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Care Heart Mediclaim Plan

Care Health Mediclaim Insurance is designed to cater to the insurance needs of individuals in terms of 16 major cardiac ailments and surgeries. The policy grants freedom to access high-quality healthcare in large cashless hospitals as well as a financial safety net for unexpected medical expenses. The Care Heart Health Insurance provides the option of annual wellness checks for tracking medical conditions.

With Care Heart Mediclaim, you can easily cover your hospitalization and treatment expenses related to heart illness so that your heartbeat doesn’t create a burden in your pocket. When you have comprehensive coverage for heart-related treatments and other benefits, it gives the best heart to your heart. The policy provides coverage for a 1/2/ 3 years tenure. Since heart ailments require long-term healthcare and monitoring, having a Care Heart Mediclaim plan is important.

Read on to know more about the Care Heart Mediclaim plan in detail!

Eligibility Criteria

Here are the eligibility conditions for the Care Heart Mediclaim plan that every buyer should meet.

ParametersDetails
Age

Minimum: 91 days to 4 years with at least 1 member of age 18 years or above is covered or 5 years on an individual basis.

Adults: 18 Years and above

Maximum: 50 Years

Exit AgeNo exit age
Age of proposer18 years or above
Coverage OptionsIndividual basis (maximum up to 6 people having same/different sum insured)
Policy tenure1/2/3 years
Ambulance CoverUp to Rs. 3,000 per hospitalization
Organ CoverUp to Sum insured or Rs. 15 Lacs, whichever is lower.
Sum Insured Options10 Lakhs, 25 Lakhs, 50 Lakhs, 1 Crore, & 2 Crores

Key Features and Benefits of Choosing the Care Heart Mediclaim Policy

Heart conditions necessitate ongoing medical care and observation. The Care Heart Mediclaim Insurance offers the insured a variety of advantages.

  1. In-patient Care: For hospital treatment lasting more than 24 hours, all incurred costs are reimbursed in cashless form.
  1. Day Care Treatment: If the hospital stay is less than 24 hours, this option offers cashless reimbursement of treatment and listed procedures’ costs.
  1. Pre and Post-Hospitalization: The insured is reimbursed for all medical costs incurred before and following hospitalization for a period of 30 days and 60 days, respectively.
  1. Global Coverage: This insurance plan covers costs associated with receiving medical care at home instead of in a hospital, which would typically be necessary.
  1. Alternative Treatment: Up to 25% of the insured amount may be used by the insured for AYUSH treatment.
  1. Ambulance Coverage: Depending on the selected plan option, costs are covered up to an individual limit per hospitalization.
  1. Co-payment: If the insured’s entry age is 70 years or less, the co-payment is 20%; if it is greater than 70 years, the co-payment is 30% of all expenses incurred.
  1. AYUSH Treatment: Non-allopathic treatments are also covered under this policy.

Exclusions Under the Care Health Mediclaim Policy

  1. When choosing to purchase Care Heart Mediclaim Insurance, the insured should be aware of the relevant exclusion:
  1. Any illness or injury resulting from dangers such as nuclear contamination, terrorism, or war-related perils is also not covered.
  1. All cosmetic procedures and surgeries are also not included.
  1. Diseases caused by drug abuse or intoxicants are not covered.
  1. The policy shall not apply to self-harm, suicide attempts, or actual suicide.
  1. Any illness directly linked to using tobacco, drinking alcohol, smoking cigarettes, having HIV or AIDS, or having other sexually transmitted diseases.
  1. Complications of pregnancy, miscarriage, childbirth, and maternity care, including C-section, or abortion.
  1. Participation in hazardous activities necessitates all treatments.
  1. Illness or injuries brought on by the insured’s violation of the law

Premium Illustration Of Care Heart Mediclaim Insurance

Let’s take an example to understand!

Mr. Dilip Ahuja looking to buy a plan that can protect him from heart-related surgeries. Since his father expired from cardiac arrest, he now become cautious and want a plan that can protect him and save money in case of such a mishap. After getting abundant suggestions and conducting thorough research, he stumbled upon Care Heart Mediclaim Insurance. Currently, he lives in the New Delhi area with his family. Here is the premium illustration according to his age and policy coverage.

No. of AdultsAgeTotal Coverage (in Rs)Policy TenurePre-Existing ConditionsPremium Amount
130 Years25 Lakhs1 YearNoRs. 2125 (Including 18% GST)
130 Years1 Crore3 YearsNoRs. 16807 (Including 18% GST)
130 Years2 Crore2 YearsNoRs. 13018 (Including 18% GST)

How to Buy the Care Heart Mediclaim Plan?

Like every other basic necessity, health expenses have also become exceptionally high in India in recent times. And to protect your savings and financial health from an unexpected medical emergency, proper medical insurance for you and your family has become one of the fundamental requirements of life today. If you are looking to buy Care Heart Mediclaim insurance, you will need to follow the steps mentioned below:

Step 1: To start, use your laptop or smartphone to access the official Care Health Insurance website.

Step 2: Then, you will need to “View All Products” in the middle. You can easily see it the moment you open the page. Then, click on it.

Step 3: Next, search for “Heart Mediclaim” under the Mediclaim tab. Simply click it when you find it.

Step 4: You can calculate the premium by entering your mobile number in the “Get a Free Quote” box on the plan page. Enter your mobile number after that, and then click “Calculate Premium” to proceed.

