Care Supreme Plan

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Care Supreme is a comprehensive health insurance policy offered by Care Health Insurance. It offers flexible coverage and various benefits, ensuring you and your loved ones can access necessary medical care without the stress of unexpected expenses. In addition to its core features, the product also offers a range of benefits in the form of add-ons to ensure a worthwhile health insurance journey.

Are You Eligible?

Minimum Entry Age

Adults: 18 years
Dependent Children: 90 days

Maximum Entry Age

Adults: No restrictions
Dependent Children: 24 years

An Overview Of The Plan’s Benefits & Limits

The plan includes coverage for expenses related to inpatient hospitalisation. This includes the costs incurred during your stay in a hospital for more than 24 hours such as room and board charges, nursing fees, medical practitioner's fees, the cost of prescribed medications and drugs, ICU charges, and any other relevant expenses.

Besides that, here is a list of other expenses that are covered in Care Supreme Plan -

Pre & Post Hospitalisation Expenses
You may need to undergo several tests before or after your admission to the hospital. In all such cases, Care Supreme ensures that you receive the necessary coverage. It will cover these expenses up to the sum insured for a reasonable duration - 60 days prior to your hospitalisation and 180 days following your discharge. It's important to note that the insurer will only cover these costs if they are directly related to the medical condition that led to your hospitalisation and if your claim is approved as part of your inpatient hospitalisation coverage.

Daycare Treatment Coverage
Daycare treatments are procedures that once required lengthy hospital stays, but can now be completed within 24 hours, thanks to the technological progress in healthcare. With the Care Supreme Plan, all necessary daycare procedures are covered up to the sum insured without any limit.

Domiciliary Treatment Coverage
Domiciliary Treatments are medical procedures for illnesses or injuries that require immediate attention in a hospital but are carried out in the comfort of your own home in case the severity of your condition prevents you from moving to the hospital or if there are no hospital beds available nearby. The Care Supreme Plan offers coverage for the expenses associated with domiciliary treatment up to the sum insured. The coverage is subject to the terms and conditions of the policy.

Organ Donor Coverage
The Care Supreme Plan also provides coverage for organ donor expenses. This covers the costs associated with harvesting the organ from the donor in the event of organ transplantation (where, you, the insured are the recipient) up to the sum insured chosen under your policy.

Modern Treatment Coverage
The healthcare industry is undergoing a rapid transformation due to advancements in technology. This has made previously unimaginable modern treatments or advanced technological methods a reality. The Care Supreme Plan is specifically designed to keep up with these advancements and provides coverage for these cutting-edge treatments, up to the sum insured.

Non-Medical Expenses
The Care Supreme Plan covers non-medical expenses such as gloves, gauze, bandages, nebulization kits, oxygen masks, and other treatment necessities. These consumables can add up to a significant amount. With the Care Supreme Plan, you can have peace of mind as it offers coverage for these expenses up to the sum insured - if you opt for an add-on.

Room Rent Limit
The room rent limit refers to the maximum amount that your insurance company will cover for the room you opt for during your hospital stay. By selecting a room that falls within this limit, you won't have to bear any expenses yourself. However, if you opt for a room beyond your eligibility, a proportionate deduction will apply. In such cases, you will be responsible for paying a proportionate share of the total bill, rather than just the difference in room rent. With the Care Supreme Plan, you have complete freedom to select the room of your choice, be it a shared room, single room, suite, or any other available option - without any restrictions.

Cumulative Bonus
With Care Supreme you can receive a bonus of 50% of the sum insured, which can go up to a maximum of 100% of the sum insured. This bonus is a reward for your staying in good health and not making any claims during the policy year. In case you make a claim under the plan, you can be assured that the accumulated bonus will not be reduced.

Unlimited Automatic Recharge
The Unlimited Automatic Recharge Benefit is a fantastic feature that ensures your sum insured is replenished unlimited times in a policy year when it gets depleted. This benefit is activated when you have fully utilised your base sum insured and any bonus. The best part is that it can be used for both related and unrelated illnesses throughout the policy year. Please note that specific terms and conditions apply to this coverage.

