Religare Care Health Insurance Plan

 

Religare Care is a comprehensive health insurance plan that pays for medical expenses incurred by the policyholder due to any injury, illness or accident. The plan covers expenses incurred during hospitalisation, prior and post hospitalisation, day-care treatments (that do not require hospitalisation), health check-up and much more.

 

 

 

·         No upper-limit for entry age

·         No premium increase due to any claim made

·         Get annual health check-up for all insured members - regardless of claims history

·         Feature to reduce PED wait period

·         Get automatic policy recharge if claim amount exhausts your coverage, at no extra cost

·         Avail treatment anywhere in the world

·         Daily allowance to meet incidental expenses

·         Ease of cashless treatment & settlement of claims directly by the company

·         Options of sum insured 2- 60 lacs

 

 

 

·         Cashless Hospitalisation

·         Policy Term options of 1, 2 or 3 years

·         Tax benefit on premiums paid under Section 80D of the Income Tax Act, 1961

·         Free look period of 15 days from the receipt of policy documents

·         Extra premium of up to 50% may be levied on the premium payable based on individual underwriting

·         No caps/limits on doctor/surgery fees, operation theatre, room rent and intensive care unit

·         7.5% Discount on 2 year policy terms and more

·         10% increase in Sum Insured after every claim-free year up to a max of 50% increase

 

 

 

	Minimum	Maximum
Sum Assured (in Rs)	2,00,000	60,00,000
Policy Term (in years)	1	3
Entry age	91 days	No age bar
Renewal age	-	Lifelong Renewability
Co-payment (SI 5 Lac & above)	20% of the claim amount If you are 61 years old or more
Waiting period	30 days for any illness except injury
Waiting period for pre-existing illnesses	4 years of continuous coverage
Grace period	30 days from the date of expiry to renew the policy

 

 

 

In-patient care: Hospitalisation expenses such as room rent, nursing expenses, ICU charges, surgeon’s fees, doctor’s fees, anaesthesia, blood, oxygen, operation theater charges, etc.

 

Day care treatment: Medical expenses incurred if hospitalisation is less than 24 hours,   

 

Pre and Post hospitalisation: Medical expenses incurred 30 days immediately before hospitalisation will be covered. Expenses incurred up to 60 days after being discharged from the hospital such as follow-up visits to medical practitioner, medication, etc will be covered.

 

Ambulance charges: Charges of Ambulance provided by the hospital or any service provider will be reimbursed

 

Daily Allowance: Out-of-pocket expenses such as transportation, attendant’s cost, etc while visiting the hospital or doctor are also provided. A lump sum amount for each completed day of hospitalisation is paid as Daily Allowance.

 

Organ Donor Cover: Medical expenses incurred by an organ donor while undergoing the organ transplant surgery if the organ is for the use of the insured person.

 

Second opinion: If the insured is suffering from a major illness as stated in the policy and wants to take a second opinion from any other doctor then Religare arranges the same free of cost. This 2^nd opinion is available to each of the members covered every year for each illness.

 

Domiciliary Hospitalisation: Medical expenses incurred by the insurer for treatment at home will be reimbursed. The medical treatment should be for a period exceeding 3 consecutive days and should merit hospitalisation.

 

Health Check up: The policy pays for annual health check-up of the insured and those family members who are not covered as policyholder’s child under the policy.

 

Recharge of Sum Assured: If the Sum Assured in the policy is exhausted due to claims made, then the company reinstates the entire sum assured once in the policy year. This reinstated amount can be used for future claims, not related to the illness / injury for which the claim has already been made during the same year.

 

Treatment anywhere in the world: For select diseases / ailments / treatments, the Company will reimburse the cost of medical expenses, whether the insured gets these treatments anywhere in India or abroad. All payments under this benefit will be made in India, in Indian Rupees and on a re-imbursement basis only.
 

 

 

