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Reviewed by Finzony Finance TeamLast updated:
Care Health Care Advantage is a high sum insured health plan for people who want a large cover without a cap on the hospital room. The sum insured runs from ₹25 lakh up to ₹6 crore, on an individual or floater basis. The base policy has no sub-limit on room rent or ICU charges, pays for in-patient stays of 24 hours or more, covers listed day care procedures and 12 advanced technology treatments, and adds 30 days of pre-hospitalisation and 60 days of post-hospitalisation expenses, road ambulance, organ donor expenses and AYUSH treatment, all up to the sum insured. Two features build the cover. A No Claims Bonus adds 10% of the sum insured for every claim-free year, up to 50%, and Automatic Recharge restores your base sum insured once in a policy year after it is used up. Optional covers go further: No Claims Bonus Super adds another 50% a year up to 100%, and Unlimited Automatic Recharge refills the cover any number of times. Individuals can join from age 5 and floaters from 91 days with at least one adult, and adults have no upper age limit. Global coverage, air ambulance, Claim Shield and several other extras are optional add-ons.
No room rent or ICU limit on ₹25 lakh to ₹6 crore cover, with automatic recharge.
Finzony reads Care Advantage as a plan for buyers who want a very large cover, ₹25 lakh and above, and do not want to be capped on the hospital room. The base policy has no sub-limit on room rent or ICU charges, restores your sum insured once a year through Automatic Recharge, and builds a 10% yearly No Claims Bonus up to 50%. Optional extras go further: No Claims Bonus Super adds 50% a year up to 100%, Unlimited Automatic Recharge refills the cover as often as needed, and the Protect Plus add-on policy brings global coverage. Read what is not in the base plan. The wording lists no maternity, OPD, dental, vision, IVF or newborn cover, and there is no built-in super top-up. Pre-existing diseases wait 36 months, and the 24-month list of named conditions is long: it includes cataract, hernia, stones and joint replacement, and also genetic disorders, Parkinson's disease, epilepsy and immune system diseases. The base bonus is smaller than the one in Ultimate Care (50% a year up to 100%), and a claim reduces the bonus you have built up. Treatment abroad is not covered unless you add Protect Plus, which is not offered to NRIs or to people working or studying abroad. Non-payable items such as consumables are not paid unless you add Claim Shield. Be careful with the headline price. Care's starting rate of ₹23 a day is worked out for a ₹1 crore sum insured in a Zone 3 city with Room Rent Modification and Smart Select, so a typical quote will be higher. Care's product page and its policy wording also differ on a few benefit numbers, so confirm the bonus and the pre and post hospitalisation days on your quote.
Care Health Insurance
Key Insights
Founded
2012
Care Health Insurance was established 14 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
95.2% CSR, calculated as a 3-year average
Care Health Insurance settles 95.2% of all claims it receives, demonstrating strong credibility.
Network Hospitals
11,400+
Care Health Insurance has a network of 11,400+ hospitals, ensuring wide accessibility and convenience for policyholders.
Pays the expenses of in-patient treatment in India up to the sum insured, on a cashless or reimbursement basis, when you are admitted for at least 24 consecutive hours on the written advice of a medical practitioner and the treatment is medically necessary.
Shorter stays are paid only for listed day care procedures. Admissions mainly for investigations or evaluation are not paid.
Pays listed day care procedures, where the stay is under 24 hours but would otherwise need an in-patient admission, up to the sum insured.
The procedure must be on the policy's Annexure I list. Treatment normally taken on an outpatient basis is not day care.
The eligible room category and ICU charges under the base policy are both "no sub-limit", so there is no separate restriction on room, boarding, nursing or ICU charges during hospitalisation.
If you add Room Rent Modification for a lower premium, a room above a single private AC room means you bear a proportionate share of the associated medical expenses.
Covers 12 listed treatments up to the sum insured, including uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, monoclonal antibody immunotherapy given as an injection, intravitreal injections, robotic surgery, stereotactic radiosurgery, bronchial thermoplasty, prostate laser vaporisation, IONM and stem cell therapy for bone marrow transplant in blood conditions.
Advanced technology methods outside this list are excluded.
Pays doctor fees, tests and pharmacy for 30 days before admission and 60 days after discharge, for the same illness, on a reimbursement basis.
Care's product page shows 60 days before and 180 days after, but the wording and brochure say 30 and 60, so confirm on your quote. The optional Pre-Post Hospitalisation Expenses Modification changes the number of days.
