Care Joy vs Care Super Mediclaim

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.

Room eligibility depends on the sum insured and applicable variant. The official overview lists a single private room for certain sum insured levels and all room categories for higher eligible sum insured levels. Check the current policy schedule for the precise entitlement.

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.

ICU expenses are covered subject to the sum insured and applicable policy terms. The official product overview lists ICU charges without a separate limit for the displayed variants.

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.

A co-payment option may be available, and the applicable percentage depends on the policy selected. Check the current policy schedule for any mandatory or optional co-payment.

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).

Variant-specific conditions, procedures and benefits may have limits. Critical Mediclaim covers specified critical illnesses, Cancer Mediclaim covers eligible cancer-related treatment, Heart Mediclaim covers specified heart conditions, and Operation Mediclaim covers defined surgical procedures.

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.

Cashless treatment is available at eligible network hospitals, subject to network status, pre-authorisation and policy conditions. The network may change over time.

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.

Automatic recharge may be available as an optional benefit under applicable product versions. It should not be described as a standard or unlimited benefit unless confirmed in the current policy schedule.

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.

No-claim bonus can increase the sum insured by up to 100% over three consecutive claim-free policy years, subject to the applicable variant’s bonus schedule and claim conditions.

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.

Eligible daycare procedures are covered up to the applicable sum insured, subject to the variant’s covered-procedure list and policy terms.

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.

Separate comprehensive coverage for non-medical consumables is not established as a standard benefit in the reviewed product overview. Eligible hospital expenses remain subject to policy terms.

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

Eligible AYUSH treatment is covered under applicable variants and policy conditions. The historical brochure identifies variant-specific restrictions, including limits for certain treatments.

30 days

Generally 30 days for illnesses from policy inception, except eligible claims arising from accidents, subject to 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.

A 24-month waiting period applies to specified illnesses or procedures where listed in the applicable policy wording. The applicable list depends on the variant.

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.

The historical product information lists a 36-month waiting period for pre-existing diseases. Any available reduction option and the applicable current waiting period must be checked against the selected policy version.

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.

Coverage depends on the selected variant and applicable policy terms. Refer to the current variant wording for the eligible advanced procedures and limits.

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.

Annual health check-ups are available from the second policy year after continuous coverage, subject to the applicable policy conditions.

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

Eligible medical expenses incurred during the 30 days immediately before hospitalisation are covered, subject to policy terms.

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

Eligible post-hospitalisation medical expenses are covered for up to 60 days after discharge, subject to the policy terms and claim admissibility.

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 benefits may be available for eligible covered conditions under the applicable variant and policy limits. Under the historical product information, OPD expenses are linked to an admissible hospitalisation claim for the same illness.

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

A deductible option may be available to reduce the premium. Availability, deductible amount and application conditions depend on the selected variant and policy schedule.

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.

Available variants include Critical Mediclaim for specified critical illnesses, Cancer Mediclaim for cancer, Heart Mediclaim for specified heart-related conditions and Operation Mediclaim for defined surgical procedures.

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

Use Care Health Insurance’s insurer-level claim settlement ratio for the relevant financial year. Do not represent it as a product-specific ratio or a guarantee of claim approval.

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.

Maternity cover is not identified as a standard benefit in the reviewed Super Mediclaim product overview.