Features/Sum Insured	3, 4 Lacs	5, 7, 10 Lacs	15, 20, 25, 30, 40 Lacs	50, 60, 75 Lacs
Pre-hospitalisation	30 days	30 days	30 days	30 days
Post-hospitalisation	60 days	60 days	60 days	60 days
Day Care Treatments	Yes	Yes	Yes	Yes
Room Rent	1% of SI per day	Single Private	Single Private	Single Private
ICU Charges	2% of SI per day	No Limit	No Limit	No Limit
Doctor's Fee etc	No Limit	No Limit	No Limit	No Limit
Other Medical Charges	No Limit	No Limit	No Limit	No Limit
Daily Allowance	500/day up to 5 days	-	-	-
Ambulance Cover	1,500/hospitalization	2,000/hospitalization	2,500/hospitalization	2,500/hospitalization
Domiciliary hospitalisation	Up to 10% of SI	Up to 10% of SI	Up to 10% of SI	Up to 10% of SI
Organ Donor Cover	50,000	1,00,000	2,00,000	3,00,000
Annual Health Check-up	Yes	Yes	Yes	Yes
Second Opinion	Yes	Yes	Yes	Yes
No Claim Bonus	Yes	Yes	Yes	Yes
Auto-Recharge of Sum Insured	Yes	Yes	Yes	Yes
Care Anywhere	-	-	-	Yes
Alternative Treatments	Upto Rs.15,000	Upto Rs.20,000	Upto Rs.20,000	Upto Rs.30,000
Maternity Cover	-	-	-	Upto Rs.100,000

 

 

 

The standard policy exclusions are - 

• Any pre-existing ailment/injury that was diagnosed/received within 48 months prior to issuance of the first policy
• Any diseases contracted during first 30 days of the policy start date except those arising out of accidents
• Expenses attributable to self-inflicted injury (resulting from suicide, attempted suicide)
• Expenses arising out of or attributable to alcohol or drug use/misuse/abuse
• Cost of spectacles/contact lenses, dental treatment
• Medical expenses incurred for treatment of AIDS
• Treatment arising from or traceable to pregnancy and childbirth, miscarriage, abortion and its consequences
• Congenital disease
• Tests and treatment relating to infertility and in vitro fertilization
• Some treatments such as non-infective arthritis, joint replacement etc., which are covered only after completion of 2 consecutive policy years

 

 

 

Tax benefits as a deduction from the taxable income each year under section 80D of the Income Tax under the existing tax laws of the Income Tax, 1961, on premiums paid up to Rs. 25,000 in case of individuals and Rs 30,000 for senior citizens

 

 

 

·         No medical test for individuals of 24 years of age and below for any sum assured

·         For others, refer the below grid

Sr #	Category	Tests	Sum Insured	Age
1	Test Set 1 Home Visit	CBC, ESR, URA, FBS, S CHOLESTEROL, ECG, SGPT, S CREATININE	2 lac, 3 lac, 4 lac	46 and above
2	Test Set 2	CBC, ESR, URA, GPE, HBA1C, S CHOLESTEROL, ECG, SGPT, S CREATININE	5 lac	46 and above
	Home Visit		7 lac and 10 lac	25 – 45 age
3	Test Set 3	CBC, ESR, URA, GPE, HBA1C, LIPID PROFILE, TMT, LFT WITH GGT, HBsAg, S CREATININE	7 lac and 10 lac	46 and above
	DC Visit		15, 20 and 25 lac	25 and above
4	Test Set 4 DC Visit	CBC, ESR, URA, GPE, HBA1C, LIPID PROFILE, LFT WITH GGT, HBsAg, S CREATININE, PAP (Female), PSA (Male), 2D ECHO	50 and 60 lac	25 and above

 

 

 

What is the difference between a family floater and critical illness or hospital cash insurance?

The individual or family floater health insurance works on the principle of indemnity. This means that these insurance policies will pay you only what you have spent for medical treatment in hospital. On the other hand, the critical illness or the hospital cash insurance pays you the amount insured, irrespective of the amount spent for medical treatment. These are a benefit based policies.

 

Do I need to undergo a medical check-up while buying a health insurance policy?

You may be required to undergo a medical check-up after you buy, in case any member to be insured is above 45 age or for sum insured 15 Lakhs or above.

 

What is beneficial for me - floater insurance or an individual insurance?

Buying an individual cover or a floater cover is an individual’s perception. However, as a general rule, at younger ages floater cover is advisable. As you grow older, you should go for an individual cover.

 

What is Co-payment?

Co-pay is that part of your claim amount, which you have to bear. Co-pay can be in % terms or an absolute amount. For example, in case of co-pay of 20% and claim of Rs. 10,000, insurance company will pay Rs. 8,000 (80% of 10K) and you will bear 20% (Rs. 2,000). In Religare Health Insurance policy there is No Co-payment ever, in policy Sum Insured 2/3/4 Lacs. For Sum Insured > 4, there will be no co-payment ever, if insured with Religare before age of 61.

 

What are the documents required for portability?

You can apply for CARE under portability with following documents: 

• CARE proposal form
• Portability form
• Copy of expiring health insurance policy
• Copy of renewal notice