Religare CARE Health

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ABOUT RELIGARE

Religare Health Insurance is a Specialist Health  Insurance  engaged in the Distribution  & Servicing of Health Insurance products .

Religare is Promoted by the Founders of Fortis Healthcare, which owns or manages 54 healthcare facilities in India, Dubai & Mauritius.

Religare Health Insurance Company  started the operation in the year 2012 and expertise in the Spectrum of financial services, and Preventive Health Solutions.

Religare CARE has been awarded  as one of the best Medical Insurance Product in 2015.

CARE-SUM INSURED OPTIONS (LACS)

INDIVIDUAL AND FAMILY FLOATER 
 

PLAN COMBINATIONS

                                   

AGE LIMIT

  
Entry age for individual policy is 5 years and above.  

PRODUCT DESIGN


IN PATIENT CARE

In  Religare CARE the Inpatient Treatment covers hospitalization expenses up to Sum Insured
Medical expenses for in-patient treatment :

  • Doctors’ fees .
  • Professional charges. 
  • Blood, oxygen , Operation Theater Charges. 
  • Surgeons Fees.
  • Diagnostics procedures .
  • Medicines, drugs .
  • Operation Theater charges .
  • Intensive Care Unit charges.
  • Other medical charges.

HOSPITAL ACCOMMODATION

In this policy the expenditure related to Hospital Accommodation like Room Rent and ICU charges are covered.

 

PRE&POST HOSPITALIZATION EXPENSES

Consultations, Diagnostics tests and any Medication required Pre Hospitalization up to 30 days is covered or similar  medical expenses required Immediately after being discharged from hospital for up to 60 days will be covered under the same policy.

DAY CARE PROCEDURES

Religare covers the Medical Expenses incurred for various Surgeries that do not require a minimum of 24 hours of hospitalization under the Day Care Treatment Benefits.

Religare covers all listed day care procedures prescribed by the medical Practitioner  like Chemotherapy, Radiotherapy ,Hemodialysis etc. up to sum insured.

ORGAN DONOR

The Insured Person has been medically advised to undergo an Organ Transplant and the Expenditure incurred for this is covered during the policy period.

What’s not covered: 
  • Pre or Post Medical Expenses or screening expenses. 
  • Any other costs directly or indirectly associated with the acquisition.


EMERGENCY AMBULANCE COVER

Religare covers the expenses incurred by the Insured on availing Ambulance services for necessary Transportation to the nearest Hospital in case of an Emergency.


DOMICILIARY HOSPITALIZATION

It is a treatment taken at home because the insured is not in a condition to be transferred to hospital with the doctors approval or the insured satisfies the insurance company that the beds were not available in the hospital.

As far as it involves medical treatment for a period exceeding 3 consecutive days this feature will be covered. 

ANNUAL HEALTH CHECK UP

This policy provides all insured with a Complimentary Annual Health Check-up, at any time during the policy year.
It is done up to 75 lakh sum insured for a insured person who are 18 years and above. 


RECHARGE BENEFIT

The Recharge shall be utilized only after the Sum Insured, No Claims Bonus have been completely exhausted in the Policy Year.
  • The Recharge shall be available only for all future Claims and not in relation to any Illness or Injury for which a Claim has already been admitted for that Insured Person during the Policy Year.
  • The Recharge will only be applied once for the Insured Person during the Policy Year up to sum insured.
  • Any unutilized Recharge cannot be carried forward to any subsequent Policy Year.
HOW RECHARGE WORKS 

SECOND OPINION BENEFITS

  1. Benign Brain Tumour.
  2. Cancer.
  3. End Stage Lung Failure.  
  4. Heart Attack.  
  5. Open Chest Coronary Artery Bypass Graft.  
  6. Heart Valve Replacement. 
  7. Coma.  
  8. End Stage Renal Failure.  
  9. Stroke.
  10. Major Organ Transplant.  
  11. Paralysis.
  12. Motor Neuron Disease. 
  13. Multiple Sclerosis.
  14. Major Burns.
  15. End Stage Liver Disease.

AYUSH BENEFIT

Reimbursement of Medical Expenses for Alternative Treatment taken under AYUSH, has to under go in:
  • A Government hospital 
  • In any Institute recognized by Government and/or Accredited by Quality Council of India/National Accreditation Board on Health.
  • Does not include Pre and Post Hospitalization Expenses.


No Claim Bonus-SUPER

In the policy year if we do not claim, then the sum insured is increased by 60% in the 2nd year & 3rd year, 4th year 10% ,5th year 10% to the extent of 150% ,but when the claim is made it decreases by 60%  in the same progression as it is increased  without affecting the sub limits applicable  to the policy. 

