Overview
Care Enhance Super is the predecessor of the comprehensive Care Supreme Enhance Super Top-up. It offers sum insured options ranging from ₹2L to ₹55L with deductible choices (from 2L to 20L). The plan covers inpatient hospitalisation, day care treatments, organ donor expenses, domiciliary care, and AYUSH. Added benefits include automatic recharge of sum insured and an optional rider. Its Expert Opinion add-on allows policyholders to get a second opinion on their diagnosis from a specialist medical practitioner provided by the insurer.
Experts' Review
Written by Nikhil Nair
Senior Writer
Care Enhance Super Top-up is a rare super top-up plan that does not impose maximum entry age restrictions. Even a person above the age of 65 can buy it, but expect stricter underwriting and high premiums.
It works on an aggregate deductible basis, meaning the policyholder pays medical expenses up to a chosen threshold through an existing policy or out of pocket in a given year, after which Enhance provides coverage up to the sum insured. But if you buy this policy after you turn 61, you must pay 20% of the bill every time you make a claim. You can also opt for a single private room and upgrade it further if needed, but this has restrictions.
The plan covers inpatient hospitalisation expenses including room rent, ICU charges, surgery, medication, pre- and post-hospitalization expenses (30/60) and diagnostics. It also provides health check-ups every year on a cashless basis at network facilities for a defined list of tests. The plan comes with discounts for standard long tenure, families, and Care Group employees.
Pros
Insurer has a solid track record with great claim and service metrics.
Cons
Not very feature-rich.
Premiums are relatively high.
No Restoration Benefit, which is a notable gap.
No Bonus for being healthy and not claiming insurance, which could be a drawback for some.
Maternity benefits not offered, which is a key feature.
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
93% CSR, calculated as a 3-year average
Care settles 93% of all claims it receives demonstrating strong credibility.
Network Hospitals
11,400+
Care has a strong network with over 11,400 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
42 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
If you bought this policy after you turned 61, you have to pay 20% of the bill every time you make a claim. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
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 - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Impairment of an Insured Person's intellectual faculties by abuse of stimulants or depressants unless prescribed by a medical practitioner.
Hormone replacement therapy
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.
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
No Restoration Benefit.
No Bonus for being healthy and not claiming insurance.
Maternity benefits not offered.
Doctor consultations are not covered.
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Frequently Asked Questions
Does Enhance Super Top-up 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 Enhance Super Top-up have room rent restrictions?
Does Enhance Super Top-up offer a restoration benefit?
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