Did you know that you are just one huge medical bill away from entering the poverty line? Sounds surprising, doesn’t it? Well, in the realm of health insurance, it’s crucial to choose a plan that best suits your medical needs and financial circumstances. Two popular options in the market are the Care Advantage Plan (Care Advantage Health Plan or Care Advantage) and the Star Health Assure Plan. These plans provide individuals and families with comprehensive coverage and benefits, ensuring peace of mind during unexpected medical situations. Care Health Insurance and Star Health Insurance companies are well known for their network hospitals. The former has a dedicated Network of 22,900+ healthcare providers whereas the latter has 14,000+ Network Hospitals.
By comparing the Care Advantage Plan and the Star Health Assure Insurance Policy, we can better understand their unique features, advantages, and limitations, enabling us to make an informed decision when selecting the most suitable health insurance option.
Let’s delve into the specifics of each plan to determine their respective definitions, merits, and premium calculation illustrations.
Recognizing the Distinctions Between Star Health Assure Insurance Policy and Care Advantage Plan
Let’s take a look at the differences between Star Health Assure Insurance Policy and Care Advantage Plan.
| Parameters | Care Advantage Plan | Star Health Assure |
| Minimum Age at Entry | Adult- 5 Years and Child- 91 Days (Floater Policy) | (Floater) For Adults- 18 Years For Dependent Children– 16 days |
| Maximum Entry Age | Adult– Lifelong Child- 24 Years | Maximum- Up to 75 Years For Dependent Children- 17 Years |
| Sum Insured Options | Up to Rs. 600 L (6 Crores) | Up to Rs. 2 Crores |
| Pre-Hospitalisation Expenses | 60 Days | |
| Post-Hospitalisation Expenses | 180 Days | |
| Repatriation of Mortal Remains | Up to Rs. 5 lakhs | up to Rs. 15,000/- in a policy year. |
| Ayush Treatment | Up to Sum Insured | Covered |
| Air Ambulance | Up to Rs. 5 lakhs | Covered up to 10% of the Sum Insured per policy year |
| Co-Payment | Option to opt 5% / 10% / 15% / 20% per claim, for all customers whose entry age is below 61 years | Co-payment of 10% for every claim amount for policyholders of 61 years of age or older. |
| Waiting Periods | Initial Waiting period- 30 Days Specific Diseases Waiting Period- 24 Months For Pre-existing diseases waiting period- 48 months | For Pre-Existing Diseases (3-year term) – 30 months For Pre-Existing Diseases (1- and 2-year term) – 36 months For Specific Diseases/Procedures – 24 months Initial Waiting Period – 30 days |
| Room Rent | No Sublimit | For Rs. 5 lakh Sum Insured: Room, boarding and nursing expenses incurred during in-patient hospitalization are covered up to 1% of the Sum Insured per day. For Rs. 10/15/20/25 lakh Sum Insured options Any room (except suite or above category) For Rs. 50/75/100/200 lakh Sum Insured options Any room |
| Organ Donor Cover | Up to Sum Insured | Covered |
| In-patient Hospitalisation | Up to the Sum Insured | Expenses incurred for a period of more than 24 hours on account of illness, injury or accidents are covered. |
What is a Care Advantage Plan?
Care Advantage stands out as a comprehensive health insurance policy, providing substantial coverage of up to 6 crores for you and your family, ensuring comprehensive protection at all times. In the event of a hospital stay exceeding 24 consecutive hours, the plan covers your hospital expenses, offering financial support during such situations. The policy encompasses a diverse range of coverage benefits, including daycare costs, organ donor expenses, re-hospitalization, and post-hospitalization costs, as well as in-patient hospitalization expenses, among others.
Designed to address both planned and emergency medical expenses, Care Advantage is tailored to meet the diverse healthcare needs of the insured. Notably, the policy comes with no sub-limits, providing flexibility and assurance in coverage. Additionally, it offers a co-payment waiver as an optional cover, further enhancing the flexibility and customization options for policyholders.
