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Care Supreme - Senior Premium

The Care Supreme - Senior Premium is a variant of the stable’s popular plan, Care Supreme and a tweak on its Care Supreme - Senior Super plan. The Senior Premium plan, like the Senior Super policy, offers coverage for senior citizens with complicated PEDs like heart ailments or diabetes. However, in the case of Senior Premium, there are no disease-wise sub-limits, although the policy does have a couple of caveats - 20% mandatory co-payment and room rent coverage only up to the most economical Single Private Room.

What's good here?

diseaseSublimit

You always have full cover irrespective of the disease

No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.

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prePost

Pre & Post hospitalization expenses covered

No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.

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dayCare

Day Care treatments covered

If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.

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domiciliary

Full coverage even if you are forced to hospitalize at home

The insurer will bear the costs even if you are hospitalized at home due to a condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.

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restoration

Good Restoration Benefit

Even after you claim part of the cover on one occasion, you will be allowed to claim the full cover any number of times repeatedly if you are hospitalized for same or different complications.

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ncb

Special Bonus for being healthy

Your sum insured increases by 50% each year, even if you've claimed in the previous year. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 100%. But hey, it's still a bonus.

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ayush

Covers Alternative Medicine

Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.

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What's bad here?

coPay

You will have to pay a portion of the bill

The policy will only cover 80% of the final bill. The rest is on you. They call this a co-payment.

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What's okay here?

roomRent

You can pick a Single Private room but nothing fancy

You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.

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ped

Reasonable waiting period for pre-existing diseases

If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.

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What's lacking here?

healthCheckup

Your insurer doesn’t provide free health check-ups

If you want to get a full-body checkup just to make sure you’re in fine working condition, be ready to pay for it yourself or get an add-on to cover free health check-ups under the policy by paying a little extra in the premiums.

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Add-ons

Annual Health Check-up

Insured members get a free annual health check-up at network centres so long as they get medical tests prescribed in the policy. And since the cost can vary significantly for different profiles, we recommend speaking to our advisor before you take a call.

Care OPD Senior

With this addon, each insured member can avail up to 4 in-person consultations with a General Physician (max capping of ₹1000 per consultation & 10% mandatory co-payment) and 4 with a Specified Specialist (max capping of ₹2000 per consultation & 5% mandatory co-payment) annually on a reimbursement basis. Additionally, you get Physiotherapy OPD up to ₹1000 per year and Psychologist consultation (Max ₹800 per session and max up to ₹1000 per year).

Air Ambulance Cover

You can avail an air ambulance in the event of an emergency. And the insurance company offers this benefit to everyone who buys the policy.

Disease Management Program

With this add-on, each insured member can avail up to 4 in-person consultations in a year (with max capping of ₹750/consultation related to hyperlipidemia or Diabetes Mellitus based on the condition diagnosed), Prescribed Pharmacy Up to ₹6000/year and Diagnostic tests like SGOT & SGPT (for hyperlipidemia) and HBA1c, Urine proteins – microalbuminuria; Electrolytes (for Diabetes Mellitus).

Cumulative Bonus Super

Every time you renew your policy, the insurance provider will grant you additional bonus cover totalling 100% of your sum insured. And they will continue doing this until the total cover adds up to 500% of the base sum insured. Considering the cost involved, this is a good add-on to have.

Wellness Benefit

You get a small discount on your premiums every time you renew the policy if you clock 10,000 steps over a set number of days. The insurance company will offer this benefit to everyone who buys the policy.

Palliative Care

With this add-on, the insurer pays out up to ₹5000 per day; Max up to ₹1 lakh in a policy year upon Diagnosis of Terminal Illness. But remember this benefit is available only if the insured member has heart ailment or Diabetes diagnosed at the time of policy purchase.

Frequently Asked Questions

Yes. Care Supreme - Senior Premium imposes 3 kinds of waiting periods -
  • 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
  • Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
  • Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
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