Care (Formerly Religare) Health Insurance

Care Formerly Religare Super Mediclaim Heart health insurance

The study also noted that the prevalence of Ischemic heart disease (IHD) in 1960 in urban India was 2%, and it increased sevenfold to approximately 14% recently. In rural areas, it more than quadrupled, from 1.7% to 7.4% between 1970 till date. The study further noted that early onset of myocardial infarction or heart attack was increasing in the South Asian population.

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Indians are at greater risk of mortality due to cardiovascular diseases, the incidence of which is rising in the country, according to a study by Apollo Hospitals in early 2019. According to the study, the Cardio Vascular death (CVD) rate in India, at 272 per 1,00,000 population per year, is higher than the global average of 235 per 1,00,000. "CVDs tend to impact Indians in their most productive years of mid-life, as compared to people in the Western world and this is growing at a high rate given the lifestyle and dietary habits of Indians. Other influencing factors like Hypertension, Diabetes and Blood Pressure have played their role in this increase in CVD ailments and deaths. This impacts the rich and poor equally and hence it is important for everyone to be protected against the financial risks associated with heart related conditions.
While it is important to be active and eat healthy, it is also equally important to be financially prudent and invest in a comprehensive Heart related insurance plan like Care (Formerly Religare) Super Mediclaim Heart, which can offer financial assistance and support at a crucial time in one's life.

Care Health Insurance Review

Care Health Insurance
Care Health Insurance sum insured
4 lacs − 600 lacs options available
Incurred Claims Ratio *
55.00%
Care Health Insurance tenure options
1, 2 or 3 years options available
Claims Settlement Ratio **
93.44%
List of network hospitals
7,400+ hospitals
Number of policies issued *
6,91,739
Maximum family floater coverage
Self, Spouse + dependent (children + parents)
Number of lives covered *
1,07,13,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

Care (Formerly Religare) Super Mediclaim Heart insurance plan - review

  • Key features
  • Eligibility
  • Coverages

Key features of Super Mediclaim Heart insurance plan

Some of the key features of this plan include:
  • Five Sum insured options from ₹10 lacs to ₹2 crores
  • Covers the following defined Heart Related Critical Illnesses
    • Pulmonary Thromboembolism, Primary(Idiopathic) Pulmonary, Infective Endocarditis, Heart Valve Replacement/repair, Surgery of Aorta, Cardiomyopathy, Surgery for cardiac arrhythmia, Angioplasty, Balloon Valvotomy/Valvuloplasty, Carotid Artery Surgery, Coronary Artery Bypass Graft, Pericardectomy, Surgery to Place Ventricular Assist Devices or Total Artificial Hearts, Myocardial Infarction, Implantation of Pacemaker of Heart, Implantable Cardioverter Defibrillator
  • 30/60 Pre and post hospitalization medical expenses covered
  • No Claims Bonus (NCB) offered for claim free renewals
  • Lifelong Renewability – no exist age for renewing the policy even if claims have been filed
  • Option of Equated Monthly/Quarterly Instalments
  • Room Rent Modification option available to the insured
  • International Second Opinion available while availing treatment for cancer
  • Outpatient Treatment Expenses covered under this plan for Diagnostics, Pharmacy & Consultations
  • Air Ambulance Cover during medical emergencies
  • Quick Recovery Counselling
  • Health Portal *** – insured members have access to an informative health portal providing relevant information at all times.
*** Salient Features of the Health Portal
  • Search the best deal in location of the insured
  • Discount on all Healthcare and wellness services like Doctor Consultations, Diagnostics, Pharmacy, Dental Consultation and treatment
  • Comprehensive details on Doctors like qualification & appointment details.
  • Access to Right Healthcare Service, at right time and place.
  • Symptom tracker
  • Ailment to specialty tracker
  • Automated discount coupon download
  • 24x7 on call support

Care (Formerly Religare) Super Mediclaim Heart insurance plan – eligibility

Sum Insured 10 Lakh | 25 Lakh | 50 Lakh | 1 Crore | 2 Crore
Covered Conditions (Illnesses/Diseases/Surgeries) Heart related Critical illnesses
Entry Age 5 years to 50 Years on Individual Basis
Pre - policy Issuance Medical Check up No Medicals##
Tenure 1/2/3 Years
Premium Payment Mode *** Single/Monthly
Sub Limits:
Room Rent Eligibility Single Private Room / No limit ^
ICU Charges No limit
Wait Period:
Initial Waiting Period 90 Days
Pre - existing Disease 48 months
*** Terms and Conditions Applicable
##at the discretion of the Underwriter.
^with optional benefit Room Rent Modification. Note: Other SI / Age band options also available.

