“I know hospital bills are scary, but so are the premiums for health insurance policies. So, why avail these plans?”
This myth has now been busted, thanks to the entry of new health insurance providers in the market who are offering affordable policies to help you stay financially covered during health scares. One such brand is the Care Health Insurance company. Health insurance plans from Care are comprehensive and pocket-friendly without many restrictions, terms and conditions, or exclusions. The brand is famous across the industry for its diverse range of health plans that cater to a broad portfolio of pre-existing conditions.
The Care Health Insurance policy from the stable of Care Health insurer is a decent plan. The policy offers multiple basic features with affordable premiums and some restrictions (not unreasonable ones). While the plan requires a lengthy pre-existing disease waiting period, this period can be cut down significantly with an add-on.
However, the Care insurer’s portfolio extends much beyond the Care plan, so the question is, is Care still one of the most value-worthy products from this stable? Is the Care Health Insurance policy a comprehensive one? Here’s what we think!
Quick Verdict on Care Health Care Plan
Care Health Insurance Plan is a basic pick. While the plan is decent with few restrictions, the policy has multiple sub-limits on its offerings, an extensive PED waiting period, single restoration (in one year), and a mandatory maternity perk for cases of the higher insured sum. A majority of these drawbacks can be overcome with add-ons. However, in that case, you are just seeking a comprehensive policy with much higher premiums than what is usually expected from Care’s plans.
Speaking of Care itself, the insurer is reasonably credible. However, the provider’s recent high complaint volume is a definite concern. So, if you are sure about Care being your health insurance provider, we suggest looking around for other policies. Care is just too fundamental a plan that lacks comprehensiveness.
Care Health Insurance Care Plan: Brief Overview
Care was previously known as Religare Health Insurance and was founded in 2012. The company is one of the largest standalone health insurance providers in the country, with a network of 9400+ partner hospitals nationwide. The insurer’s metrics are decent too -
- Claim Settlement Ratio (CSR) of 90.75% (the industry average is 90.97%; the higher, the better)
- Incurred Claim Ratio (ICR) of 58.01% (the industry average is 82.96%; an ideal range would be somewhere between 50-70%)
- Complaint Volume of 30.53 (the industry average is 24.029; the lower, the better)
Read more to find out how these metrics help determine the top health insurers in the market
While the insurer’s CSR and ICR make it an exceptional health insurance provider, the rising complaint volume has become a significant concern for us, considering it reflects the insurer's poor overall performance, especially in claim settlement.
Now, Care health insurance is a decent plan with extensive coverage of up to ₹75 lakhs. The plan offers a basic package of features with few outrageous conditions or restrictions. The policy is affordable as it follows Care’s USP of no loading charges irrespective of your Body Mass Index (BMI) or pre-existing conditions.
However, Care has a few clauses across its plan -
- Co-payment of 20% (in case you are 61+ when you purchase the plan),
- Your room rent is covered in full up to a single private room, but nothing above (unless you have a sum insured of ₹15 lakhs or above, in which case your room type can go above a single private room if it's unavailable).
- An extensive waiting period of 4 years is required in case of pre-existing conditions.
-and more. If you are convinced about Care being your health insurance provider, you may choose to look for other options. Care has a few of the best health insurance policies in the industry!
Features of Care Health Care Plan
| FEATURES | DETAILS |
| Coverage | From ₹5 lakhs to ₹75 lakhs |
| Copayment | 20% (if you avail of this plan after you turn 61 years) |
| Room rent restrictions | Yes, based on the sum insured |
| Affordability of premiums | Affordable |
| Waiting period |
|
| Domiciliary coverage | Up to 10% of the sum insured |
| Pre & Post Hospitalisation | 30 days and 60 days |
| Add-ons available | Care Shield | Unlimited Automatic Recharge | NCB Super | Reduction in PED | Air Ambulance | OPD | Everyday Care | Co-Pay Waiver |
Should You Buy a Care Health Care Plan?
- Care as an insurer: Over the last decade, Care has become a popular name in the health insurance industry. As a standalone health insurance provider, the company’s most highlighted feature is the no-loading charges applicable to pre-existing medical conditions. This significantly reduces the premiums for health insurance plans and makes Care a popular choice among policyholders.