Noteworthy Features You Should Be Aware Of

Instant Cover
The Instant Cover add-on is a valuable offering under the Care Supreme Plan, designed to reduce the waiting periods for pre-existing conditions such as hypertension, diabetes, hyperlipidemia, and asthma. It is an ideal option for individuals who have these medical conditions. By opting for this add-on, you can enjoy coverage for these specific health concerns without enduring lengthy waiting periods. It reduces the waiting period for these conditions to 30 days.

Cumulative Bonus Super

Cumulative Bonus Super is a reward for maintaining good health and not making any claims during the policy year. It is an add-on benefit and is an extension of the cumulative bonus. It entitles you to a bonus of 100% of the sum insured, up to a maximum of 500% of the sum insured. The terms and conditions that apply to the cumulative bonus also apply to the cumulative bonus super.

Mental Well-Being Feature
Care Supreme plan understands the significance of mental health and offers a valuable benefit - the mental well-being feature. This is an add-on that you can opt for at a certain extra cost. It provides coverage for outpatient medical expenses related to specific mental disorders, subject to some limitations.

Understanding Waiting Periods

After you buy a health insurance policy, certain illnesses and diseases may not be covered for a specific period of time called the waiting period. Once this period ends, you can make claims for these conditions.

Here are some of the types of waiting periods -

Initial Waiting Period
After buying the policy, you must wait 30 days before making a claim for any medical condition, except for accidents. This is called the initial waiting period. So, during this period, you will not be eligible to make a claim for any treatment unless it is a result of an accident.

Waiting Period For Pre-Existing Diseases
A pre-existing disease refers to any medical condition or illness that you have experienced within 48 months before applying for a health insurance policy. It's important to note that under the Care Supreme Plan, there is a waiting period of 48 months for pre-existing conditions. During this time, any expenses related to these pre-existing conditions will not be covered by the policy.
However, if you opt for the Instant Cover add-on, the waiting period will be reduced to 30 days for pre-existing conditions such as hypertension, diabetes, hyperlipidemia, and asthma.
Waiting Period For Specific Diseases
Insurance providers may impose a waiting period for particular medical conditions or illnesses apart from any pre-existing conditions you may have. This waiting period applies regardless of whether you have previously experienced these diseases or not. The duration of this waiting period is determined by the insurer and is not influenced by your current state of health. Under the Care Supreme Plan, there is a waiting period of 24 months for specific diseases.

What The Plan Does Not Cover!

Exclusions refer to specific circumstances or conditions that are not covered by your health insurance policy. Here are some of the types of exclusions -

Standard Permanent Exclusions:
It is important for you to understand that the IRDAI has implemented a set of 'standard permanent exclusions' that all insurance companies are required to follow. These exclusions encompass a range of conditions that are not covered by insurance policies.

Obesity/weight control: Treatments or surgeries for weight control or obesity.
Profession in hazardous or adventure sports: Expenses incurred as a result of engaging in adventurous activities like mountaineering, surfing, paragliding, etc. as a professional.
Excluded providers: Treatment from a medical practitioner or hospital excluded by the insurer.
Investigation and evaluation: Hospital admissions for observation or monitoring purposes.
Rest cure, rehabilitation, and respite care: Admission to a facility for bed rest, without any active treatment.
Plastic/cosmetic surgery: Treatment or surgery that aims to alter your body characteristics or appearance.
Narcotics: Treatments related to addictive conditions such as alcohol addiction, drug usage, etc.
Breach of law: Expenses related to the treatment if you have committed or attempted to commit a breach of law with criminal intent.
Change of gender treatment: Treatment that aims to change your body's characteristics to match those of the opposite sex.
Dietary supplements, substances purchased without prescription: Vitamins, minerals, or other supplements that haven’t been prescribed by a medical practitioner.
Unproven treatments: Surgeries, medical procedures, or treatments that have not been proven to be effective.
Treatments in establishments arranged for domestic purposes: Treatment received at health spas, nursing homes, or similar establishments that were arranged completely or partially for domestic reasons.
Maternity expenses: Pre/post-natal costs, expenses related to childbirth hospitalisation, and more.
Refractive error: Expenses related to correcting refractive errors of up to 7.5 diopters to improve your eyesight.
Expenses related to birth control, sterility, and infertility: Some treatments like contraception methods, sterilisation procedures, artificial insemination techniques, advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc.

