Care Health Insurance

Care Enhance (Super Top-Up)

Plain-English breakdown of the plan — every field a shopper actually needs before clicking buy. Compiled from public Care brochures and policy wordings. Always confirm against the official PDF below.

top upfamily floater

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Trust at a glance

Care Health — IRDAI FY 2024-25

Verified

Claim Settlement Ratio: 96.74%
Incurred Claim Ratio: 64.53%
Complaints / 10,000 claims: 47
Network hospitals: 22,000

Source: IRDAI Annual Report FY 2024-25 · UIN 148PolicyPlain earns no commission · numbers shown verbatim

Plan details

Every field, in one place

Sum insured options: ₹10L · ₹15L · ₹20L · ₹25L · ₹50L · ₹1Cr
Pre-existing disease (PED) waiting: 36 months
Pre-existing covered: Covered after PED waiting period
Co-payment: No copay published
Room rent: Single private AC room
Restoration of sum insured: Not available
No Claim Bonus (NCB): Variant-specific / not single value
Cashless network: 22,000 hospitals (insurer disclosure)
Free-look cancellation window: 15 days
Premium grace days: 30 days
IRDAI UIN: Not confirmed — verify on irdai.gov.in
Last verified: 2026-06 · third party aggregator

Honesty note: Care Enhance is the super top-up; Care has a separate non-super top-up — confirm variant before purchase.

Indicative premium

Order-of-magnitude only — NOT a quote

Age	Sum insured	Approx annual premium
35	₹15L	~₹5,000/yr
45	₹15L	~₹7,500/yr

Indicative figures vary by city, family member count, medical loading and policy term. Always confirm on the insurer's premium calculator.

Known exclusions

What this plan typically does NOT cover

Standard exclusions list
Maternity
Substance abuse, self-inflicted injury
Hazardous sports
Cosmetic surgery

Known traps

The fine print that decides claim outcomes

Aggregate deductible — confirm trigger mechanics in policy wording.
PED waiting 36 months — top-up doesn't reduce PED inherited from base.
Cashless restricted to PPN on some variants.
Sub-limits on cataract per eye, modern treatments.
Renewal premium re-rates with age band.

How to claim

Cashless vs reimbursement — the steps

1Notify insurer. Within 24 hours of emergency admission or 48-72 hours for planned hospitalisation. Use Care's helpline or app — keep the reference number.
2Cashless: Pre-authorisation form filled by hospital, sent to Carevia the hospital's TPA desk. Approval typically 4-6 hours during business; longer overnight. If your hospital is OUT of network (or PPN-only), you'll be on reimbursement.
3Reimbursement:Pay hospital out-of-pocket, then submit claim form + original bills + discharge summary + investigation reports + KYC. Insurer's IRDAI-mandated turnaround is 30 working days from receipt of complete documents.
4Watch for deductions. Room rent above your eligible category triggers proportionate deduction across the WHOLE bill, not just room rent. Sub-limits on cataract / modern treatment apply even when total SI is far higher.
5If denied: Ask for a written denial citing the exact clause. Internal grievance redressal first, then IRDAI Bima Bharosa or the Insurance Ombudsman.

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