The only caveat for the insurer is that post-pandemic, the insurer has taken a hit regarding its overall operational performance. This is reflected in its complaint volume numbers:
| Complaint Volume across the years | Care Health Insurance | Industry Average/year |
|---|---|---|
| 2020 - 2021 | 22.21 | 13.212 |
| 2021 - 2022 | 29.38 | 35.969 |
| 2022 - 2023 | 40 | 19.578 |
| Average of 3 years | 30.53 | 24.029 |
However, if you are willing to trust its extensive insurance track record and thus sideline the issue with its complaint volume, Care is a great pick!
2. In-Built Features: Care Health Insurance, as a standalone policy, is a basic one with few unreasonable restrictions, but some clauses limit its perks for the policyholders.
- Offered Coverage: Care is one of the first health insurance plans from the insurer and provides an extensive range of sum insured of up to ₹75 lakhs. Considering the escalating medical inflation, the capped amount is adequate to cover diverse medical treatments.
- Co-payment: Generally, policyholders need not pay any co-payments towards the hospital invoices. The insurer pays off the entire billed amount (provided you haven’t exceeded your room rent limit, you have an adequate sum insured, and there are no disease-wise sub-limits).
However, if you avail of the Care health insurance policy after you turn 61, you will pay a mandatory co-payment of 20% towards every billed amount. Care will pay off the remaining 80%.
(Please note: Care Health Insurance Plan also offers a Co-Pay Waiver add-on to help you skip the copayment requirements)
- Room rent restrictions: When recommending plans, we prefer those that have no room rent/type cappings. This is crucial, considering that if you exceed the room rent or type, you will pay a pro-rata share of the bill.
In the case of Care health insurance, there is a capping on the room rent and type depending on the availed sum insured -
| Coverage | Room rent/type capping |
|---|---|
| ₹3 lakhs and ₹4 lakhs | Up to 1% of the coverage (per day) |
| ₹5 lakhs, ₹7 lakhs, and ₹10 lakhs | Up to a single private room |
| ₹15 lakhs to ₹75 lakhs | Up to a single private room (can be upgraded to the next level if a single private room is not available) |
- Waiting period
Initial Waiting Period: The plan demands a general 30-day waiting period from the commencement of the policy. However, in case of any accidents leading to medical treatments/surgeries/procedures within these 30 days, your insurer has you covered.
Pre-Existing Waiting Period: Now, Care is one of the only health insurers in the market that demands no loading charges (an additional amount added to the premium in case of a pre-existing medical condition or high BMI). That makes it the ideal insurer for those with complicated health track records. However, the Care health insurance policy demands a waiting period of 4 years for those with pre-existing conditions. Such an extensive waiting period is a discouraging feature, and we would have preferred something much shorter - say 2 years! While the plan offers an add-on to reduce this waiting period to 2 years, this is an in-built feature for most good policies.
Specific Illness Waiting Period: As mentioned in the policy document, the insurer has a 2-year waiting period for any of the listed specific ailments.
- Domiciliary treatments: Say you are forced to be hospitalised at home due to a shortage of hospital beds or mobility issues. Health insurers generally offer coverage of up to the entire sum insured for such treatments. However, in the case of Care, the cap on this kind of coverage (Domiciliary) is 10% of the chosen cover amount. This means you will be spending a significant portion of the bill from your pocket.
- No-claim bonus: If you have kept healthy and made no claims, the insurer rewards you for staying fit by offering a bonus. In the case of Care health insurance, the No-Claim Bonus is only 10% per year and is capped at 50% of the sum insured. While this is a stingy range for a No-Claim Bonus, you can opt for an add-on to boost this range from 50% to 100%. However, we would have preferred the in-built range to be higher than opting for a rider.
3. Add-Ons: Care Health Insurance is a basic, decent, and affordable policy with a few hurdles via cappings and limitations on its built-in features. Thus, in the case of this plan, add-ons can play a crucial role in ensuring that this becomes a value-worthy plan. Here are the available health insurance add-ons with the Care Plan -
- Care Shield: Care Shield is a 3-way package add-on, possibly one of the best picks from the insurer’s list of riders. Under this add-on, you are covered for -
- Medical inflation - Your coverage increases every year as per the annual CPI average
- Non-consumables - Care Shield offers coverage for specified 68 non-payable items.
- NCB protection - If the claim amount is less than 25% of your opted sum insured, your No-Claim Bonus isn’t impacted.
- Unlimited Automatic Recharge: The in-built restoration feature of Care only allows your sum insured to be restored once (in a year) upon partial exhaustion for the same or different illnesses. On the other hand, the Unlimited Automatic Recharge extends the same perk but for an unlimited number of times. This might initially seem like a great add-on, but please remember that Care already has health insurance policies that extend unlimited restoration as a built-in benefit.
