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Reviewed by Finzony Finance TeamLast updated:
Care Senior is a health insurance plan from Care Health Insurance for people aged 61 and above, with no upper limit on entry age. It comes in two forms inside Care's base health product: Care 8 with a ₹3 lakh sum insured, and Care 9 with ₹5, ₹7 or ₹10 lakh. You can buy it for yourself or as a floater of up to 6 people, for 1, 2 or 3 years. No pre-policy medical check-up is required, although the underwriter can ask for one, and cover is issued after tele-underwriting. The base cover pays for in-patient hospitalisation and 541 day care procedures up to the sum insured, 30 days of pre-hospitalisation and 60 days of post-hospitalisation expenses, twelve listed advanced technology treatments, an annual health check-up for every insured person, an automatic recharge of the sum insured once a year, a 10% No Claims Bonus up to 50%, organ donor cover, ambulance cover, treatment at home, alternative (AYUSH) treatment and a second opinion for 15 major illnesses. OPD cover, No Claims Bonus Super, unlimited recharge and a shorter pre-existing disease wait are optional covers for extra premium. It is a plan with firm limits. A 20% co-payment applies at this age, though a waiver is available for extra premium. If you take the Smart Select discount, treatment outside Care's listed hospitals carries a further 20%. Pre-existing diseases wait 36 months, 14 groups of conditions wait 24 months, and ailments such as cataract, knee replacement, hernia and cancer carry per-ailment caps. Maternity is not covered, and OPD is not part of the base plan.
Health cover of ₹3L to ₹10L for ages 61 and above, with an annual health check-up, a 10% yearly bonus up to 50% and a 20% co-payment that can be waived.
Finzony sees Care Senior as an entry-level senior plan. It takes new buyers at any age above 61, skips the pre-policy medical check-up, and keeps the premium within reach through a built-in co-payment. What you give up is size and flexibility. The sum insured stops at ₹10 lakh, many common senior-age surgeries carry fixed caps, and two of the features buyers look for, OPD cover and a bigger bonus, cost extra. Care also sells Ultimate Care Senior, so compare the two before you pay. The co-payment is the first thing to price in. At 61 or above, 20% of each admissible claim is yours to pay, so a ₹2 lakh bill leaves you with ₹40,000. The waiver removes it but raises the premium, so ask for both quotes. If you also take Smart Select for its 15% discount, going to a hospital outside Care's list adds another 20%, which means treatment at a non-listed hospital can leave you paying around 36% of a claim in total. Check that list for the hospitals near you before choosing it. Read the caps next to the waits. Cataract is capped at ₹20,000 per eye on the ₹3 lakh plan and ₹30,000 per eye on the higher plans, knee replacement at ₹80,000 or ₹1 lakh per knee, and hernia, hysterectomy, prostate surgery and kidney stone treatment at ₹50,000 or ₹65,000 each. Those same conditions also wait 24 months, and pre-existing diseases wait 36 months. The optional cover that cuts the pre-existing wait to 24 months must be chosen at the start, so decide early if you have diabetes, blood pressure or a heart condition. The automatic recharge refills the sum insured once a year, and only after the sum insured and the bonus are fully used. It is not available for an illness that has already been claimed in that policy year, so it protects you against a different illness, not a repeat of the same one. Unlimited recharge, a No Claims Bonus Super that adds 50% a year, and the OPD Care cover of ₹5,000 or ₹10,000 are all add-ons, so price them before comparing with other plans.
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.
Adults can join from age 61 with no maximum entry age. You can buy an individual policy or a floater of up to 6 people, and cover is issued through tele-underwriting without a pre-policy medical check-up.
The brochure says the check-up is waived at the underwriter's discretion, so Care can still ask for one.
Care 8 has a sum insured of ₹3 lakh. Care 9 has ₹5 lakh, ₹7 lakh or ₹10 lakh. The policy term is 1, 2 or 3 years.
Care's product page also shows a benefit table with sum insured options from ₹7 lakh to ₹1 crore, which appears to be shared with other plans. The brochure and the plan highlights stop at ₹10 lakh, so confirm the options on your quote.
