En Ultimate Care is designed for Tamil Nadu residents and offers Value and Essential variants, with a mandatory 10% copayment on eligible hospitalization claims outside the state.
Key Plan Details
Sum Insured Options: Essential offers ₹7 lakh to ₹50 lakh, while Value includes unlimited coverage, subject to age eligibility.
Cover Types: Individual plan covers up to six people, and floaters cover two adults and two children.
Entry Age: Adults can enter from age 18, while children are eligible from 91 days.
Unlimited Automatic Recharge: Replenishes coverage for subsequent eligible claims after it is exhausted.
Room Rent and ICU Limits: Both variants have no standard room or ICU limits.
Bonuses: Both accumulate bonuses regardless of claims, with Essential offering uncapped growth.
Wellness & E-Consultations: Offers discounts up to 30% and unlimited network consultations.
Imagine living in Chennai, buying a health insurance plan meant specifically for Tamil Nadu, and then needing hospitalization while visiting Bengaluru. Would your policy still cover you the same way?
That's where Care Health's En Ultimate Care gets interesting. It's a health insurance plan designed for Tamil Nadu residents. It follows a growing trend of state-specific health insurance plans, with insurers like Bajaj General also introducing similar products, such as Aapke Liye.
But there's a catch: when you seek treatment outside the state, you may have to pay a portion of the hospital bill yourself.
So, does choosing a state-specific health insurance plan make sense, or are you better off with a standard nationwide policy?
In this guide, we break down En Ultimate Care's eligibility, benefits, premiums, pros, and cons to help you decide.
En Ultimate Care is a state-specific health insurance plan offered by Care Health Insurance for people seeking health insurance in Tamil Nadu.
While the plan covers eligible hospitalization expenses across India, treatment outside Tamil Nadu attracts a geographic copayment. The plan also offers benefits like automatic restoration and coverage for modern medical treatments, subject to policy terms.
Eligibility Criteria for En Ultimate Care
Criteria
Details
Plan Type
Individual and family floater
Adult Entry Age
18 years with no upper age limit
Child Entry Age
91 days to 24 years
Waiting Periods
30 days initially (except covered accidents), 24 months for specified illnesses, and 36 months for pre-existing diseases
Family Floater Structure
Up to 2 adults and 2 children
Individual Policy Structure
Maximum 6 insured members
Policy Tenure
1, 2, or 3 years
Renewability
Lifelong for adults, subject to policy terms
Important: Geographic Copayment
Unlike standard nationwide plans such as Care Supreme and Ultimate Care, En Ultimate Care has a mandatory 10% copayment on admissible hospitalization-related claims outside Tamil Nadu.
For example, if you live in Chennai but are hospitalized in Bengaluru, you would have to pay ₹50,000 yourself on an admissible claim of ₹5 lakh. Care Health would cover the remaining ₹4.5 lakh, assuming sufficient coverage and no other deductions.
En Ultimate Care Variants: Key Features & Riders Compared
En Ultimate Care is available in two variants, Value and Essential, which primarily differ in their sum insured options and coverage bonuses.
Key Features of En Ultimate Care Health Insurance
The following benefits are available under both Value and Essential.
Feature
Details
Inpatient Hospitalization
Eligible hospitalization expenses are covered up to the available sum insured
Room Rent and ICU Charges
No separate limits on room rent or ICU charges
Pre- and Post-Hospitalization
60 days before and 90 days after hospitalization
Domiciliary, AYUSH, Modern Treatments, and Day-Care Treatments
Covered up to the sum insured
Ambulance Cover
Covered up to the sum insured for medically necessary transportation by road, air, train, or other eligible modes
Other Key Features of En Ultimate Care
01
Unlimited Automatic Recharge
Restores up to the base sum insured unlimited times for subsequent eligible claims after the base SI and bonuses are exhausted. It applies from the second claim onward and cannot increase the first claim payout.
02
Loyalty Boost
Adds 100% of the eligible base sum insured after seven consecutive claim-free years. It is granted once during the policy lifetime, with no fresh waiting periods on the added coverage.
03
Wellness Benefit
Offers up to a 30% renewal discount for meeting daily step targets. The maximum discount requires 270 qualifying days, with targets of 10,000 steps for adults below 60 and 8,000 for those aged 60 or above.
04
Newborn Waiting Period Benefit
A newborn added within 90 days of birth gets credit for waiting periods already served by the primary insured, subject to underwriting. Fresh waiting periods apply if added from day 91 onward.