- NCB Super: As stated before, the No-Claim Bonus in the policy only offers a measly bonus of 10% to a maximum of 50% of the sum insured. But with an NCB Super in place, you can boost this range from a minimum of 50% to a maximum of 100%. If you are sure about opting for Care as your health insurance plan, availing of this rider might be a good move.
- Reduction in PED: In general, Care Health Insurance has a waiting period of 4 years for those with pre-existing medical conditions (also called PED). This waiting period is too extensive and an unfavourable limitation that might discourage policyholders from opting for this plan. Hence, this add-on, the reduction of the PED waiting period, has been introduced. Under this rider, your PED waiting period gets reduced from 4 years to 2 years.
And again, if you have finalised that Care is your health insurance policy, this rider is a good pick.
However, we suggest you shop around the Care stable a bit more. You will find plans with an in-built reduced waiting period apart from multiple other perks.
- Air Ambulance: With this add-on, you will be covered for your air ambulance charges for up to ₹5 lakhs.
- OPD: Medical inflation doesn’t just affect your hospitalisation bills. Consider visiting your physicians for nominal check-ups following an infection, fever, etc. The fees and diagnostic tests are not exactly easy on your pocket. Under such circumstances, if you opt for the OPD add-on with your Care Health Insurance Plan, you are covered for - doctor consultations, prescribed pharmacy and diagnostics. This coverage ranges from ₹5000 to ₹50,000 based on the limit you choose at the time of purchase.
We recommend that you steer clear from plans offering OPD coverage as an in-built feature. Subsequently, the OPD coverage add-on is better not opted for since your premiums increase substantially, and the coverage extends a capping on your visitation frequency and per visitation fees.
However, if you are 45+ and located in Zone 3, this add-on is mandatory for your plan.
- Everyday Care: Under the Everyday Care add-on, you are covered for OPD, diagnostic examinations, and health care services. However, in each of these cases, there is a capping on the perks offered -
| Perks under Everyday Care | Coverage Offered |
|---|---|
| Doctor consultations | Up to 1% of the sum insured |
| Prescribed diagnostics | Up to 1% of the sum insured |
Apart from this capping on the coverage offered, one more clause applies to this add-on of Everyday Care. Irrespective of your age, you are bound to pay a 20% copayment on the incurred bill. Thus, much like OPD, this isn’t much of a value-adding add-on for your plan (and is only available in a few locations across the country, namely, Delhi NCR, Mumbai, Pune, Bengaluru and Chennai).
4. Maternity coverage: Care offers maternity coverage of up to ₹1 lakh against a waiting period of 2 years. However, this is only available for the high-end coverage option of ₹50 lakhs, ₹60 lakhs, and ₹75 lakhs. Since the feature is an in-built perk, you don’t have much say in whether you want to opt for it if you have opted for high cover amounts.
However, this might be why you should avoid the Care Health Insurance policy. As you know from our videos and blogs, maternity health insurance plans are not easy on your pocket, come with extensive waiting periods, and extend inadequate covers that may lead to you paying significantly during deliveries.
5. Affordability of premiums: Much like any other health insurance policy from the Stable of Care, Care Health Insurance is affordable. However, let’s get a quick comparison of its premiums against the others in its class (from the same insurer) to gauge its affordability better:
Case study: A 25-year-old man with no pre-existing conditions opting for a cover of ₹25 lakhs (location: Bangalore)
| Health Insurance Plans | Premiums |
|---|---|
| Care Supreme | ₹11,755 |
| Care Plus Youth | ₹17,198 |
| Care Advantage | ₹10,418 |
| Care Care | ₹13,180 |
What’s Unique about the Care Health Care Plan?
Care Health Care Plan is specifically affordable, without many conditions. The policy offers unique add-ons in the form of PED reduction and Everyday Care and even offers maternity coverage as an in-built feature. The plan would have been much better if the in-built PED waiting period had been shorter and maternity wasn’t an in-built feature for high-sum insured policies. Additionally, the plan has multiple cappings on its perks, making looking around for other options important.
Conclusion
Care health insurance from the stable of Care was one of the first health insurance policies launched by the insurer. Accordingly, the insurer fell short of offering a comprehensive structure of features, which would have made it a good pick. However, the stable of Care remains one of the most affordable insurers in the industry. So, we recommend you look around for a better plan from the insurer, provided you don’t prioritise the insurer’s recent increase in complaint volume.