Step 5: Next, decide which members you want to include in the plan. Select the members, then click “Continue” to purchase the plan for yourself, your spouse, your son, your daughter, your father, or your mother.

Step 6: It will then prompt you to choose your age from a list of available ages. Make sure you choose the appropriate age to prevent future misunderstandings. You will then need to select your citizenship and enter the name of your city. Press the “Get a Quote” button.

Step 7: A new page will open with the required premium amount (including GST) and other policy information on the right side, including the scope of coverage and the length of the policy.

Step 8: Click the “Buy Now” button, which appears clearly at the top and is yellow in colour, if the information is satisfactory to you and you are ready to purchase the policy.

Step 9: A page will then show up asking you to select one of the IDs to verify your identity. If you choose “PAN Card,” for instance, you will be asked to enter your PAN number and birthdate before clicking “Verify.”

Step 10: On the same page, complete the form by providing your personal information (first and last names, phone number, pin code, eldest member’s birthday, and PAN number), then click “Next”. Verify the details you entered are accurate to avoid any misunderstandings in the future.

Step 11: After verifying all the information, you must purchase the policy online using Net Banking, a credit card, or a debit card.

How To File a Claim for Your Care Heart Mediclaim Insurance Plan?

The Care Mediclaim insurance policy allows for two different kinds of claims. These are listed below:

  • Cashless
  • Reimbursement

Let’s understand the meaning and the processes involved in both these types of claims.

  1. Cashless Claims

When receiving medical care, you have the option of a cashless hospital stay. This indicates that the hospitalization expenses will be covered by the health insurance provider. Only the portions that the health insurance provider does not cover by insurance regulations will be the responsibility of the policyholder. According to the terms and conditions of the health insurance plan, the claim is approved. The hospital in question should also be a part of the insurer’s network of medical facilities.

  • Check the list of network hospitals in your area and choose one if you have a medical problem and need to be admitted.
  • When you are admitted, you must fill out and turn in a pre-authorization form to the third-party administration (TPA) counter. Informing your insurance provider in advance is a good idea since the TPA sends the form to them for final approval.
  • Any relevant documents will be accepted for submission at the Third-Party Administration counter. This might include the cashless medical care your insurer offers. Additionally, copies of some KYC documents will be kept for verification purposes.
  • By this point, your hospitalization has received the insurance company’s cashless approval. They keep track of all the paperwork related to your care and during your stay. People should get a copy of the same document as well for record-keeping purposes.
  • If you adhere to the above recommendations, the claims will be resolved without incident. Make sure you have all of your discharge paperwork, physiological test results, and medical reports with you. All of this paperwork must be preserved for upcoming needs or references.
  1. Reimbursement Process

Here are the steps involved in availing reimbursement of your Care Heart Mediclaim insurance plan.

  • To receive treatment, the insured would need to be admitted to a hospital that is not affiliated with the insurance provider.
  • The insured should keep all original medical records and invoices. The insured should also foot the bill for any medical expenses.
  • The insured should request a discharge certificate or discharge summary from the hospital where treatment was received after being released from the hospital.
  • Following that, the insurance company should receive this discharge certificate or summary along with a properly completed claim form, original copies of all medical records and bills, and any other pertinent paperwork that they may request.
  • The insurance provider would then review the claim, associated paperwork, and outlay of funds. After that, the costs would be reimbursed.

Documents Required for Filing Reimbursement Claim

Listed below are the documents needed for filing a reimbursement claim for your Care Heart Mediclaim Plan.

  • Health Card Copy
  • Duly Filled Claim Form
  • Original Hospital Discharge Summary
  • Investigation Reports like scans, X-rays, blood reports, etc
  • Cash Receipts from Hospitals
  • If an accident happens, then FIR or medico-legal certificate (MLC)
  • Doctor’s Consultation Papers and Pre-Admission Investigations
  • Copy of KYC documents
  • Contact Info, NEFT details
  • Invoices of pharmacy supported by respective prescriptions.

How To Renew Your Care Heart Mediclaim Policy?

The insured person will forfeit all accrued benefits, including waiting period benefits, if the policy is not renewed on time and it lapses. You shouldn’t take the chance of going uninsured, given the increasing risk of serious illnesses and skyrocketing medical costs, because you never know when you’ll need a health plan.

If you don’t know how to renew it, here are the steps to renew your Care Heart Mediclaim Policy.

  1. The first thing you should do is visit Care Health Insurance’s official website.
  1. Next, you must find the “Renew” button at the top of the home page.
  1. Before entering the captcha code in the third step of the renewal process, you must enter your Policy Number, Date of Birth, and Contact Number. Select “Let’s Renew” from the menu.
  1. Following that, your policy’s specifics will show up. Before using a credit card, debit card, or net banking to make the payment, double-check that the information is correct.
  1. Your Care Heart Mediclaim policy will be renewed after you complete these steps.

Frequently Asked Questions

Here are the persons that should consider buying the Care Heart Mediclaim Policy;

  • A single earning member in the family.
  • Chronic history of heart-related ailments.
  • People over 40 years of age.

Yes, you can easily buy the Care Heart Mediclaim Policy even if you are diagnosed with any heart-related ailments at per underwriter’s discretion.

According to the underwriting of the policy, you will indeed need to go through a pre-policy medical examination. If the company’s underwriting team approves your proposal, the cost of the medical tests will be covered by the company.

Yes, there are multiple options for monthly or quarterly premium payments available. Also, there are adaptable EMI with a policy duration of two and a half years available.

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