Care Health Insurance

Care Senior

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.

seniorindividual

Get official policy wording from Care ↗I already have a PDF — decode it →

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: ₹3L · ₹5L · ₹7L · ₹10L
Pre-existing disease (PED) waiting: 24 months
Pre-existing covered: Covered after PED waiting period
Co-payment: 20% from entry age 61+
Room rent: Single private AC room
Restoration of sum insured: Once per policy year
No Claim Bonus (NCB): 10% per claim-free year
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 Senior brochure refreshed in 2025; field values reflect that brochure but not the policy wording line-by-line.

Indicative premium

Order-of-magnitude only — NOT a quote

Age	Sum insured	Approx annual premium
65	₹5L	~₹32,000/yr
70	₹5L	~₹45,000/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

Cosmetic surgery, dental (unless accidental)
Hazardous activities
Substance abuse
Maternity-related (irrelevant to senior bracket but listed)
Treatment outside India

Known traps

The fine print that decides claim outcomes

20% copay above age 61.
Annual health check-up benefit only triggers on claim-free renewal.
Cataract per-eye sub-limit applies even on higher SI variants.
PED reducible by add-on but at significant extra premium.
Restoration once per policy year for related-OR-unrelated illness (more generous than some peers, BUT only full exhaustion).

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.

Got a Care PDF in hand?

PolicyPlain's extractor reads your specific Care wording and surfaces the exact clauses, sub-limits and traps from your policy — not just the catalog defaults.

Upload my Care PDF →← Back to plans library