Hospital stays of more than 24 hours are covered up to the sum insured, and so are 541 listed day care procedures that need less than 24 hours in hospital.
Named ailments are subject to the caps listed below, and the 24-month wait applies to listed conditions.
Room rent is covered up to 1% of the sum insured per day, and the ₹5, 7 and 10 lakh plans also limit you to a single private AC room. ICU charges are covered up to 2% of the sum insured per day.
If you take a costlier room or ICU, a ratable proportion of room, nursing, operation theatre charges, doctor fees and diagnostics is deducted. Bonus you have earned is not counted in the sum insured when the room limit is worked out.
Covered up to the sum insured: uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, monoclonal antibody immunotherapy given as an injection, intravitreal injections, robotic surgeries, stereotactic radiosurgery, bronchial thermoplasty, laser prostate vaporisation, intra-operative neuro monitoring, and stem cell therapy for bone marrow transplant in blood disorders.
These are paid within a hospitalisation claim, so room limits, the co-payment and waiting periods still apply.
Reimburses outpatient doctor consultations, diagnostics and pharmacy expenses up to ₹5,000 or ₹10,000 a year, depending on the plan.
It is paid on reimbursement only, you can file claims just twice in a policy year, and the amount is over and above the sum insured.
Adds another 50% of the sum insured for each claim-free year, up to 100%, over and above the 10% No Claims Bonus. Together with the base bonus, the sum insured can grow by up to 150%.
These clocks run from the first start date of the policy with Care Health. Time already served on another Indian health policy can be credited if you port, under IRDAI portability rules. If you raise the sum insured, or add an optional cover or benefit afresh at renewal, a new waiting period applies to the increase or the addition. The renewal grace period is 30 days, and no cover is available for the period in which no premium has been received.
Initial waiting period
A new illness is not covered in the first 30 days of the first policy. Accidents are not held to this wait, and it falls away once you have had more than twelve months of continuous cover.
Named ailments and procedures
The 14 groups of listed conditions wait 24 months of continuous cover, except where an accident is the cause. If a listed condition is also a pre-existing disease, the longer wait applies.
Pre-existing diseases
A condition present before the policy waits 36 months of continuous cover, and cover after that depends on it having been declared and accepted. A raised sum insured starts the wait again on the increase.
Conditions or treatments that the policy clearly says it will not cover.
The conditions and procedures below sit behind the 24-month named ailment wait, even if they begin after the policy starts. Accident claims are not held to this wait, and if one of them is also a pre-existing disease, the longer wait applies. Care also applies per-ailment caps to several of them, listed under the sub-limits in the features. The list follows Care's policy wording, and your policy schedule is the final reference.
Insurer
Care Health Insurance plans and claim process
Care Senior is a health plan from Care Health Insurance for people aged 61 and above, with no upper age limit. It covers hospital and day care treatment up to a sum insured of ₹3 lakh, ₹5 lakh, ₹7 lakh or ₹10 lakh, and includes an annual health check-up, automatic recharge and a 10% No Claims Bonus. A co-payment and waiting periods apply, and OPD cover is optional.
Adults can join from age 61, and there is no maximum entry age. You can buy an individual policy or a floater of up to 6 people. Cover is issued through tele-underwriting, and a pre-policy medical check-up is not required as a rule, although the underwriter can ask for one. The policy renews for life.
The brochure lists ₹3 lakh (Care 8) and ₹5 lakh, ₹7 lakh and ₹10 lakh (Care 9), and Care's plan highlights say cover goes up to ₹10 lakh. Care's product page also shows a larger list in a benefit table that looks shared with other plans, so confirm the options on your quote. The term can be 1, 2 or 3 years.
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)
After a claim, the accrued No Claims Bonus Super is reduced by 50% of the sum insured at the next renewal, never below the base sum insured. It is forfeited if you do not renew this cover.
Extends the automatic recharge so that the sum insured can be restored any number of times in a policy year.
A single claim can still pay no more than the sum insured, and the recharge applies only to later claims not related to an illness already claimed.
Cuts the waiting period for pre-existing diseases to 24 months of continuous cover.
It can be bought only when the policy starts, and only for the sum insured chosen then.
Removes the 20% co-payment that applies when the insured or the eldest insured member is 61 or older.
