Care Joy vs Care Plus

Covers a Single Private Room with AC. A higher room category means room, boarding, nursing, OT and doctor/surgeon fees are reduced in proportion to the difference in room rent.

1. Normal: eligible to opt for a single A/C room or any low category room.

    

2. ICU: No limit, the plan will cover the entire costs without restrictions

ICU charges (ICU bed, monitoring devices, critical care nursing and intensivist charges) are payable as part of in-patient hospitalisation up to the sum insured. There is no separate ICU sublimit.

For sum insured below ₹5 lakh, ICU charges are limited to 2% of the sum insured per day under the referenced brochure. For sum insured of ₹5 lakh or more, ICU charges have no separate monetary limit, subject to policy terms.

1. Provides coverage for advanced treatments like;
2. Deep brain stimulation
3. Oral chemotherapy
4. Uterine artery embolization
5. HIFU
6. Robotic surgeries And many more.

20% of each admissible claim applies if the insured's entry age (eldest member for a floater) is 60 years or above. No co-payment applies for entry ages below 60.

Mandatory copayment limit of 20% for individuals above the age of 61.

No disease-specific caps apply to general hospitalisation, which is payable up to the sum insured. Fixed limits apply to maternity (₹35,000/₹50,000), newborn baby (₹30,000/₹50,000) and ambulance (₹1,000 per claim).

Cashless treatment is available at 11,400+ Care network hospitals across India. Pre-authorisation is required, and the network list can change, so check the hospital list before admission.

24800 + network hospitals

Not available. Once the sum insured is used, it is not restored within the same policy year. The optional No Claim Bonanza is a bonus for claim-free years, not a restoration benefit.

Unlimited automatic recharge of the sum insured is a key advertised benefit. The brochure states that it can be used for the same insured person and the same illness. Actual utilisation remains subject to the applicable recharge rules and policy conditions.

Optional "No Claim Bonanza", available for an additional premium. After three consecutive claim-free policy years, the sum insured increases by 100% of the expiring sum insured. The accrued bonus cannot exceed 100% of the sum insured in the renewed policy. If a claim is made, the accrued bonus is not carried to the next renewal, but the base sum insured is never reduced. The bonus is lost if the policy is not renewed within the grace period.

The No Claim Bonus Protect benefit increases the sum insured by 50% for each claim-free policy year, up to 200% of the base sum insured. The accrued bonus can reduce after a claim, subject to the policy's claim thresholds and bonus rules.

Covers a long list of procedures that need less than 24 hours of hospitalisation (for example cataract, dialysis, chemotherapy and radiotherapy, lithotripsy, tonsillectomy and arthroscopy). Cover is up to the sum insured and subject to waiting periods.

3 - 7 lacs sum insured for up to 24 hour hospitalization. 

Not covered. Non-medical items (for example gloves, masks, diapers, kits, belts, surcharges and similar items in the policy's non-payable list) are excluded. Some items, such as admission and registration charges, are treated as part of room or procedure charges and are not paid separately.

Standard hospitalisation coverage should not be interpreted as coverage for every non-medical consumable. Consumables are covered only where included under the applicable policy terms or an eligible add-on.

Not offered as a standard benefit. Treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, and other non-allopathic treatment, is excluded.

3 - 7 lacs sum insured for any non allopathic treatment covered by AYUSH.

30 days

30 days for illnesses from policy commencement. This waiting period does not apply to eligible accident-related treatment, subject to the policy terms.

24 months of continuous coverage for listed conditions and procedures. These include arthritis and spinal disorders, joint replacement, benign ENT disorders, benign prostatic hypertrophy, cataract, piles/fissure/fistula, hernia and hydrocele, hysterectomy for fibroids, kidney or gall bladder stones, and varicose veins. Accident-related claims are exempt. Prior continuous coverage can reduce the waiting period. If a listed condition is also pre-existing, the longer waiting period applies.