UNLIMITED AUTOMATIC RECHARGE

  •  Through this policy they can recharge the entire sum insured unlimited times during the policy year.
  •  Any UN-utilized recharge cannot be carried forward.
  • This re-instated amount  can be used for future/further claims, not related to the Illness / Injury for which the claim  has been made during the same Policy year.
  •  No claim bonus or no claim bonus super shall  not be considered while calculating unlimited automatic recharge.

POLICY CONDITION


PRE-EXISTING DISEASES (PED) WAITING PERIOD

Any regular medication, past surgery, or any medical condition or past accidental injury will qualify as pre existing disease or condition and the same will have a waiting period. PED waiting is 4 years in CARE Plan.

WAITING PERIODS

  • Any Claim for or arising out of following specific Illness or Surgical Procedure will not be covered for the first 2 year.
  • Any treatment related to Arthritis,Osteoarthritis and Osteoporosis, Gout, Rheumatism, Spinal Disorders(unless caused by accident), Joint Replacement Surgery(unless caused by accident), Arthroscopic Knee Surgeries/ACL Reconstruction/Meniscal and Ligament Repair 
  • Surgical treatments for Benign ear, nose and throat (ENT) disorders and surgeries (including but not limited to Adenoidectomy, Mastoidectomy, Tonsillectomy and Tympanoplasty), Nasal Septum Deviation, Sinusitis and related disorders 
  •  Benign Pro static Hypertrophy 
  • Cataract 
  •  Dilatation and Curettage 
  • Fissure / Fistula in anus, Hemorrhoids / Piles, Pilonidal Sinus, Gastric and Duodenal Ulcers 
  •  Surgery of Genito-urinary system unless necessitated by malignancy 
  •  All types of Hernia & Hydrocele 
  • Hysterectomy for menorrhagia or Fibromyoma or prolapse of uterus unless necessitated by malignancy 
  •  Internal tumors, skin tumors, cysts, nodules, polyps including breast lumps (each of any kind) unless malignant 
  •  Kidney Stone / Ureteric Stone / Lithotripsy / Gall Bladder Stone.

PERMANENT EXCLUSIONS

  1. Psychiatric and Psychosomatic Conditions
  2. Obesity
  3. OPD Treatment 
  4. Self-inflicted injuries
  5. Sexual problem and gender issues
  6. Sexually transmitted diseases
  7. Sleep disorders
  8. Sleep disorders
  9. Treatment for developmental problems
  10. Unrecognised physician or Hospital
  11. Unlawful Activity
  12. Ageing and puberty
  13. Artificial life maintenance
  14. Congenital conditions
  15. Convalescence and Rehabilitation
  16. Addictive conditions and disorders
  17. Cosmetic surgery.
  18. Dental/oral treatment.
  19. Dressings for OPD Treatment or take-home use.
  20. Eyesight.
  21. Unproven/Experimental treatment.
  22. Health hydros, nature cure, wellness clinics etc.
  23. HIV and AIDS.
  24. Hereditary conditions (Specified).
  25. Items of personal comfort and convenience.
  26. Genetic disorders.  

PRE-POLICY HEALTH CHECK UP

When your entering the policy first time , and above 50 years of age with 25 lakh of sum insured medical test is compulsory.

TENURE

  • If the customer takes insurance for 2 consecutive years they will get a discount of 7.5% on .
  • If they take for 3 years then the discount increases to 10%.

HIGHLIGHTS

  • ROOM RENT -1% or Single Private Room (up gradable to next level only if Single Private Room is not available).
  • ICU CHARGES - 2%of sum insured or no limits in case of ICU charges 
  • PRE-POST HOSPITALIZATION-30 days before and  60 days after the hospitalization expenditure are covered for same illness
  • EMERGENCY AMBULANCE COVER-  1500-3000 Emergency Per Ambulance cover depending the Sum insured opted. 
  • RECHARGE/REFILL/RESET BENEFIT- Recharge benefit can be used once your sum insured is exhausted for different illness or injury up to sum insured 
  • PRE-EXISTING WAITING PERIOD- 4 years waiting period for  Pre Existing Diseases .
  • SPECIFIC DISEASES WAITING PERIOD-  2 years of waiting period for specific diseases.
  • DAY CARE PROCEDURES-All day care procedures are covered.

ABOUT RELIGARE

Religare Health Insurance is a Specialist Health  Insurance  engaged in the Distribution  & Servicing of Health Insurance products .

