Care Joy Plan
96%
Claim Settlement Ratio
22,000+
Network Hospitals
5.5/10
Plan Rating
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Our Verdict
Expert Review: Care Joy
Final Verdict
About
What Is Joy?
Joy Ratings
Joy
Insurer Rating
7.51
out of 10
Insurance Rating
5.5
out of 10
No Room Rent Limit
Yes
Consumables Covered
No
No Co-payment
Yes
Loyalty Bonus >= 500%
No
No Disease Sublimits
Yes
Unlimited Restoration
No
Additional Benefits (Informational Only — Not part of score)
PED Waiting <= 2 Years
No
Maternity Available
Yes
Waiting Period Waiver
No
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Inclusions and Exclusions
Care Joy Inclusions and Exclusions
Modern Treatment
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.
ICU Charges
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.
Consumable Cover
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.
Cumulative Bonus
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.
Initial Waiting Period
30 days
PED Waiting Period
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.
Post-Hospitalisation
60 days after discharge. Expenses must relate to the same illness or injury and the main hospitalisation claim must be admissible.
Deductible Option
No deductible applies. This is a base indemnity plan, not a top-up.
Specific Waiting Period
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.
Annual Health Checkup
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.
Outpatient Department Cover (OPD Expense)
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.
Coverage Options
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.
Claim Settlement Ratio
96.74% for FY 2024-25 (insurer-level, based on IRDAI public disclosures). This reflects Care Health Insurance overall, not Care Joy specifically.
Maternity Cover
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.
Room Rent
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.
AYUSH Treatment
Not offered as a standard benefit. Treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, and other non-allopathic treatment, is excluded.
Pre-Hospitalisation
30 days before admission. Expenses must relate to the same illness or injury and the hospitalisation claim must be admissible.
Co-payment
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.
Cashless Healthcare Providers
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.
Daycare Treatment
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.
Disease-wise sublimits
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).
Restoration Benefit
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.
Exclusions
Expenses for hospital admission primarily for diagnostics are excluded.
Expenses for bed rest, custodial or palliative care excluded.
Surgery covered only under strict medical criteria and guidelines.
Expenses for any procedure to alter gender characteristics excluded.
Covered only for accident, burns, cancer, or medical necessity.
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About the company
About Care
Carе Hеalth offеrs a widе rangе of plans tailorеd for individuals, familiеs, sеnior citizеns, and corporatе groups. Each policy is thoughtfully dеsignеd to covеr hospitalization еxpеnsеs, surgеriеs, daycarе procеdurеs, and both prе- and post-hospitalization costs. Thе insurеr also providеs global covеragе options, wеllnеss-basеd bеnеfits, and top-up plans to еnhancе protеction basеd on spеcific hеalthcarе nееds.
FAQs
Frequently Asked Questions
This content has been reviewed by Aman Shetty, Senior Insurance Advisor | BQP code: 33905
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