PolicyPlain

Care Health Insurance

Care Supreme

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.

family floaterindividual

Trust at a glance

Care Health — IRDAI FY 2024-25

Verified
Claim Settlement Ratio
96.74%

FY 2024-25

Incurred Claim Ratio
64.53%

% of premium paid as claims

Complaints / 10,000 claims
47

Lower is better

Network hospitals
22,000

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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
₹7L · ₹10L · ₹15L · ₹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
Unlimited (subject to clauses)
No Claim Bonus (NCB)
100% 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 policy variants (Care, Care Plus, Care Supreme, Care Advantage) overlap; field values reflect public Care Supreme brochure as of 2026-06.

Indicative premium

Order-of-magnitude only — NOT a quote

AgeSum insuredApprox annual premium
35₹10L~₹15,000/yr
45₹10L~₹21,000/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 / aesthetic surgery (non-reconstructive)
  • Maternity unless waiting period (36 months) served and rider opted
  • Hazardous sports / war / nuclear risk
  • Treatment for obesity below specified BMI threshold
  • Hormone replacement therapy unless medically necessary

Known traps

The fine print that decides claim outcomes

  • Cashless restricted to Preferred Provider Network (PPN) on some Care variants — outside PPN means reimbursement only.
  • Day-care procedures listed in annexure — anything not on the list goes to claims review.
  • Unlimited restoration triggers after partial / full exhaustion but is for UNRELATED illnesses only.
  • Co-payment of 20% on non-network hospitals (varies by variant).
  • Renewal premium can be re-rated at insurer's discretion after age 60.

How to claim

Cashless vs reimbursement — the steps

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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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