05
Unlimited E-Consultations
Provides unlimited online consultations with general physicians and specialists through Care Health’s network.
06
Medi Vouchers
At the first renewal, each eligible insured member gets two ₹250 pharmacy vouchers, subject to Care Health’s terms.
En Ultimate Care Value vs. En Ultimate Care Essential
Although their core hospitalization benefits are similar, Value and Essential differ in coverage amounts and bonus structures.
Feature
Value
Essential
Sum Insured (SI) Options
₹7 lakh, ₹10 lakh, ₹15 lakh, ₹20 lakh, ₹25 lakh, and unlimited SI
Increases the base SI by 50% after each completed policy year, up to 100%, irrespective of claims made
Not available
Unlimited Bonus
Not available
Increases the base SI by 150% after each of the first two completed policy years and 100% annually thereafter, without a cumulative cap, irrespective of claims made
Note: The ₹50 lakh and ₹1 crore sum insured options are available only for individuals aged 65 and above, while the unlimited SI option is available only for those aged up to 64 years.
Optional Riders in En Ultimate Care
Infinity Bonus: Increases the available coverage by 100% of the base sum insured, without a cumulative cap, irrespective of claims made. Available only with the Value variant, subject to continuous renewal.
Annual Health Check-Up: Provides one health check-up per insured person annually through Care Health's network.
Claim Shield: Covers specified non-payable hospital expenses, including eligible consumables listed under Annexure I, up to the available sum insured.
Premium Payback: Refunds the first year's base premium after five consecutive years without a hospitalization-related claim, subject to renewal. The refund excludes rider premiums and is available once every qualifying five-year period.
Note: This is not an exhaustive list of optional benefits. For other riders, eligibility, coverage limits, and conditions, refer to the official En Ultimate Care brochure.
Note
With the unlimited sum insured option under the Value variant, benefits designed to increase a finite sum insured, such as Cumulative Bonus, Infinity Bonus, and Loyalty Boost, do not apply. Unlimited Bonus is also unavailable because it is exclusive to the Essential variant.
Talk to an expert today and find the right insurance for you.
Sample Premiums by Age and Sum Insured
Profiles
Value
Essential
(Individual Plan): Age 25
₹6,753
₹7,561
(Family Floater, 2A): Ages (31, 32)
₹10,447
₹11,681
(Family Floater, 2A 1C): Ages (35, 34, 5)
₹13,799
₹15,448
(Family Floater, 2A): Ages (62, 63)
₹41,026
₹49,468
Note: Here, A stands for adult and C for child. These are indicative premiums for a Chennai resident (PIN code: 600001) for ₹25 lakh, and include recommended add-ons and discounts. Your premium can change based on age, city, medical history, plan variant, added discounts, and chosen add-ons.
Premium Insight: Essential costs around 12% more than Value for younger buyers and 21% more for senior couples, but offers faster coverage growth through substantially higher, uncapped bonuses.
Care Health: Performance Metrics
When evaluating Care Health insurance reviews, look beyond the plan’s features and consider the insurer's overall performance.
Lower Out-of-Pocket Expenses: No standard room rent, ICU, or disease-wise sub-limits help reduce the risk of proportionate deductions and unexpected expenses during hospitalization, unless you select restrictive optional benefits.
Higher Coverage Over Time: Both variants increase available coverage through bonuses regardless of claims, with Essential offering faster accumulation and no cumulative bonus cap.
Protection Against Multiple Hospitalizations: Unlimited automatic recharge helps prevent coverage exhaustion and keeps policyholders protected against subsequent eligible hospitalizations in the same year.
Rewards for Staying Active: Wellness discounts of up to 30% can help reduce renewal premiums for policyholders who consistently meet the required step targets.
Cons of En Ultimate Care
Mandatory Geographic Copayment: A 10% copayment applies to admissible hospitalization-related claims outside Tamil Nadu, making the plan less suitable for people who travel frequently for work or vacations or may relocate to another state.
Key Benefits Are Optional: Claim Shield, annual health check-ups, Premium Payback, and Premium Freeze require additional premiums rather than being included in the base plan.
High Complaint Volume: Care Health recorded an average of 42.67 complaints per 10,000 claims during FY 2023–24 to FY 2025–26, exceeding the cross-insurer average of 29.35.
