of the newborn baby.
26. Newborn Vaccination

    It covers the cost of vaccinations of the newborn baby until the baby turns 1 year old.
27. Assisted Reproductive Treatment

    It pays for the medical expenses incurred on assisted reproductive treatments availed by the insured women.
28. Durable Medical Equipment

    It covers the cost of medically necessary medical devices, aids or durable medical equipments, prescribed by the doctor at the time of hospital discharge.
29. Cancer Care

    It pays for the medical expenses incurred on the treatment of any cancer or metastasis or recurrence of cancer.
30. PED Wait Period Modification

    It reduces the waiting period for pre-existing diseases (PED) from 3 years to 2 years or 1 year.
31. Travel Plus

    It pays for the overseas medical expenses incurred on emergency in-patient care and OPD treatments, along with compensation for the loss of passport or international driving license, delay or loss of checked-in baggage, trip cancellation and trip interruption. Moreover, this benefit comes with optional coverage for life-threatening conditions due to pre-existing diseases.
32. Surrogacy Care

    It covers the hospitalization expenses of the surrogate mother resulting from pregnancy and post-partum delivery complications. However, this coverage is available only under a policy tenure of three or more years.
33. Oocyte Care

    It pays for the hospitalization expenses of the oocyte donor resulting from complications due to oocyte retrieval.
34. Smoking and Alcohol Rehabilitation

    It enables the insured to avail online tobacco cessation and de-addiction program, including sessions with cessation & de-addiction specialists and withdrawal and cravings management, through the insurer’s network providers.
35. Wellness Benefit

    It provides wellness benefits, including up to 30% wellness discount on achieving target step count and access to digital fitness coaching, nutritionist/wellness coach and AI fitness coaching.
36. Deductible

    It offers a discount on the premium if the policyholder agrees to pay an aggregate deductible on all claims in a policy year.
37. Co-payment

    It levies a fixed percentage of co-payment payable by the policyholder on every claim.
38. Smart Select

    It provides a premium discount if the policyholder opts to avail cashless treatment only at smart select hospitals listed by the insurance company.
39. OPD Reward

    It provides OPD vouchers of up to ₹5000 or ₹10,000 to the policyholder in case no non-accidental hospitalization claims have been raised for the last 3 consecutive years.
40. Initial Wait Period Modification

    It removes the initial waiting period of 30 days and starts medical coverage from day 1 of the policy.
41. Named Ailment Wait Period Modification

    It modifies the waiting period for specified/named illnesses from 2 years to 1 year or 3 years.
42. Pre-Post Hospitalization Expenses Modification

    It modifies the maximum number of days covering pre-hospitalization and post-hospitalization expenses during the policy year.
43. Concierge/Geriatric Care

    It provides concierge services, including emergency doctor on call, fortnightly electronic health check-ups, access to 24x7 helpdesk and access to health-related content.
44. Be-Fit Plus Benefit

    It allows the insured to visit fitness centres at a network provider of the insurance company unlimited times in a policy year.
45. Spouse Care

    It allows the newly married spouse of the policyholder to avail the accrued cumulative bonus of the policy. Moreover, the waiting period served under the policy is also passed on to the spouse.
46. Policyholder – Child Protection

    It provides a 25% discount on renewal premiums to the dependent child until the age of 30 years in case of the policyholder’s death.
47. Room Rent Modification

    It modifies the eligible hospital room category to single private AC room, twin sharing room, general ward or general ward with a maximum limit of ₹3000 per day.
48. Grace Period Cover

    It covers the hospitalization expenses incurred during the grace period of the policy, which are otherwise not covered.
49. Women Support Program

    It provides access to an online comprehensive program to support women-related health issues, including PCOS/PCOD, breast cancer, cervical cancer, Premenstrual Syndrome (PMS), contraception, Urinary Tract Infection (UTI), anaemia, osteoporosis and Sexually Transmitted Infection (STI).