Overview
The Care Plus Complete plan is a comprehensive health insurance policy designed to cater to diverse healthcare needs for individuals and families. It offers sum insured options ranging from up to ₹25 lakhs and includes benefits such as unlimited restoration of the sum insured, annual health check-ups, pre- and post-hospitalization expenses (60-90 days respectively), alternative treatments (AYUSH)(up to SI), and daycare procedures (up to SI). Unique features include an inflation shield, no co-payment clause, and coverage for advanced treatments (up to SI).
Experts Review
Written by Nikhil Nair
Senior Writer
The Care Plus Complete plan stands out as an all-inclusive health insurance policy offering robust financial protection against medical emergencies. Its unlimited restoration benefit ensures continuous coverage for multiple claims within a policy year, making it ideal for families or individuals with recurring healthcare needs. The inflation shield is a valuable addition, ensuring the sum insured grows annually to keep pace with rising medical costs.
The absence of co-payment and disease-specific sub-limits enhances flexibility during claims, while coverage for AYUSH treatments and advanced procedures broadens healthcare options. Features like OPD cover, Organ Donor cover (up to SI), and second-opinion consultations for critical illnesses add significant value. However, the plan has some drawbacks. It imposes room rent restrictions, allowing only a single private room, which may limit flexibility during hospitalization.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
Maternity benefits not offered, which is a notable gap.
Care
Key Insights
Founded
2012
Care was established 13 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
90% claims settled in 30 Days
Care settles 90% of all claims it receives. This is reasonable performance, though there is room for improvement compared to top insurers.
Network Hospitals
11,400+
Care has a strong network with over 11,400 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
36 complaints per 10,000 claims registered
Care has a relatively high volume of complaints, which may point to ongoing issues in customer service or claim handling.
Features
All
Great
Good
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Customisable
Get 15% discount on premiums with 20% Co-payment for the insured members if treatment is taken in Non-Smart Select Network Hospitals.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 90 days after discharge. This includes the cost of medication by the way.
Add-ons
Smart Select
Get 15% discount on premiums with 20% Co-payment for the insured members if treatment is taken in Non-Smart Select Network Hospitals.
International Second Opinion
With this add-on, you can get a second opinion from a medical practitioner outside India once per major illness/injury per policy year.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Mental retardness
Expenses related to any kind of RMO charges, Service charge, Surcharge, night charges levied by the hospital under whatever head.
Remicade, Avastin or similar injectable treatment which is undergone other than as a part of In-Patient Care Hospitalisation or Day Care Hospitalisation is excluded.
Impairment of an Insured Person's intellectual faculties by abuse of stimulants or depressants unless prescribed by a medical practitioner.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Arthritis (if non-infective), including:
Osteoarthritis
Osteoporosis
Gout
Rheumatism
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
What's missing in the policy
Maternity benefits not offered.
Customer Reviews
S
Sameer Ali
Annual health check-ups bhi milte hain, good for keeping track of health.
G
Geeta M.
Self-inflicted injuries aur cosmetic surgeries covered nahi hain, which is standard but good to note.
M
Meera Iyer
Koi co-payment nahi aur na hi disease-specific sub-limits, claims process easy rehta hai.
S
Sunita Wadhwa
Is plan ka unlimited restoration benefit kamaal ka hai, multiple claims ki chinta nahi.
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Frequently Asked Questions
Does Care Plus Complete have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
Does Care Plus Complete have room rent restrictions?
Does Care Plus Complete offer a restoration benefit?
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