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Conclusion
En Ultimate Care offers strong hospitalization benefits, generous coverage bonuses, and unlimited automatic recharge. However, its mandatory 10% copayment on claims outside Tamil Nadu is a significant drawback, especially for people who travel for work, go on vacations, or may relocate.
We recommend considering standard nationwide plans like Care Supreme or Ultimate Care instead, as they don't impose this geographic copayment. You can also explore our guide to the best health insurance plans in India to compare other suitable options.
Frequently Asked Questions
What happens if I need hospitalization outside my chosen region under En Ultimate Care?
You can receive eligible hospitalization treatment outside Tamil Nadu, but a mandatory 10% geographic copayment applies to admissible claims. For example, if your approved hospitalization claim in Bengaluru is ₹5 lakh, you must pay ₹50,000, while Care Health pays ₹4.5 lakh, subject to available coverage and other policy conditions. This applies even when you travel temporarily for work or vacation, making treatment outside your chosen region more expensive.
Can I choose a higher sum insured under En Ultimate Care at renewal?
Yes, you can request a higher sum insured when renewing your En Ultimate Care policy, subject to Care Health's approval and the coverage options available for your age and variant. Your existing waiting period credits continue for the previously insured amount. However, the increased portion of coverage is subject to fresh applicable waiting periods. The renewal premium also increases according to the revised coverage and applicable rates.
Can I switch from Ultimate Care to En Ultimate Care without losing waiting period credits?
Yes, you can request migration from Ultimate Care to En Ultimate Care because both products belong to Care Health Insurance. Under IRDAI's migration framework, eligible waiting period credits transfer to the new policy, subject to the applicable sum insured and continuity conditions. However, migration requires the insurer's underwriting assessment and product eligibility checks. Any increase in coverage is subject to the applicable waiting periods for the additional amount.
How can I earn the wellness discount on my En Ultimate Care renewal premium?
You must enroll in the wellness program and track your daily steps using Care Health's designated platform. The target is 10,000 steps per qualifying day for adults below 60 and 8,000 steps for those aged 60 or above. Completing 270 qualifying healthy days earns the maximum 30% renewal premium discount. Lower discounts apply at specified milestones, and the calculation follows the insurer's tracking and renewal conditions.
What happens to my accumulated benefits if I make a claim under En Ultimate Care?
Making a claim does not reduce your accumulated Cumulative Bonus under Value or Unlimited Bonus under Essential. Both bonuses continue growing after each completed policy year, regardless of claims, provided you maintain continuous coverage. However, a hospitalization-related claim interrupts the seven consecutive claim-free years required for Loyalty Boost. Your available sum insured is also reduced by paid claims during the policy year, with automatic recharge available for subsequent eligible claims.
Can I include my parents and in-laws in the same En Ultimate Care family floater?
En Ultimate Care permits eligible family relationships, including parents and parents-in-law, but a family floater covers a maximum of two adults and two children. Therefore, you cannot include yourself, your spouse, both parents, and your in-laws under one floater. You need separate policies or eligible individual coverage arrangements. The individual policy option accommodates up to six insured members, subject to relationship eligibility, entry ages, underwriting, and policy conditions.
Will I pay extra if I choose a room above my eligible room rent under En Ultimate Care?
Both Value and Essential have no standard room rent or ICU limits, so you can choose your preferred hospital room without triggering room-category-based proportionate deductions under the base coverage. However, if you select the optional Room Rent Modification benefit to restrict your room eligibility, choosing a higher category can result in proportionate deductions on associated medical expenses. Other policy exclusions, copayments, and coverage limits continue to apply.
What is the Care Health Insurance claim settlement ratio?
The Care Health Insurance claim settlement ratio averaged 95.45% between FY 2024–26, compared to the industry average of 92.02%. This indicates a strong claim settlement record. However, the insurer also recorded 42.67 complaints per 10,000 claims, exceeding the industry average of 29.35. These figures reflect Care Health's overall performance, not En Ultimate Care specifically. You should also consider the plan's copayments, disease-wise sub-limits, and exclusions before purchasing it.
How can I contact Care Health Insurance customer care?
You can contact Care Health Insurance customer care at 1800-102-4488 for policy servicing and claim-related queries or reach them via WhatsApp at 8860402452. You can also email customerfirst@careinsurance.com or use the insurer's website, mobile app, or self-help portal to track claims, manage policies, and submit requests. For new policy inquiries, call 1800-102-4499. Visit the official Care Health contact page for further assistance.
