There are various plan variants each with a different level of Sum Insured and coverage benefits. Moreover, the Religare Care Health Insurance Plan has a unique No Claim Bonus feature which doubles the Sum Insured in a mere two claim-free years.
Step 1 – The policyholder chooses the Sum Assured, the term of the plan and the members covered.
Step 2- If the covered member (s) face any medical contingency and the related expenses are covered by the plan the expenses incurred are paid by the plan.
Step 3 – if the plan matures and no medical contingencies occur, no benefit is paid.
Chetan buys the plan for a Sum Insured of Rs.5 lakhs. He chooses the Super NCB feature to the plan.
Option 1 – if, in the first policy year, Chetan faces hospitalization or any other medical expenses covered by his plan, the expenses would be paid up to the Sum Insured.
Option 2 – if the plan matures and Chetan doesn’t suffer any medical emergency, he earns a No Claim Bonus of 10%. Moreover, he also earns a bonus of 50% for Super NCB feature. After these tow additions, the Sum Insured becomes Rs.8 lakhs.
|Coverages||Sum Insured Rs.1,1.5 lakhs (Care 1)||Sum Insured Rs.2,2.5 lakhs
|Sum Insured Rs.3,3.5,4,4.5 lakhs (Care 3)||Sum Insured Rs.5-10 lakhs (Care 4)||Sum Insured Rs15,20,25,30,40 lakhs (Care 5)|
|Room rent||Up to 1% of Sum Insured||Up to 1% of Sum Insured||Up to 1% of Sum Insured||Single Private Room||Single Private Room|
|ICU charges||Up to 2% of Sum Insured||Up to 2% of Sum Insured||Up to 2% of Sum Insured||No sub-limits||No sub-limits|
|Day care treatments||Covered||Covered||Covered||Covered||Covered|
|Pre-hospitalization||30 days||30 days||30 days||30 days||30 days|
|Post hospitalization||60 days||60 days||60 days||60 days||60 days|
|Domiciliary hospitalization||Not Covered||Up to 10% of Sum Insured||Up to 10% of Sum Insured||Up to 10% of Sum Insured||Up to 10% of Sum Insured|
|Organ Donor expenses||Not Covered||Up to Rs.50,000||Up to Rs.50,000||Up to Rs.1 lakh||Up to Rs.2 lakhs|
|Daily allowance||Rs.250/day up to 5 days||Rs.500/day up to 5 days||Rs.500/day up to 5 days||Not covered||Not covered|
|AYUSH Coverage||Not covered||Not covered||Up to Rs.15,000||Up to Rs.20,000||Up to Rs.30,000|
|Ambulance cover||Up to Rs.1000 per hospitalization||Up to Rs.1500 per hospitalization||Up to Rs.1500 per hospitalization||Up to Rs.2000 per hospitalization||Up to Rs.2500 per hospitalization|
|Health check-ups||Not available||Annually||Annually||Annually||Annually|
|Automatic Recharge||Not covered||Up to Sum Insured||Up to Sum Insured||Up to Sum Insured||Up to Sum Insured|
|Second opinion||Not covered||Not covered||Once per illness per policy year||Once per illness per policy year||Once per illness per policy year|
|Coverages||Sum Insured Rs.50,60,75 lakhs (Care 6)||Sum Insured Rs.1,1.5,2,3,6 crores
|Room rent||Single Private Room||Single Private Room|
|ICU charges||No sub-limits||No sub-limits|
|Day care treatments||Covered||Covered|
|Pre-hospitalization||30 days||30 days|
|Post hospitalization||60 days||60 days|
|Domiciliary hospitalization||Up to 10% of Sum Insured||Up to 10% of Sum Insured|
|Organ Donor expenses||Up to Rs.3 lakhs||Up to Rs.5 lakhs|
|AYUSH Coverage||Up to Rs.40,000||Up to Rs.50,000|
|Global Coverage||Not covered||Up to Sum Insured|
|Ambulance cover||Up to Rs.3000 per hospitalization||Up to Rs.5000 per hospitalization|
|Vaccination cover||Not covered||Up to Rs.10,000|
|Care anywhere||Up to Sum Insured||Not covered|
|Maternity cover||Up to Rs.1 lakh||Up to Rs.2 lakhs|
|Automatic Recharge||Up to Sum Insured||Up to Sum Insured|
|Second opinion||Once per illness per policy year||Once per illness per policy year|
|Age at entry (in completed years)||Adults – 18 years
Dependent Children - 3 months
|Plan tenure||1 year||3 years|
|Premium paying options||Single pay|
|Sum Assured||Rs.1 lakh||Rs.6 crores|
Illnesses suffered during the first 30 days of the plan commencement are not covered.
Pre-existing illnesses or conditions are not covered by the plan in the first 4 years of the policy
Maternity related benefits have a waiting period of 2 years.
Specific illnesses are not covered in the first two years of the plan.
Illnesses or accidents caused due to genetic disorder or stem cell surgery, substance abuse, participation in adventure sports or hazardous activities, criminal acts, attempted suicide, war and hazardous substances, etc. are not covered.
Treatments like cosmetic treatments, artificial life support, weight loss treatments, non-allopathic treatments or due to HIV/AIDS, etc. are not covered.
Below are the sample rates of premium payable by a non-smoking male living in Mumbai aged 35 years for different combinations of plan option and members covered. The Sum Insured is Rs.5 lakhs and the policy is taken for 1 year.
Yes, co-pay of 20% is applicable on each claim if the age of the insured is 61 years and above.How many members can be covered under the plan?
A maximum of 6 members can be covered in any combination. Maximum adults who can be covered are 2 and maximum children are 4.Are pre-entrance medical check-ups required?
No medical check-ups are required if the insured is aged up to 45 years and the Sum Insured chosen is less than Rs.15 lakhs.What is the age limit on free health check-ups?
There is no age limit. Health check-ups are available at all ages.How long is the plan renewable?
The plan is renewable lifelong.