It costs extra premium. Ask for the exact difference on your quote.
Gives a 15% discount on the premium. If you are treated at a hospital outside Care's Smart Select list, you bear an additional 20% co-payment on that claim.
There is no additional co-payment at hospitals on the list, which Care updates on its website.
Pre-existing diseases with the reduction cover
The optional Reduction in PED Wait Period cover brings the wait down to 24 months. It must be chosen when the policy starts and applies only to the sum insured chosen then.
Higher sum insured or new add-ons
If you raise the sum insured, the waiting periods apply afresh to the increase. Benefits or optional covers added at renewal also start their own waiting periods.
Yes. If the insured or the eldest insured member is 61 or older, you bear 20% of each admissible claim. A co-payment waiver is available for extra premium. If you take Smart Select for a 15% premium discount, an additional 20% co-payment applies when you are treated at a hospital outside Care's Smart Select list. A co-payment does not reduce the sum insured.
There is a 30-day initial wait for any illness, except accidents, which falls away after more than 12 months of continuous cover. The listed named ailments wait 24 months. Pre-existing diseases wait 36 months, or 24 months with the optional reduction cover. A higher sum insured, or a benefit added afresh at renewal, starts a new wait for the increase. Time served on another Indian policy can be credited when you port.
Yes, after 36 months of continuous cover, and only if the disease was declared at the time of application and accepted by Care Health. You can cut the wait to 24 months with the optional Reduction in PED Wait Period cover, which must be chosen when the policy starts. Existing conditions such as diabetes, blood pressure or heart disease are covered only once that wait is over.
Not in the base plan. Doctor visits, tests and medicines are covered only if you add the optional OPD Care cover. It reimburses consultations, diagnostics and pharmacy bills up to ₹5,000 or ₹10,000 depending on the plan, and you can file claims only twice in a policy year. The amount is over and above the sum insured.
If a claim is payable, Care restores the sum insured once in a policy year, and the restored amount can be used for later claims in that year. It is used only after the sum insured and the bonus are completely exhausted, and not for an illness or injury already claimed for that person that year. An unlimited recharge is available as an optional cover.
For each claim-free year, Care adds 10% of the sum insured, up to a maximum of 50%. If you claim, the accrued bonus is reduced by 10% of the sum insured at the next renewal, and never below the base sum insured. With the optional No Claims Bonus Super, you earn another 50% a year up to 100%, so the sum insured can grow by up to 150% in total.
Room rent is covered up to 1% of the sum insured per day, and on ₹5, 7 and 10 lakh plans you are also limited to a single private AC room. ICU is covered up to 2% of the sum insured per day. A costlier room reduces other charges in proportion. Some ailments carry fixed caps, for example cataract at ₹20,000 to ₹30,000 per eye and knee replacement at ₹80,000 to ₹1 lakh per knee. Your policy schedule is the final word.
Yes. Every insured person gets one check-up a policy year through Care's network or empanelled providers, on a cashless basis. It does not reduce the sum insured. The tests differ slightly between the ₹3 lakh plan and the ₹5, 7 and 10 lakh plans.
Not as a rule. Care issues the policy through tele-underwriting and does not require a pre-policy medical check-up, though the underwriter can ask for one. You must still declare your health history truthfully, because pre-existing diseases are covered only after the waiting period and only if declared and accepted.
Smart Select gives a 15% discount, with an additional 20% co-payment at hospitals outside Care's list. A 3-year term carries a discount of up to 10%. Keeping the 20% co-payment instead of buying the waiver also lowers the premium. Your age, sum insured, city, tenure and add-ons decide your actual quote.
For planned hospitalisation, tell Care at least 48 hours before admission, and for an emergency within 24 hours. For cashless treatment, go to a network hospital and submit a pre-authorisation request at the TPA desk. For reimbursement, pay the bill, keep the original receipts and send the claim form with the documents after discharge. Check your policy for the exact deadlines.
Yes. The policy is renewable for life except for fraud or misrepresentation, there is a 30-day grace period, and no loading is applied on renewal because of your own claims. You can also port the policy to Care from another insurer and transfer the waiting period credit, subject to the portability rules.