What are the Major Features and Benefits of a Care Advantage Plan?
Here are some of the attractive benefits of Care Advantage Health Insurance:
- Automatic Recharge of Sum Insured
The Care Advantage plan includes a valuable feature where, if the sum insured is exhausted during a claim, the amount will automatically get recharged once in a policy year, up to the specified sum insured. This recharged sum can then be utilized for another claim within the same policy year. Notably, if you opt for the Unlimited Automatic Recharge cover, this sum-insured recharge can be done an unlimited number of times
- Annual Health Check-up
Policyholders can avail themselves of a free health check-up facility once every year. This annual health check-up is a valuable feature, as it allows individuals to proactively monitor their health, detect potential issues early on, and take preventive measures.
- No Claim Bonus
The Care Advantage plan incorporates a No Claim Bonus (NCB) feature, rewarding policyholders for claim-free years. A 10% NCB is granted to the policyholder for each claim-free year, up to a maximum of 50%. Additionally, policyholders have the option to enhance their NCB benefits by purchasing the No Claim Bonus Super optional cover.
- No Sub-limits
One notable feature of the Care Advantage plan is the absence of sub-limits on hospital room rent or ICU (Intensive Care Unit) charges. This implies that the policy does not impose any restrictions on the maximum amount or percentage of coverage for these specific expenses.
- Co-payment Waiver
If you choose to include the specified add-on in your Care Advantage plan, a noteworthy benefit comes into play. In situations where the age of the eldest member covered by the policy is 61 years or above, this add-on allows you to eliminate the 20% co-payment clause.
- Cashless Hospitalization
Care Health Insurance provides a convenient and efficient healthcare service by offering the insured the option to avail cashless hospitalization facilities at a vast network of over 22,900 hospitals across India.
- Room Rent Modification
The Care Advantage plan ensures that it will cover the cost of a single private room in a hospital in the event the insured individual is hospitalized. This feature provides financial support for accommodation expenses, allowing the policyholder to stay in a private room during their hospitalization.
- Advance Technology Treatments
The Care Advantage plan covers medical expenses incurred on treatments involving advanced technology, such as robotic surgeries, stem cell therapy, oral chemotherapy, and more. This feature ensures that policyholders have financial support for cutting-edge and innovative medical procedures that may be part of their treatment plan.
- In-patient Hospitalization Expenses
The Care Advantage plan provides coverage for medical expenses incurred during hospitalization for a minimum duration of 24 hours. This coverage encompasses various components of hospitalization expenses, including room rent, doctor’s fees, nursing charges, and other related costs.
What is the Star Health Assure Plan?
The Star Health Assure Insurance Policy stands out as a comprehensive and versatile health insurance plan, offering extensive coverage for self, spouse, dependent children, parents, and parents-in-law. It can be availed on an individual or family floater basis, providing flexibility in coverage options. One notable feature is that individuals are not required to undergo any pre-medical check-ups when enrolling in this plan.
This policy is well-suited for young couples planning to get married or start a family. The mid-term inclusion benefit allows the policyholder to cover a newly wedded spouse, a newborn baby, or a legally adopted child under the policy by paying an additional premium. Several attractive features make the Star Health Assure Insurance Policy appealing. These include coverage for assisted reproduction treatment, chronic severe refractory asthma, home care treatment, and automatic restoration of the sum insured.
What Sets Star Health Assure Insurance Policy Apart?
The following are the features and benefits of Star Health Assure Insurance Policy.
- High Sum Insured Options
The Star Health Assure Insurance policy provides a broad spectrum of sum insured options to insured individuals, ranging from 5 Lakhs to 2 Crore. This wide range of sum-insured options offers individuals the flexibility to choose a coverage that aligns with their specific healthcare needs and requirements.