Adds a flat 50% of your sum insured for every completed, claim-free policy year, up to 100%, on top of the base No Claims Bonus.
After a claim, it reduces at the same 50% rate. If you stop renewing this option, the accumulated amount is lost.
Makes the Automatic Recharge available an unlimited number of times in a policy year, for the same or different illnesses.
A single claim can still be paid only up to the base sum insured.
A 30-day wait applies to any illness except accidents, and it does not apply if you have been continuously covered for more than 12 months. 15 named conditions wait 24 months and pre-existing diseases wait 36 months. The optional Reduction in PED Wait Period cuts the pre-existing wait to 24 months, but only for the sum insured of your first policy with Care. Waits apply to each insured person separately, and they start again on any amount you add to your sum insured. The grace period is 30 days, or 15 days for monthly payment.
Initial waiting period
Any illness in the first 30 days of the policy is not covered. Accidents are covered from day 1, and the wait does not apply if you have been continuously covered for more than 12 months.
Named ailments
15 listed conditions and procedures, such as cataract, hernia, stones and joint replacement, wait 24 months of continuous cover, unless an accident caused them.
Pre-existing diseases
Declared and accepted pre-existing diseases are covered after 36 months. If a named ailment is also pre-existing, the longer wait applies.
Conditions or treatments that the policy clearly says it will not cover.
These named conditions and procedures are excluded for the first 24 months of continuous cover, unless an accident caused them. If one of them is also a pre-existing disease, the longer wait applies. The list below follows the policy wording, and your policy schedule is the final reference.
Insurer
Care Health Insurance plans and claim process
Care Advantage is Care Health's high sum insured health plan. It has no sub-limit on room rent or ICU charges, a 10% yearly No Claims Bonus up to 50%, Automatic Recharge once in a policy year, and optional covers such as NCB Super, Unlimited Automatic Recharge, air ambulance and Protect Plus global coverage.
You can choose a sum insured from ₹25 lakh up to ₹6 crore, on an individual or floater basis. Care's website offers terms of 1, 2 or 3 years. Check the exact steps on your quote.
Care Health lists a starting price of ₹23 a day, about ₹8,395 a year, worked out for a ₹1 crore sum insured in a Zone 3 city with Room Rent Modification and Smart Select. A normal quote will be higher, and it depends on your age, city, sum insured and add-ons.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official Care Health Insurance website before purchasing.
Contact Details
1800 102 6655
Headquarters: Tower C, 3rd Floor, Vipul Tech Square, Golf Course Road, Sector 43, Gurugram, Haryana – 122009
The aforementioned ratios have been averaged over three years (FY24-FY26)
Pays an air ambulance in India from the place of emergency to the nearest hospital, or between hospitals for better care, when your doctor certifies that it is needed.
The amount is in your schedule (the brochure shows up to ₹5 lakh), it is over and above your sum insured, and it needs an accepted hospitalisation claim. Cashless only if Care approves in advance.
A separate add-on policy that gives treatment cover abroad, either worldwide excluding India, or worldwide excluding the USA, Canada and India. Planned hospitalisation is covered, and emergency hospitalisation is covered at the higher sum insured options of ₹2, 3 and 6 crore.
The sum insured is part of your base sum insured. Not available to NRIs, PIOs, OCIs, foreign nationals or people employed or studying abroad. Limits for air ambulance, repatriation and other benefits are in the Protect Plus wording.
Pays non-payable items, which the brochure counts as 68 items, that the base policy does not pay.
A separate add-on policy on extra premium. Care's newer notice mentions Claim Shield Plus covering the lists in Annexure 1, so check the version you are offered.
NCB Shield stops you losing your No Claims Bonus or NCB Super on renewal if the claims paid in the previous year are less than 25% of the base sum insured. Inflation Shield raises your cover each year in line with the average CPI of the previous year.
Both are paid add-ons shown in the brochure, and their terms are in the add-on wording.
Cuts the 36-month wait for pre-existing diseases to 24 months of continuous cover.
Counts from your first policy with Care and applies only to the sum insured you chose at that time.
Limits your eligible room to a single private room for a lower premium.
If you take a higher room, you bear a proportionate share of the associated medical expenses such as room, nursing, operation theatre and surgeon fees.
Reduce your premium by bearing a yearly deductible, or a fixed percentage of every claim as co-payment.
The deductible is counted across all claims in the policy year. The amounts are in your schedule.
Lowers your premium if you accept a 20% co-payment whenever you are treated outside the hospitals listed in Annexure IV.
