The health insurance industry used to include maternity coverage as a built-in feature or an add-on. However, none of the plans were explicitly tailored for maternity perks. Now, with rising medical expenses, increased childbirth complications, and a growing demand for child health insurance, providers are developing policies with a focus on maternity coverage.
Care Joy, a new-age insurance plan, stands out with its unique approach. It offers minimal waiting periods for maternity coverage, a No-Claim Bonanza as an add-on, newborn coverage, and more. Coming to Care as a health insurance provider - this well-known insurer consistently offers competitively priced policies and a selection of plans without loading charges.
However, regarding Care Joy, we have a few concerns about its adequacy of coverage, the universal applicability of the 9-month waiting period, and whether this plan will be worth purchasing.
Let’s get a quick look into Care Joy and all its features to understand the policy better!
Quick Verdict on Care Joy
Care Joy offers many perks and is provided by a reputed insurer. These may make the product appealing. However, this policy, akin to the other maternal health insurance plans in the market, has significant drawbacks, including high premiums, restrictive conditions, limited coverage options, room rent constraints, disease-specific sub-limits, and increased complaint volumes.
Thus, we recommend avoiding this and any other maternity health insurance policies. Instead, choose a comprehensive policy with lower premiums and use the saved amount to build a family planning fund.
Care Joy Maternity Insurance Plan: Brief Overview
Care, formerly Religare Health Insurance, is known for its affordable plans and diverse coverage. While its Claim Settlement Ratio is decent at 90.75% (average of the last 3 years), the high complaint volume at 30.53 (average of the last 3 years) is concerning, exceeding the industry average of 24.029. Despite competitive pricing, features, and coverage, Care needs to enhance its claims department for overall customer satisfaction.
Now, Care Joy, as a maternity health insurance plan, is an average policy lacking comprehensiveness. It comes in two variants - Joy Today and Joy Tomorrow, with waiting periods of 9 months and 24 months, respectively. Despite being marketed as a new-age maternity coverage policy, it has numerous restrictions and exclusions. The policy offers a 9-month waiting period with conditions on multi-year premium payments. The optional No-Claim Bonanza doubles the sum insured, but only if chosen as an add-on. Moreover, the coverage of ₹3 lakhs - ₹5 lakhs is inadequate for overall health needs. It's crucial to note that while Care Joy is a maternity health insurance plan, there's a sub-limit on the extended maternity coverage.
Here’s a quick look at the most important features of Care Joy -
Features of Care Joy Health Insurance Plan
| FEATURES | DETAILS |
|---|---|
| Variants | Joy Today (9 months waiting period) | Joy Tomorrow (24 months waiting period) |
| Coverage | ₹3 lakhs | ₹5 lakhs |
| Copayment | 20% co-pay (if you are above 61 years old) |
| Room rent restrictions | Up to a single private room with AC |
| Affordability of premiums | Not affordable |
| Waiting period | Initial: 30 days Pre-Existing: 4 years Specific: 2 years Maternity:24 months (1-year payment) | 9 months (3-year payment COVID: 30 days |
| Daycare coverage | Up to the sum insured |
| AYUSH coverage | NO |
| Pre & Post Hospitalisation | 30 and 60 days |
| Modern Treatment | Covered |
| Add-ons available | No-Claim Bonanza |
Should You Buy Care Joy Health Insurance Plan?
- Care as an insurer: Pre-pandemic, Care excelled as a health insurance provider, but post-pandemic, its Claim Settlement Ratio dropped, and complaints surged, indicating a decline in operational efficiency. Despite having 9400 network hospitals and a generous CSR, the insurer is working to uphold its reputation.
On a positive note, some of Care's products, especially for individuals with pre-existing conditions, stand out in the industry. With no loading charges on basic offerings, Care provides affordable and comprehensive health insurance plans.
2. The 9-month waiting period comes with conditions: Care Joy has been highlighting that the policy has a 9-month waiting period. While there are other health insurance policies in the market offering this kind of waiting period, for Care, this is a novelty. However, it's here’s the catch - this waiting period perk is only available to those opting for a 3-year premium payment.
