Overview
Care Advantage by Care Health Insurance is a high-value plan that offers coverage of up to ₹6 crore. This makes it ideal for those seeking extensive protection. With features like global coverage, unlimited e-consultations, and comprehensive pre- and post-hospitalization benefits, the policy ensures access to quality healthcare worldwide. In addition, add-on benefits such as air ambulance cover, reduced waiting periods for pre-existing conditions, and inflation shields make it a solid option for individuals and families looking for premium healthcare solutions at affordable prices.
Experts Review
Written by Nikhil Nair
Senior Writer
Care Advantage is a well-thought-out health insurance plan that ticks many boxes for anyone looking for comprehensive coverage. The global coverage option under the Protect Plus add-on is a huge plus, especially for frequent travelers or those considering international medical care. Features like no sub-limits on diseases/treatments, no room rent or ICU charges limit and unlimited e-consultations make it practical and user-friendly.
The optional Care Shield add-on is another highlight. It adjusts your coverage for inflation and provides extended coverage for generally excluded items like syringes, gloves, PPE kits etc called consumables, which is a smart move given rising medical costs. It also comes with a no claim bonus feature, which increases your sum insured by 10% for every claim-free year (capped at 50% of original sum insured).
However, the premiums are on the higher side, which is expected given the extensive benefits. Also, while global coverage is appealing, it’s limited to planned hospitalizations unless you opt for emergency hospitalization at an additional cost.
Pros
Feature set is satisfactory.
Premiums are relatively well priced.
Insurer has a solid track record with great claim and service metrics.
Cons
Your insurer doesn’t provide free health check-ups, which is a notable gap.
No coverage if you are forced to hospitalize at home, 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
90% claims settled in 30 Days
Care settles 90% of all claims it receives. This is reasonable performance, though there is room for improvement compared to top insurers.
Network Hospitals
11,400+
Care has a strong network with over 11,400 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
36 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
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Customisable
Choose a co-payment of 20% to reduce premiums.
Customisable
Get 15% discount on premiums with 20% Co-payment for the insured members if treatment is taken in Non-Smart Select Network Hospitals.
Room Rent
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
Customisable
Change Any room to Single Private Room.
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.
Customisable
For any illness: Pre existing disease waiting period is modified/reduced from 3 years to 2 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 - 60 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.
Customisable
Modifies the pre & post-hospitalisation coverage to 60 and 180 days respectively
Add-ons
Unlimited e-consultations
Mandatory
Each insured member can get unlimited e-consultations from General Physicians.
Pre Post Hospitalisation Expenses
Mandatory
Modifies the pre & post-hospitalisation coverage to 60 and 180 days respectively
NCB Super
Recommended
Additional bonus of 50% up to a maximum of 100%, with a clawback of 50% if claimed in the previous year.
Care OPD
Recommended
Total 8 doctor consultations with 4 from General Physicians capped at ₹500 and 4 from Specified Specialists capped at ₹500.
Reduction in PED
Recommended
For any illness: Pre existing disease waiting period is modified/reduced from 3 years to 2 years.
Unlimited Restoration
Recommended
Restores the cover unlimited times up to 100% of the sum insured for any illness.
Claim Shield Plus
Recommended
Covers non-medical items as per list I, II, III & IV
Room Modifier
Change Any room to Single Private Room.
Annual Health Checkup
Annual health check-up for specified tests, with a maximum limit up to the sum insured on a cashless or reimbursement basis.
Co-Payment
Choose a co-payment of 20% to reduce premiums.
Smart Select
Get 15% discount on premiums with 20% Co-payment for the insured members if treatment is taken in Non-Smart Select Network Hospitals.
Air Ambulance
With this add-on, the insurance company will provide coverage for Air Ambulance up to ₹5 lakhs.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
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.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are 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 periodCustomisable
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. This policy also further allows to reduce the PED waiting period to 2 years for all diseases.
What's missing in the policy
Your insurer doesn’t provide free health check-ups.
No coverage if you are forced to hospitalize at home.
Maternity benefits not offered.
Customer Reviews
H
Hrithik Sharma
Coverage up to ₹6 crore is massive! Gives great peace of mind for any major illness.
I
Ishaan Gupta
Unlimited e-consultations are super convenient. Used it multiple times already.
K
Kavya Patel
The Care Shield add-on for inflation protection is very smart. Medical costs keep rising.
L
Laksh Reddy
Global coverage is mainly for planned hospitalizations unless you pay extra for emergency.
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Frequently Asked Questions
Does Care Advantage 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 Care Advantage have room rent restrictions?
Does Care Advantage offer a restoration benefit?
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