The extra 20% is on top of any other co-payment in your policy, and no discount applies to the air ambulance, health check-up, daily allowance and e-consultation covers.
Pays a fixed daily amount from your schedule for each completed 24 hours in hospital, and twice that amount for each day in an ICU.
Up to 30 days a policy year, for in-patient care only.
If you are hospitalised for emergency care after an accident, Care gives an extra sum insured equal to your in-patient sum insured, used only after your sum insured is completely used up.
Applies once in the policy period, and only to the person whose accident claim is accepted.
Gives unlimited online consultations with general physicians at Care's network, by voice, video or chat, within India.
Changes the pre and post hospitalisation period to the number of days shown in your policy schedule. The brochure shows 60 days before and 120 days after.
Care's page shows 60 and 180 days, so confirm the days on your quote.
A yearly check-up at network centres on a cashless basis, with a basic panel such as CBC with ESR, urine routine, blood group, fasting sugar, lipid profile, TMT and kidney function test for sum insured up to ₹75 lakh, and a wider panel above that.
Once a year for each insured person, and it does not reduce your sum insured. You can add it mid-term after paying its full premium.
Reduction in PED Wait Period (optional)
The optional cover cuts the pre-existing wait from 36 to 24 months, counted from your first policy with Care and only for the sum insured you chose then.
Portability and migration
If you port from another insurer or migrate within Care without a break, the waits are reduced to the extent of your earlier cover.
Higher sum insured or a new optional cover
If you raise your sum insured, the waits start again only for the added amount. A benefit or optional cover added afresh at renewal also serves the waits again from that renewal.
No. The base policy has no sub-limit on room rent or ICU charges. If you add Room Rent Modification to reduce your premium, your room is limited to a single private room, and a higher room means you bear a proportionate share of the associated medical expenses.
At the end of each completed, claim-free policy year, Care adds 10% of your sum insured, up to 50%. After a claim, the bonus you have built up is reduced at the same 10% rate, and you lose all of it if you do not renew within the grace period.
When your sum insured, bonuses and any additional accident cover are used up in a policy year, Care restores up to your base sum insured once in that year, for the same or a different illness. For unlimited recharges you need to add Unlimited Automatic Recharge, and unused recharge does not carry forward.
No Claims Bonus Super is an optional extension of the bonus. It adds a flat 50% of your sum insured for every completed claim-free year, up to 100%, over and above the base bonus. You lose it if you stop renewing the option.
Not in the base plan, which covers treatment in India only. The Protect Plus add-on policy brings global coverage, with emergency hospitalisation covered at the ₹2, 3 and 6 crore sum insured options, but it is not offered to NRIs, PIOs, OCIs, foreign nationals or people working or studying abroad.
Pre-existing diseases wait 36 months of continuous cover. The optional Reduction in PED Wait Period cuts this to 24 months, but only for the sum insured of your first policy with Care.
15 named groups of conditions and procedures wait 24 months, including cataract, hernia, kidney and gall bladder stones, joint replacement, benign prostate enlargement, hysterectomy, varicose veins, genetic disorders, epilepsy and immune system diseases. The wait does not apply to claims caused by an accident.
No. The wording lists no maternity, newborn, OPD, dental, vision or IVF cover, and there is no add-on for them. You get only discounted rates through Discount Connect, and optional e-consultations and an annual health check-up.
An individual policy starts from age 5, and a floater from 91 days with at least one adult aged 18 or above. Adults have no upper entry age and there is no exit age. You can cover your spouse, children, parents and parents-in-law.
For cashless treatment, go to a network hospital and submit a pre-authorisation request at the TPA desk. For reimbursement, get treated anywhere, pay the bill, and send your claim form with receipts and documents within 30 days of discharge. Intimate Care at least 48 hours before planned hospitalisation, and as early as possible in an emergency.
A new individual policy has a free look period of 30 days from receiving the policy, and it does not apply on renewals, porting or migration. After 5 continuous years, no claim can be contested except for proven fraud and permanent exclusions.
You can add No Claims Bonus Super, Unlimited Automatic Recharge, Air Ambulance, Reduction in PED Wait Period, Room Rent Modification, Deductible, Co-payment, Smart Select, Daily Allowance, Additional Sum Insured for Accidental Hospitalization, Unlimited E-Consultations, Pre-Post Hospitalisation Modification and Annual Health Check-up. Protect Plus, Claim Shield, NCB Shield and Inflation Shield are separate add-ons.