3. Limited sum insured: Care Joy, despite emphasizing maternity coverage, markets itself as a "new-age insurance product" with comprehensive offerings. However, offering coverage only at ₹3 lakhs or ₹5 lakhs raises the question: is it sufficient for all medical needs?
We assert it's not, especially considering that restoration (boosting the sum insured back to its original amount when the claim(s) raised leads to partial or complete exhaustion of the SI) kicks in only once, and only upon complete sum insured utilisation (for specific ailments). This will leave Care Joy's coverage insufficient to fund diverse medical requirements.
4. Disease-wise sub-limit on maternity coverage: Care Joy is a maternity health insurance plan, right? So, at least the assigned coverage should be optimum. Well, here’s what the maternity cap looks like in this policy -
| Coverage | ₹3 lakhs | ₹5 lakhs |
|---|---|---|
| Sub-Limit | up to ₹35k | up to ₹50k |
(the offered coverage includes pre and post-natal expenses)
5. Copay is mandatory after a certain age: If you choose this policy after turning 61, you must pay a mandatory 20% co-payment, requiring out-of-pocket expenses despite having health insurance. Our recommendation: avoid policies with co-payment unless you're a senior citizen or have specific pre-existing conditions making it difficult to find other health insurance options.
6. Newborn coverage is available: Since Care Joy is a maternity product, your newborns will be covered from Day 1. Additionally, in case your child is diagnosed with Down's syndrome or Cerebral Palsy, the entire sum insured will be disbursed as a lump sum amount to be spent at your discretion.
7. Premiums are pricey: In general, Care hosts one of the most affordable products in the market. However, Care Joy seems to be an exception.
Say you are a 25-year-old, seeking ₹5 lakhs coverage under Care Joy, here’s how your premiums look -
| Tenure | Waiting Period | Premium |
|---|---|---|
| 1 year | 24 months | ₹25740 |
| 3 years | 9 months | ₹74439 |
Now, what happens to your premiums (yearly) if you opt for another product of Care, as a 25-year-old seeking ₹10 lakhs coverage -
| Care Supreme | Care Plus Youth |
|---|---|
| ₹7,701 | ₹11,755 |
So, you get double the coverage, for less than half the premiums.
8. No-Claim Bonanza: Renewing or continuing the plan for three consecutive years doubles your sum insured for the following year. This cumulative bonus cannot exceed 100% of the sum insured. However, raising a claim means the bonus won't be available for the next year.
9. Nominal pre-post hospitalisation coverage: This policy provides only 30 days of pre-hospitalisation and 60 days of post-hospitalisation coverage, falling short of the standard 60 and 180 days offered by top-notch health insurance plans.
10. Room rent restrictions are applicable: With the Care Joy plan, you can access rooms up to a single AC private room. Exceeding this room type incurs a pro-rata share of total invoices.
Our recommendation at Ditto is to avoid plans with room restrictions. What if a top-notch room is the only one available for stay following an emergency treatment? You will end up paying an unfair share of the total hospital bill despite having paid timely premiums towards your health insurance policy.
What’s Unique with Care Joy?
Care Joy uniquely features a 9-month waiting period and a lump sum for the diagnosis of Down's syndrome or Cerebral Palsy in newborns. However, these advantages are offset by a comprehensive list of restrictions, limitations, and terms.
Conclusion
If you have read our piece on maternity health insurance or watched our YouTube video on the topic, you know that we have yet to find a maternity health insurance plan that is flexible, affordable, and without any outrageous conditions. Care Joy hasn’t changed our opinion. Its expensive premiums, room rent restrictions, 1-time restoration after complete exhaustion of sum insured for different ailments, mandatory co-pay (after you turn 61), disease-wise sub-limit and limited coverage (only ₹3 lakhs and ₹5 lakhs) make it a poor pick. In case you are fixed on purchasing a health insurance policy from Care, there are multiple other value-worthy choices (reach out to us and we can help you).