Religare is Promoted by the Founders of Fortis Healthcare, which owns or manages 54 healthcare facilities in India, Dubai & Mauritius.

Religare Health Insurance Company  started the operation in the year 2012 and expertise in the Spectrum of financial services, and Preventive Health Solutions.

Religare CARE has been awarded  as one of the best Medical Insurance Product in 2015.

SUM INSURED OPTIONS(IN LACS )

PLAN COMBINATIONS

                                         

AGE LIMIT

           
                                              
                                                   Entry age for individual policy is 5 years and above.  

CARE GLOBAL BENEFITS

                                                

IN-PATIENT TREATMENT

In  Religare CARE Global the Inpatient Treatment covers hospitalization expenses up to Sum Insured

Medical expenses for in-patient treatment :
Doctors’ fees .
Professional charges. 
Blood, oxygen , Operation Theater Charges. 
Surgeons Fees.
Diagnostics procedures .
Medicines, drugs .
Operation Theater charges .
Intensive Care Unit charges.
Other medical charges.

HOSPITAL ACCOMMODATION

In this policy the expenditure related to Hospital Accommodation like Room Rent and ICU charges are covered.
                
   Room Rent                                     
                                    
  ICU Charges
                                     

PRE & POST HOSPITALIZATION EXPENSES

Consultations, Diagnostics tests and any Medication required Pre Hospitalization up to 30 days is covered or similar  medical expenses required Immediately after being discharged from hospital for up to 60 days will be covered under the same policy.
                              
                     

DAY CARE PROCEDURES

Religare covers the Medical Expenses incurred for various Surgeries that do not require a minimum of 24 hours of hospitalization under the Day Care Treatment Benefits.

Religare covers all listed day care procedures prescribed by the medical Practitioner  like Chemotherapy, Radiotherapy , Hemodialysis etc. up to sum insured

ORGAN DONOR

The Insured Person has been medically advised to undergo an Organ Transplant and the Expenditure incurred for this is covered during the policy period.
What’s not covered: 
Pre or Post Medical Expenses or screening expenses. 
Any other costs directly or indirectly associated with the acquisition.

                                              

EMERGENCY AMBULANCE COVER

Religare covers the expenses incurred by the Insured on availing Ambulance services for necessary Transportation to the nearest Hospital in case of an Emergency.
                   
                                 

AIR AMBULANCE COVER

Religare covers the expenses incurred by the Insured on availing AIR Ambulance services  ( A MEDICALLY-EQUIPPED AND STAFFED HELICOPTER OR PLANE) When medicals are necessary,at Least One Or Both Of The Source Or Destination Should Be Within India.
                                  
                                    

RECHARGE BENEFIT

The Recharge shall be utilized only after the Sum Insured, No Claims Bonus have been completely exhausted in the Policy Year.

The Recharge shall be available only for all future Claims and not in relation to any Illness or Injury for which a Claim has already been admitted for that Insured Person during the Policy Year.

The Recharge will only be applied once for the Insured Person during the Policy Year up to sum insured.

Any unutilized Recharge cannot be carried forward to any subsequent Policy Year.

INTERNATIONAL SECOND OPINION

Religare Gives the Option to get a Second Opinion on  Health From Internationally Renowned Doctors only Once in a policy year for major illnesses.

ANNUAL HEALTH CHECK UP

This policy provides all insured with a Complimentary Annual Health Check-up, at any time during the policy year.

VACCINATION COVER

In this policy the Vaccination will be covered  only if the maternity is claimed.
                                            
                                           

AYUSH BENEFIT

Reimbursement of Medical Expenses for Alternative Treatment taken under AYUSH, has to under go in:
A Government hospital 

In any Institute recognized by Government and/or Accredited by Quality Council of India/National Accreditation Board on Health.

Does not include Pre and Post Hospitalization Expenses.


                                                       

MATERNITY BENEFIT

  • Medical Expenses for the delivery of a child and/or related to a Medically Necessary termination of pregnancy is covered.
  • Maternity may be claimed twice during the lifetime of the Policy.
  • Maternity Benefit can be availed after 2 years of taking the policy.        
                                                   

NO CLAIM BONUS (NCB)

We increase your sum insured by 10% of the expiring policy sum insured if you do not file a claim during the previous policy period.

This benefit accrues every year up to a maximum of 50% of the total Sum Insured in the renewed policy.

The increase in Sum Insured under this Bonus does not increase the sub limits applicable to the policy.
                         
                                    

POLICY CONDITION

                      

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