24 months for specified illnesses and procedures listed in the policy. The applicable exclusions and conditions continue to apply.

36 months of continuous coverage from the first policy with Care. Pre-existing conditions must be declared at proposal. If the sum insured is increased, the waiting period applies afresh to the increased amount. Continuous prior coverage with another insurer can reduce the waiting period on porting.

36 months for pre-existing diseases under the referenced policy version, subject to accurate disclosure, underwriting and applicable policy terms.

Covers 12 listed advanced treatments within the sum insured: uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, monoclonal antibody immunotherapy (injection), intravitreal injections, robotic surgeries, stereotactic radio surgeries, bronchial thermoplasty, laser prostate vaporisation (green laser or holmium laser), intra-operative neuro monitoring (IONM), and hematopoietic stem cell therapy for bone marrow transplant in blood disorders. Advanced methods outside this list are not covered.

Covers eligible advanced technology treatment methods listed under the policy, subject to medical necessity, admissibility conditions and the applicable sum insured.

Not available as a benefit. Depending on age and sum insured, Care may ask for pre-policy medical tests at its own cost. If the proposal is declined or the policy is cancelled in the free-look period, the test cost is deducted from the refund.

Available once in each policy year for each eligible insured member, subject to the insurer's prescribed arrangements and conditions.

30 days before admission. Expenses must relate to the same illness or injury and the hospitalisation claim must be admissible.

Covers eligible medical expenses for up to 60 days before hospitalisation, subject to the related hospitalisation claim being admissible.

60 days after discharge. Expenses must relate to the same illness or injury and the main hospitalisation claim must be admissible.



Not covered. Routine consultations, tests and pharmacy bills without hospital admission are not payable. Pre- and post-natal expenses are covered only within the maternity limit and as part of the delivery hospitalisation claim.

OPD consultation and specified dental and ophthalmic treatment benefits are available within prescribed limits. The referenced brochure lists limits of ₹1,500 for sum insured of ₹5–7 lakh and ₹2,500 for sum insured of ₹10–25 lakh, with a maximum of ₹350 per consultation. Check the applicable variant terms for eligibility.

No deductible applies. This is a base indemnity plan, not a top-up.

Deductible options are available as optional choices, including ₹1 lakh, ₹2 lakh, ₹3 lakh and ₹5 lakh under the referenced prospectus. Availability and applicable terms depend on the selected policy option.

Sum insured of ₹3 lakh or ₹5 lakh, on an Individual or Family Floater basis. Policy term is 3 years. Entry age is 18 to 65 years for adults, 1 day to 24 years for children, and 1 day to 90 days for newborns. Lifelong renewability. Maternity cover is available only for insured women aged 45 or below.

Deductible options are available as optional choices, including ₹1 lakh, ₹2 lakh, ₹3 lakh and ₹5 lakh under the referenced prospectus. Availability and applicable terms depend on the selected policy option.

96.74% for FY 2024-25 (insurer-level, based on IRDAI public disclosures). This reflects Care Health Insurance overall, not Care Joy specifically.

Care Health Insurance's insurer-level claim settlement ratio is reported as 96.74% for FY 2024–25 in a secondary source referencing IRDAI data. This is an insurer-level metric, not a guarantee of approval for an individual Care Plus claim.

Covers delivery hospitalisation (normal and C-section) including pre-natal and post-natal expenses: up to ₹35,000 on a ₹3 lakh sum insured and up to ₹50,000 on a ₹5 lakh sum insured. Waiting period is 9 months of continuous coverage. Newborn baby cover applies if the maternity claim is admissible. Voluntary termination of pregnancy in the first 12 weeks and miscarriage (unless caused by an accident) are not covered. Ectopic pregnancy is covered under regular hospitalisation, not the maternity limit.

Deductible options are available as optional choices, including ₹1 lakh, ₹2 lakh, ₹3 lakh and ₹5 lakh under the referenced prospectus. Availability and applicable terms depend on the selected policy option.