- Pre and Post-Hospitalisation Expenses
This plan provides coverage for specified expenses up to a set limit within a defined timeframe: 60 days preceding hospital admission and 180 days following discharge. It’s crucial to note that the plan will only reimburse these costs if they are directly associated with the medical condition that resulted in hospitalization and if your claim is approved under the inpatient hospitalization coverage.
- Star Wellness Program
The Star Health Assure Insurance Policy includes a wellness program designed to inspire and incentivize insured individuals to adopt a healthy lifestyle. By completing specific health and fitness tasks and activities, policyholders can earn up to a 20% discount on their renewal.
- Optional Deductibles
Under the Star Health Assure Insurance Policy, insured individuals have the option to choose deductibles, and by doing so, they can access discounted premium rates. Deductibles are the amount that policyholder agrees to pay out of pocket before their insurance coverage begins.
- Rehabilitation and Pain Management
Insured individuals have the benefit of covering expenses related to rehabilitation and pain management. The coverage extends up to a specified sub-limit or a maximum amount, which is capped at 20% of the total sum insured.
- Tax Benefits
Premiums paid towards the Star Health Assure Insurance Policy are eligible for tax benefits as per the Income Tax Act, 1961. This means that policyholders may be able to claim deductions on the premiums paid, providing a potential tax advantage.
- Organ Donor Coverage
In the Star Health Assure Insurance Policy, coverage extends to include inpatient expenses incurred by the organ donor in the event of an organ transplantation surgery. This coverage is applicable when you, as the insured individual, are the recipient of the organ.
- AYUSH Treatment
Under the Star Health Assure Insurance Plan, medical expenses incurred during inpatient hospitalization for treatment under Ayurveda, Unani, Siddha, and Homeopathy (AYUSH) systems of medicine in an AYUSH Hospital are covered.
- Second Medical Opinion
Under the specified terms of the policy, the insured person has the option to seek a Second Medical Opinion from a doctor within the network of medical practitioners affiliated with the insurance company. To initiate this process, the insured person can submit all relevant medical records online to the chosen doctor.
- Limits on surgeries/treatments
In the Star Health Assure Insurance policy, certain treatments and surgeries, such as cataract treatment and joint replacement surgery, are covered up to the sum insured without imposing any sub-limits. This means that the plan provides coverage for these specific medical procedures up to the maximum limit specified in the policy, without placing additional restrictions or sub-limits on the expenses associated with these treatments.
Premium Calculation of Care Advantage Plan and Star Health Assure Insurance Policy
Mr. Rohit Gupta, a 30-year-old male who works as a senior analyst at Waldner Technologies, a renowned IT company in New Delhi. Despite his busy work schedule, Rohit understands the importance of having a comprehensive health insurance plan to safeguard his well-being and financial stability. As he starts researching different options, he comes across two intriguing plans: the Care Advantage Plan and the Star Health Assure Insurance. Now, Rohit finds himself at a crossroads, unsure which plan would best suit his needs. Let’s explore his considerations and help him make an informed decision.
Care Advantage Plan:
| Gender | Age | Policy Tenure | Health Insurance Cover | Premium Amount (In Rs.) |
| Male | 30 Years | 1 Year | Rs. 50 Lakhs | Rs. 12114 (Premium includes 18% GST) |
Star Health Assure Insurance Policy:
| Age | Policy Tenure | Policy Type | Health Insurance Cover | Premium Amount |
| 30 years | 1 Year | Individual | Rs. 50 Lakhs | Rs. 20,992 (Including Tax) |
What Should You Pick: Care Advantage Plan or Star Health Assure Plan?
Determining the winner between the Care Advantage Plan and the Star Health Assure Plan depends on individual preferences, specific coverage needs, and budget considerations. Both plans have their own unique features and benefits. It’s crucial to evaluate how each plan aligns with your requirements to make an informed decision. Assessing each plan’s coverage, network, affordability, flexibility, and reputation will help you determine which plan best aligns with your requirements. It’s recommended to thoroughly compare the features and benefits of both plans side by side and consider seeking guidance from an insurance advisor if needed.
