Care Advantage

Coverage

  • Inpatient treatment up to sum insured

  • Day care treatment up to sum insured

  • Pre & post hospitalization expenses for 30 & 60 days respectively

  • Advance Technology Methods

    • Uterine Artery Embolization and HIFU

    • Balloon Sinuplasty

    • Deep brain simulation

    • Oral chemotherapy

    • Immunotherapy

    • Intra vitreal injections

    • Robotic surgeries

    • Stereotactic radio surgeries

    • Bronchial Thermoplasty

    • Vaporisation of the prosrate

    • IONM-(Intra Operative Neuro Monitoring)

    • Stem cell therapy 

No Coverage

  • Ayush

  • Domiciliary

  • Maternity


Special Features

  • No room rent capping

  • No claim bonus @ 10%; maximum 50%(bonus reduces at 10% in case of a claim)

  • Automatic recharge up to sum insured

  • No maximum age of entry

  • Copay of 20% if age of entry is 61 years or above (but it can be waived off by payment of additional amount of premium)

Some Optional covers

  • No Claim Bonus Super

    • Bonus increases @ 50%; maximum 100%; reduces @ 50% in case of a claim

    • Extra premium has to be paid

  • Smart Select

    • Discount on premium @ 15% may be available if policyholder undergoes treatment only at select hospitals

    • If treatment is taken at other hospitals , a copayment of 20% will be applicable

  • Reduction in Pre Existing Waiting period

    • This waiting period can be reduced from 48 months to 24 months by paying an additional amount of premium 

  • Annual Health check Ups

    • List of medical tests offered with sum insured of 25,50 and 75 lakhs

    • Complete blood count with ESR, Blood group fasting, Lipid profile kidney function test etc. 

  • Unlimited automatic Recharge

    • Recharge shall be available unlimited times during the policy year

    • However, in case of a single payout, the maximum liability of the Co. shall not exceed the base sum insured.


Waiting periods

Initial 30 days

Pre Existing Disease: 48 months

Specified diseases: 36 months

(Cataract, Hernia, Gout, Genetic disorders, Fistula, Osteoarthritis etc.)


Permanent Exclusions:

There are 39 exclusions listed under this head in the policy.Some important ones are:

  1. Investigation & evaluation

  2. Rest cure, rehabilitation and respite care

  3. Obesity, weight control

  4. Cosmetic or plastic surgery

  5. Breach of Law

  6. Treatment of alcoholism, drug or substance use

  7. Unproven treatments

  8. Sterility & fertility

  9. Maternity

  10. Non allopathic treatment

  11. War etc.

  12. Self inflicted injury, attempt to suicide


The policy has no maximum age of entry which is a big positive. And no room capping.There are a few great optional covers.Health checkups are optional which is surprising. The recharge facility is applicable for different claims so that is a restriction. Domiciliary treatment is also not covered. 

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