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Are you struggling to find health insurance due to pre-existing conditions like diabetes, obesity, or hypertension? Care Freedom by Care Health Insurance offers a tailored solution for individuals with these severe health issues. In this blog, we’ll explore the key features, pros, cons, and eligibility of the Care Freedom plan to help you decide if it’s the right choice for you.

What is Care Freedom Health Insurance?

Care Freedom is a specialized health insurance plan designed for people with lifestyle conditions such as diabetes, high blood pressure, or obesity. Unlike standard plans, it provides coverage even if other insurers have declined your application due to medical reasons. However, it comes with a mandatory copayment and certain sub-limits, making it a unique option for those with severe health challenges.

Key Features of Care Freedom Health Insurance

• Coverage for Pre-Existing Conditions: Covers severe conditions like diabetes, obesity, and hypertension after a waiting period of just 2 years.

• Inpatient Hospitalization: Covers hospital stays up to the sum insured, with a mandatory copay of 20% or 30% based on your entry age.

• Pre- and Post-Hospitalization Expenses: Covers expenses 60 days before and 180 days after hospitalization, up to 7.5% and 10% of payable hospital expenses, respectively.

• Daycare Treatments: Includes all daycare procedures (less than 24 hours of hospitalization) without sub-limits.

• Alternative Medicine (AYUSH): Covers treatments like Ayurveda or Homeopathy with applicable copays or sub-limits.

• Non-Medical Expenses: Includes consumables with a daily upper limit.

• Free Annual Health Check-Up: Available for all members.

• Restoration Benefit: Restores 100% of the sum insured once per policy year if exhausted.

• Ambulance Cover: Provides Rs. 1,000 per hospitalization.

• Domiciliary Hospitalization: Covers at-home hospitalization for at least 3 consecutive days under medical supervision.

Pros of Care Freedom Health Insurance

• Ideal for individuals with severe conditions who are often denied coverage elsewhere.

• Short 2-year waiting period for pre-existing conditions.

• Comprehensive pre- and post-hospitalization coverage.

• Includes non-medical items and a free annual health check-up for all members.

• Affordable compared to other health insurance plans.

Cons to Consider

• Mandatory Copayment: Requires a 20% or 30% copay depending on your age at entry.

• Room Rent Limits: Restricted to twin-sharing or single private rooms based on the sum insured.

• Sub-Limits on Treatments: Includes caps on major illnesses like cardiovascular disorders and procedures like cataracts.

• High Volume of Complaints: Reports 39 complaints per 10,000 claims (FY 2023-24), indicating potential claim settlement challenges.

Who is Eligible for Care Freedom?

• Entry Age: 90 days to 24 years for dependent children; 18 years and above for adults.

• Coverage Types: Available as individual or family floater plans (up to 6 members).

• Sum Insured Options: Ranges from Rs. 3 Lakh to Rs. 10 Lakh.

• Policy Tenure: Choose from 1, 2, or 3 years with annual premium payments.

Care Freedom Insurer Metrics (FY 2023-24)

• Claim Settlement Ratio (CSR): 92.61% by number of policies and 86.31% by amount settled (based on 37 claims data).

• Incurred Claim Ratio (ICR): 58.00% (based on 20 data points).

• Volume of Complaints: 39 per 10,000 claims (based on 45 data points).

Care Health Insurance, the provider of Care Freedom, is a prominent player in India’s health insurance market. With a turnover of Rs. 7,022 Crore in FY24 and a network of over 11,400 hospitals, it’s a reliable choice for many.

Why Choose Care Freedom for Diabetes, Obesity, or Hypertension?

If you’ve been denied insurance due to pre-existing conditions, Care Freedom offers a lifeline. Its short waiting period, coverage for alternative treatments, and comprehensive hospitalization benefits make it a strong option. However, be prepared for copayments and sub-limits, which may increase out-of-pocket costs.

Exclusions to Understand

• Waiting Periods: 30 days initial waiting period (except accidents), 24 months for pre-existing diseases and special access conditions.

• Medical Exclusions: Cosmetic surgeries, unproven treatments, OPD, dental treatments, and maternity-related expenses.

• Non-Medical Exclusions: Self-injury, substance abuse, treatments outside a practitioner’s discipline, and injuries from hazardous sports.

Is Care Freedom Right for You?

Care Freedom is best for individuals with diabetes, obesity, or hypertension who need affordable coverage despite pre-existing conditions. If you’re comfortable with copayments and room rent limits, this plan can provide essential financial protection. Be sure to review the policy document for sub-limits on specific treatments.