Care Freedom Health Insurance Plan

What is Covered under the Care Freedom Health Insurance Plan

In Patient Care: In case you are hospitalized for a minimum of 24 hours, the plan will cover:

1. Room charges.
2. Nursing expenses.
3. ICU (Intensive Care Unit) expenses.
4. Surgeon's fees.
5. Doctor's fees.
6. Blood charges.
7. Oxygen expenses.
8. Anaesthesia.
9. Operation Theatre expenses, etc.

Day Care Treatment: In case hospitalization lasts less than 24 hours, the plan will cover:

1. Over 170-day care treatment.

Pre-hospitalization: There are expenses that one will incur before the actual hospitalization, coverage under this plan includes:

1. Examinations.
2. Tests.
3. Medication.
4. Investigative tests and medications.

Post-hospitalization: Expenses don't stop after the period of hospitalization ends; post-hospitalization expenses include:

1. Follow-up charges for medical professionals.
2. Medication.
3. Confirmatory medical tests.
4. All medical expenses incurred after hospitalization, up to 30 days beyond the policy end date.

Ambulance charges:

1. All ambulance expenses incurred are reimbursed.

Domiciliary care expenses: In case hospitalization is not possible and treatment must be sought at home, the plan will cover:

1. All expenses incurred for treatments exceeding 3 days, for a condition meriting hospitalization.

Consumable allowance: A lumpsum amount is given each day of hospitalization to meet non-medical expenses like:

1. Transportation.
2. Consumables.
3. Attendant's fees.
4. Other daily expenses.

What is not covered under the Care Freedom Health Insurance Plan

The Care Freedom Heatlh Insurance plan does not cover:

1. Pre-existing ailments or injuries are not covered for up to 24 continuous months from the start of the policy.
2. Any diseases contracted within the first 30 days of policy start (except those arising out of accidents) are not covered.
3. Any sort of OPD treatments will not be covered.
4. Self-afflicted injury or attempted suicide are not covered.
5. Alcohol and drug abuse/use/misuse are not covered.
6. Spectacles and contact lenses that require no hospitalisation are not covered.
7. Expenses arising out of dental treatment that require no hospitalisation are not covered.
8. Medical expenses for treatment of AIDS are not covered.
9. Medical expenses for treatments traceable to pregnancy, childbirth, miscarriage, abortion, and the consequences thereof are not covered.
10. Congenital diseases are not covered.
11. Any tests and treatments which are related to infertility will not be covered.

What are the benefits of the Care Freedom Health Insurance Plan

Cashless treatment at leading hospitals.

Direct Claim Settlement:

1. Cashless hospitalization upon presenting the Care Health Card at over 8350+ hospitals.
2. Quick reimbursement.
3. There's no need for a medical check-up before taking on this health insurance policy, no matter what your age is and what Sum Assured option you've chosen.

Policy Term Options: Three policy term options, 1 year, 2 year and 3 years.

1. A 24-month waiting period applies in case of Pre-Existing Diseases.

Free-look period: The policy can be returned to the company within 15-days from the date on which you receive the policy. Premium will be refunded after deducting proportionate risk period and stamp duty charges as applicable.

Sum Insured Recharge: In case the claim amount exhausts the limit of coverage, the sum insured can be recharged at no extra cost. Recharged sum can be used for other members under the same policy, and by the policyholder (but not for the same ailment in the same year).

Health Check-up:

An annual health check-up will be arranged, irrespective of claims history, for:

1. Complete Blood Count with ESR.
2. Urine routine analysis.
3. Fasting Blood Sugar.
4. Lipid Profile.
5. Kidney Function Tests.
6. ECG.
7. The plan has lifetime renewability.
8. Premiums paid are exempt from taxation under Section 80C of the Income Tax Act, 1961.

Companion Benefit: additional lumpsum payout will be made if the period of stay in the hospital exceeds 10 (consecutive) days.

Dialysis cover: Dialysis expenses will be covered with a fixed amount per sitting, for up to 24 months.

Home Care (optional cover 2): Nurses fees will be covered for a maximum of 7 days per illness or injury, and a maximum of 45 days per policy year, after a deductible of 1 day.

Health Check+ (optional cover 3): Annual health check-up can be upgraded to either Diabetes health check-up or Cardiac health check-up which covers:

How to place a claim under the Care Freedom Health Insurance Plan

You can choose from the options of 'Emergency Hospitalisation' and 'Planned Hospitalisation' when you want to place a claim under the Care Freedom Health Insurance Policy. Care Insurance offers the option of cashless hospitalisation as well as reimbursement. To place an insurance claim under the Care Freedom Heatlh Insurance plan, you will be required to follow the steps mentioned below:

Step 1: In the case of emergency hospitalisation, inform the insurance provider about the same within 24 hours of hospitalisation of the insured.

In the case of planned hospitalisation, inform the insurance provider about the same at least 48 hours prior to the hospitalisation of the insured.

Step 2: In the case of hospitalisation in a network hospital, you can avail the benefit of cashless claim. However, you will be required to request for the pre-authorisation.

In the case of reimbursement claims, you will be required to settle the bills yourself and submit the relevant documents to the insurance provider for the reimbursement process.

Step 3: Complete the pre-authorisation by filling up and submitting the relevant forms. The form has to be faxed to Care Health Insurance.

Step 4: Care Health Insurance will evaluate and validate the forms and documents received by them and accordingly approve, sanction, or reimburse the insurance claim.

GST rate of 18% applicable for all financial services effective July 1, 2017.