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Reviewed by Finzony Finance TeamLast updated:
Ultimate Care Senior is a senior-focused health insurance plan from Care Health Insurance designed for older adults who want high coverage with benefits that can keep increasing over time. The current product page offers sum insured options of ₹7 lakh, ₹10 lakh, ₹15 lakh, ₹25 lakh, ₹50 lakh and ₹1 crore. The plan covers in-patient hospitalisation, day care procedures and specified advanced technology treatments up to the sum insured. It also includes pre-hospitalisation expenses for 60 days and post-hospitalisation expenses for 180 days. AYUSH treatment, domiciliary hospitalisation, organ donor expenses and ambulance cover are also included subject to the policy terms. Its major senior-focused benefits include Infinity Bonus, which adds 100% of the base sum insured at every renewal without a maximum number of increases, Premium Payback after every block of five claim-free years, Loyalty Boost after seven claim-free years, and unlimited automatic recharge during the policy year. The standard waiting period for pre-existing diseases is 36 months and named ailments have a 24-month waiting period. Instant Cover Plus is available for faster coverage of specified pre-existing diseases, subject to the applicable terms and conditions.
Senior version of Ultimate Care with Infinity Bonus, Premium Payback and Instant Cover Plus
Finzony sees Ultimate Care Senior as a strong option for seniors who want a large and continuously growing cover rather than a plan with a fixed long-term ceiling. The combination of Infinity Bonus, Unlimited Automatic Recharge and Loyalty Boost can make the cover substantially larger over time. The strongest differentiator is the Infinity Bonus. Care states that the base sum insured increases by 100% at every renewal and that claims do not reduce the accrued Infinity Bonus. Premium Payback also gives back the first policy year's base premium after every block of five claim-free years, while Loyalty Boost adds an amount equal to the first policy year's base sum insured after seven claim-free years, once in a lifetime. The plan also has useful hospitalisation benefits for seniors, including 60 days of pre-hospitalisation and 180 days of post-hospitalisation cover, AYUSH treatment, domiciliary hospitalisation, organ donor cover and ambulance cover. Care also states that there are no sub-limits or caps on several of these benefits. The main point to check before buying is the waiting period structure. The normal PED waiting period is 36 months and named ailments have a 24-month wait. Seniors with existing conditions should specifically compare the cost and scope of Instant Cover Plus or the PED waiting-period modification before choosing the policy.
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.
Ultimate Care Senior offers sum insured options of ₹7 lakh, ₹10 lakh, ₹15 lakh, ₹25 lakh, ₹50 lakh and ₹1 crore.
The available sum insured is subject to the insurer's underwriting and applicable policy terms.
Hospitalisation requiring more than 24 hours is covered up to the selected sum insured, including eligible room rent, ICU, diagnostics and treatment expenses.
Coverage remains subject to the policy terms, waiting periods and exclusions.
Eligible day care procedures that do not require a 24-hour hospital stay are covered under the plan, including procedures such as cataract treatment, chemotherapy and dialysis.
The procedure must fall within the applicable policy coverage.
Specified advanced technology treatments performed during hospitalisation are covered up to the applicable sum insured.
Treatment must satisfy the conditions listed in the policy wording.
Eligible medical expenses are covered for 60 days before hospitalisation and 180 days after discharge when linked to an admissible hospitalisation claim.
The expenses must relate to the same condition and satisfy policy requirements.
Instant Cover Plus can provide immediate coverage for specified pre-existing diseases such as diabetes, hypertension, hyperlipidemia, asthma, obesity and eligible coronary artery disease.
The benefit applies only to the listed conditions and is subject to underwriting and policy terms.
Instant Cover provides earlier coverage for selected pre-existing diseases after the applicable initial waiting period.
The standard initial waiting period is 30 days for illnesses, with accidental injuries excluded from this initial wait. Named ailments have a 24-month continuous-cover waiting period and pre-existing diseases have a 36-month continuous-cover waiting period. Instant Cover Plus can waive the standard PED wait for specified conditions subject to its terms.
Initial waiting period
Illnesses are generally not covered during the first 30 days. Accidental injuries are not subject to this initial illness waiting period.
Named ailments and procedures
Specified named ailments and procedures are subject to a 24-month continuous-cover waiting period.