Coverages under Super Mediclaim Heart insurance plan

Sum Insured (all figs in ₹ INR) 10 Lakh | 25 Lakh | 50 Lakh | 1 Crore | 2 Crore
Plan Name Heart Mediclaim
Sum Insured (all figs in ₹ INR) 10 Lakh | 25 Lakh | 50 Lakh | 1 Crore | 2 Crore
Benefits
In-Patient Care Up to SI
Day Care Treatment Listed as per the Plan, Up to Sum Insured
Pre-Hospitalization and Post-Hospitalization Pre-Hospitalization for 30 days & Post-Hospitalization for 60 days; Maximum up to SI
Ambulance Cover Up to ₹3000 per hospitalization
Organ Donor Cover Up to SI or 15 L whichever is lower
Second Opinion Once per Covered Condition per policy year
No Claim Bonus* 50% / 25% / 25% - Corresponding increase in SI for 1st, 2nd and 3rd continuous claim-free Policy Years respectively, Max up to 100% of SI(50%/25/25%-Corresponding decrease in SI per Policy Year in case a claim has been paid; Such decrease is only in SI accrued as NCB)
International Second Opinion# Once per Covered Condition per policy year
Room Rent Eligibility Single Private Room / No limit^
Air Ambulance# Up to Rs. 5 Lakhs
Health Services
Quick Recovery Counselling Up to Rs 1000 Per Session, Maximum 8 Sessions Post Hospitalization in a Policy year( can be availed twice in a month)
Doctor on Call Yes(Telephonic/Online Mode)
Health Portal Value added services through Company’s Website
Global Coverage: Coverage outside India - 45 continuous days in a single trip; Max. 90 days on a cumulative basis, in a Policy Year. Up to SI; only for SI >=1Cr (Limited to In-Patient Care and Day-Care treatment with a Co-payment of 10% per Claim)
OPD Expenses (Diagnostics + Consultations + Pharmacy ) Up to 1% of SI ,Max up to Rs 25,000
Benefits
Hospitalization Expenses  
In-Patient Care Up to SI
Day Care Treatment Up to SI
Pre-Hospitalization and Post-Hospitalization 30 days/60 days
Chemotherapy and Radiotherapy Cover Up to SI
Ambulance Cover Up to Rs 3000 per hospitalization
Organ Donor Cover Up to SI or 15 L whichever is lower
Second Opinion Once per Covered Condition per policy year
No Claim Bonus* 50% / 25% / 25% - Corresponding increase in SI for 1st, 2nd and 3rd continuous claim-free Policy Years respectively,Max up to 100% of SI(50%/25/25%-Corresponding decrease in SI per Policy Year in case a claim has been paid; Such decrease is only in SI accrued as NCB)
International Second Opinion# Once per Covered Condition per policy year
Room Rent Eligibility Single Private Room / No limit^
Air Ambulance# Up to Rs. 5 Lakhs
Annual Health Check-up Annual from 2nd Policy Year on Continuous Coverage
Health Services
Quick Recovery Counselling Up to Rs 1000 Per Session, Maximum 8 Sessions Post Hospitalization in a Policy year( can be availed twice in a month)
Doctor on Call Yes(Telephonic/Online Mode)
Health Portal Value added services through Company’s Website
Global Coverage: Coverage outside India - 45 continuous days in a single trip; Max. 90 days on a cumulative basis, in a Policy Year. Up to SI; only for SI >=1Cr (Limited to In-Patient Care and Day-Care treatment with a Co-payment of 10% per Claim)
OPD Expenses (Diagnostics + Consultations + Pharmacy ) Up to 1% of SI ,Max up to Rs 25,000
#Optional Benefit.
^with optional benefit Room Rent Modification.

Care (Formerly Religare) health insurance FAQ's

There is no upper limit on the number of claims during the policy period. However, the total cumulative claim amount cannot exceed the Policy Sum Insured.

As on date Care (Formerly Religare) Health have settled 4.7 lacs + health claims

The process is as follows:
  • Cashless - For any emergency hospitalisation, the insured should intimate Care (Formerly Religare) Health within 24 hours from the time of hospitalization. For any planned hospitalization, the Insured should seek cashless authorization from us at least 48 hours prior to hospitalization.
  • Reimbursement - In case of a reimbursement claim, the insured pays the hospitalization expenses (which is otherwise claimable under his insurance policy) himself and then claims for a reimbursement of those expenses from Care (Formerly Religare). The Insured should submit all the bills and treatment papers in original to us and intimate regarding the hospitalization as per policy terms & conditions.

Brochure

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Policy wordings

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
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