Additional Permanent Exclusions
In addition to the standard permanent exclusions mentioned earlier, insurance providers may also apply specific exclusions in your policy for particular circumstances or medical conditions. If you have certain diseases or severe medical conditions that insurers perceive as high-risk to cover, they may choose to permanently exclude them from your policy. In India, insurers are permitted to apply permanent exclusions only to a specified list of illnesses provided by the Insurance Regulatory and Development Authority of India (IRDAI). They cannot exclude any illness beyond this list.
Non-Standard Exclusions (Specific Exclusions)
The Care Supreme Plan has additional exclusions that go beyond the standard permanent exclusions set by the IRDAI. It is important to understand that these exclusions can differ among insurance companies and are dependent on the specific terms and conditions of the policy.
Here are some specific exclusions listed under the Care Supreme Plan -

Engaging in a naval, military, air force, or aviation operation in a professional or partially professional capacity.
Hair loss solutions such as alopecia wigs, toupees, and various hair fall treatments and products.
Services such as screening, counselling, or treatment for any external congenital anomaly, illness, or defects, as well as any treatment related to external birth defects.
Circumcisions unless they are necessary due to an illness or are required for a treatment related to an accident.
All forms of preventive healthcare (excluding those eligible for the 'Annual Health Check-up' benefit), vaccinations and immunizations (excluding post-bite treatment), and tonics.
Any deliberate self-harm/suicide/attempt to suicide, or any illness or injury cause by the consumption or abuse of substances like alcohol, tobacco, drugs, etc.
Impaired intellectual abilities due to the misuse of stimulants or depressants, unless they have been specifically prescribed by a medical professional.
Therapy for hormone replacement.
Artificial life maintenance. This comprises the usage of a life support machine in cases of a vegetative/brain-dead state by the treating medical practitioner, where such procedures won’t lead to a recovery or restoration of the previous health status.

A Quick Recap Of The Benefits & Limits

Product Benefits	Coverage Limits
Pre-Hospitalisation Expenses	Covered for 60 days up to the sum insured
Post-Hospitalisation Expenses	Covered for 180 days up to the sum insured
Daycare Treatment Coverage	Up to the sum insured
Domiciliary Treatment Coverage	Up to the sum insured
Organ Donor Coverage	Expenses for harvesting the organ up to the sum insured are covered
Non-Medical Expenses	Up to the sum insured if you opt for an add-on
Modern Treatment Coverage	Up to the sum insured
Room Rent Limit	No restrictions
Cumulative Bonus	50% increase in sum insured every year, subject to a maximum of 100%. It is not affected by any claims you make.
Unlimited Automatic Recharge	Unlimited restoration of the sum insured after you have completely used up your base sum insured and bonus.
Pre-Existing Diseases	Covered after a 48-month waiting period. This can be reduced to 30 days for Hypertension, Diabetes, Hyperlipidemia, and Asthma if you go for the Instant Cover Add-on.
Specific Diseases	Covered after a 24-month waiting period.

The OG Reading Material for Your Reference

FAQs

Are AYUSH treatments covered by the Care Supreme Plan?
Yes, the Care Supreme Plan provides coverage for AYUSH/alternative/non-allopathic treatments.
Is there a room rent limit that applies to the Care Supreme Plan?
There is no restriction on the room rent, which means you have the freedom to choose any type of room.
What is the highest level of coverage available under the Care Supreme Plan?
The Care Supreme Plan provides you with health coverage of up to INR 15 lakhs.
Does Care Supreme offer any restoration benefits?
Certainly! Care Supreme ensures that your sum insured is reinstated unlimited times if you require hospitalisation for either the same or different illnesses within a policy year.
Are modern treatment covered under Care Supreme?
Yes! Care Supreme provides coverage for modern treatment expenses up to the sum insured.