Pre-existing diseases
Pre-existing diseases are generally covered after 36 months of continuous coverage, subject to declaration, underwriting and policy terms.
Instant Cover Plus
Instant Cover Plus can remove the standard PED waiting period for specified conditions including listed conditions such as diabetes, hypertension, hyperlipidemia, asthma, obesity and eligible coronary artery disease.
Conditions or treatments that the policy clearly says it will not cover.
The current official product information confirms a 24-month waiting period for named ailments and a 36-month waiting period for pre-existing diseases. Care does not publish the complete named-ailment list in the main product-page text, so the detailed policy wording and policy schedule should be treated as the final reference for the exact conditions and procedures covered by these waiting periods.
Insurer
Care Health Insurance plans and claim process
Ultimate Care Senior is a senior-focused health insurance plan from Care Health Insurance with high sum insured options, Infinity Bonus, Premium Payback, Loyalty Boost, unlimited automatic recharge and senior-oriented hospitalisation benefits.
The current Ultimate Care Senior product page states that the minimum adult entry requirement is 61 years, with one adult required to meet the senior age condition. The plan also allows eligible family members under its family floater structure.
The current product page lists ₹7 lakh, ₹10 lakh, ₹15 lakh, ₹25 lakh, ₹50 lakh and ₹1 crore sum insured options.
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)
Exact conditions and waiting period are governed by the selected benefit and policy wording.
This option can reduce the standard pre-existing disease waiting period according to the modification selected at policy inception.
The exact modified period and eligible conditions depend on the chosen option.
Care OPD can provide cover for eligible outpatient consultations and other listed outpatient expenses according to the selected benefit.
OPD is not part of the base cover unless the applicable option is selected.
Premium Freeze can keep the policyholder's entry age and premium frozen according to the applicable benefit terms until a claim is paid.
Availability and conditions should be checked in the quote and policy schedule.
Smart Select can provide a premium discount when treatment is taken at hospitals included in the applicable Smart Select network.
Treatment outside the selected network can attract additional co-payment according to the applicable terms.
The optional co-payment benefit can reduce the premium by requiring the insured member to bear a specified percentage of eligible claim expenses.
The current Ultimate Care Senior product page states that a 20% co-payment can be selected.
Additional benefits and modifications
Any newly selected benefit, increased coverage or policy modification can be subject to its own waiting period or applicable conditions.
Infinity Bonus increases the base sum insured by 100% at every renewal. Care states that the bonus can continue increasing without a maximum number of renewals and claims do not reduce the accrued Infinity Bonus.
Premium Payback allows the policyholder to receive the first policy year base premium after every block of five claim-free years, subject to the applicable policy terms.
Loyalty Boost provides an additional sum insured equal to the first policy year base sum insured after seven claim-free years. Care states that this benefit is available once in a lifetime.
The standard waiting period for pre-existing diseases is 36 months of continuous coverage. Eligible customers can choose Instant Cover Plus or an applicable PED waiting-period modification benefit subject to the policy terms.
Yes. Care states that Instant Cover Plus can provide coverage from the first day for specified pre-existing diseases including diabetes, hypertension, hyperlipidemia, asthma, obesity and eligible coronary artery disease. The benefit is subject to the applicable terms and underwriting.
Yes. The plan provides unlimited automatic recharge of the selected sum insured during the policy year, subject to the applicable policy conditions.
The current product page states 60 days of pre-hospitalisation cover and 180 days of post-hospitalisation cover for eligible expenses related to an admissible hospitalisation claim.
Yes. Eligible AYUSH hospitalisation is covered up to the sum insured when the treatment takes place at an eligible AYUSH facility and satisfies the policy conditions.
Yes. Domiciliary hospitalisation is covered under specified circumstances when treatment is provided at home instead of in a hospital, subject to the applicable policy conditions.
OPD treatment is not part of the standard base cover unless the applicable Care OPD benefit is selected. The available OPD benefit and its limits depend on the chosen option.
A 20% co-payment can be selected as an option under the current product information. Choosing a co-payment can reduce the premium but increases the amount the insured member pays towards eligible claims.
For planned hospitalisation, Care asks customers to intimate the insurer at least 48 hours before admission. For emergencies, intimation should be made within 24 hours of hospitalisation. Cashless claims are processed through the network hospital and reimbursement claims require the applicable claim form and supporting documents.