Ultimate Care in one table
| Insurer | Care Health Insurance Limited |
|---|---|
| Sum insured | ₹5 lakh to ₹1 crore, in tiers of 5 / 7 / 10 / 15 / 20 / 25 / 50 / 75 / 100 lakh, plus an Unlimited Sum Insured option |
Claim settlement and complaint figures are IRDAI-published and held centrally by NYVO, not taken from the insurer's marketing.
What Ultimate Care covers
These are the terms that decide what you are actually paid when you claim. Room rent, co-pay and restoration do more to shape a settlement than the sum insured does, and they are read from Care Health's own policy wording.
| Feature | This plan | What good looks like |
|---|---|---|
| Co-payment | None in the base plan. One only applies if you choose it to cut the premium, or if you take Smart Select and then treat outside its hospital list. | No Co-payment |
| Room Rent Limit | No cap – room rent and ICU are both payable up to the sum insured | No room rent capping |
| Disease sub-limit | None. In-patient care, day care and the listed advanced-technology methods are all payable up to the sum insured. | No sub-limit |
| Cumulative Bonus | 50% of the base sum insured added each year, to a ceiling of 100%. A claim has no effect on it, so it is a guaranteed bonus rather than a no-claim bonus. | 50% each year (Minimum upto 100%) |
| Loyalty Boost | An extra 100% of the sum insured after seven consecutive claim-free years, once in the life of the policy, with no fresh waiting period on it | Included |
| Restoration Benefit | Unlimited Automatic Recharge – refills the base sum insured without limit in a policy year, for the same illness as well as a different one. It applies from the second claim of the year onward. | 100% restoration once in a year |
| Pre-Hospitalization | 60 days, up to the sum insured | At least 60 days |
| Post-Hospitalization | 90 days, up to the sum insured | At least 120 days |
| Consumables | Not covered in the base plan. The paid Claim Shield benefit covers the non-payable items in Lists I to IV, up to the sum insured. | Consumables covered |
| Day-Care Procedures | All day care procedures, covered up to the sum insured | Covered without a capped list |
| Ambulance Cover | Up to the sum insured, and not limited to road – air, train or any other mode qualifies | Included |
| AYUSH Treatment | In-patient AYUSH treatment covered up to the sum insured | Included |
| Domiciliary Hospitalisation | Up to the sum insured, once treatment at home runs beyond three consecutive days | Included |
| Newborn waiting period | A baby added within 90 days of birth inherits the waiting periods already served on the policy. Added at 91 days or later, the clocks start afresh. | Included |
| Entry age | Adults from 18 with no upper limit · children 91 days to 24 years | No maximum entry age |
Ultimate Care add-ons you can buy with it
Each of these costs extra and each has its own conditions. Some are genuinely worth it; several exist to patch a gap in the base plan. Ask what each one adds before it goes on your quote.
Ultimate Care discounts you can ask for
Published discounts on this plan. Most are applied at quote stage rather than offered, so it is worth naming the ones you qualify for. Every figure is a ceiling, not a promise - what you actually get depends on the case.
| Discount | Worth | When it applies |
|---|---|---|
| Welcome discount | Up to 30% | For new buyers, tapering over the first three years – 30% in year one, 20% in year two, 10% in year three. |
| Tenure discount | Up to 7.5% to 15% | Applied year by year on a multi-year policy paid up front – 7.5% on year two, rising to 15% on year five. |
| Family discount | Up to 5% or 10% | On each member beyond the eldest, where everyone holds their own sum insured. 5% for two or three people, 10% for four or more. |
| Early Bird discount | Up to 10% | Buy before 36 and renew without a break, and from age 40 you get up to 10% off the renewal premium on the base cover you started with. Not available if you take the Premium Freeze benefit. |
| NRI discount | Up to 15% | For non-resident Indian policyholders. |
| Wellness renewal discount | Up to 30% | Through the paid Wellness Benefit, for logging 10,000 steps a day across 270 days of the year, or 8,000 steps if you are 60 or over. |
From the plan's own prospectus and brochure. Discounts multiply rather than add, and the total is capped at 45% of the premium.
Ultimate Care waiting periods: when each part of the cover starts
Waiting periods run from the day cover began, not from the day you fall ill, and they run in parallel rather than one after another.
| Initial Waiting Period | 30 days, shortenable by a paid option |
|---|---|
| Named Ailment | 24 months, shortenable by a paid option |
| Pre-Existing Disease | 36 months, or 1 to 2 years with the paid modification |
The named illnesses that wait 24 months
These wait 24 months from the start of your first policy, whether the condition was pre-existing or picked up later. An accident is covered from day one. This list is indicative – the wording carries all 14 entries, and the wait can be shortened by a paid option.
Ultimate Care exclusions: what the plan will not pay for
Every policy carries exclusions, and they are the clauses people read for the first time at claim stage. These are the ones worth knowing before you buy.
Where Ultimate Care falls short
No plan is right for everyone, and a page that only lists strengths is not much use to you. These are the gaps we would raise on a call before recommending it.
Ultimate Care questions, answered
Is the 100% yearly bonus part of the base plan?
No. The base plan gives you a 50% Cumulative Bonus each year, capped at 100% of the sum insured. The 100%-a-year uncapped version is Infinity Bonus, an optional benefit with its own premium. It is worth being clear about because our own page used to count it twice, and it changes the compounding materially – the base bonus doubles your cover and then stops, while Infinity Bonus keeps going.
How does the MoneyBack premium refund actually work?
It is the Premium Payback optional benefit. Go five consecutive policy years without a hospitalisation claim and the insurer refunds your first policy year's base premium, provided you renew. It repeats in every subsequent five-year block. Base premium means the premium for the base plan alone – optional benefits and GST are not refunded, so the cheque is smaller than a year's outgoing.
What is Loyalty Boost, and is it a paid extra?
Loyalty Boost is in the base plan. After seven consecutive claim-free years the insurer adds a further 100% of your sum insured to the cover, once in the lifetime of the policy, with no fresh waiting period applied to that additional amount. If you increased your sum insured along the way, the calculation uses the original amount you started with, not the current one.
Does the unlimited restoration apply from my first claim?
Not by default. Unlimited Automatic Recharge is a base benefit and refills the sum insured without limit, for the same illness as well as a different one, but the wording states it applies from the second claim made in the policy year. The Unlimited Automatic Recharge Booster is a paid option that brings it forward to the first claim. If you are choosing between add-ons, this one is easy to overlook and expensive to miss.
Does Instant Cover mean my pre-existing conditions are covered from day one?
No. Instant Cover waives the 36-month pre-existing disease wait on seven named conditions – diabetes, hypertension, high cholesterol, asthma, obesity, hypothyroidism and coronary artery disease where the PTCA was over a year ago – but cover begins on the 31st day of the policy, after the standard 30-day initial wait. It can only be taken on your first policy with the insurer and cannot be combined with the PED wait period modification.
What does the Unlimited Sum Insured option cover?
It removes the annual sum insured ceiling, but it is not compatible with everything else in the plan. The brochure notes that the cumulative bonus, unlimited automatic recharge, Loyalty Boost, Infinity Bonus, Unlimited Care and Tenure Multiplier do not apply alongside the Unlimited Sum Insured option, because each of those works by adding to a defined sum insured. Read your schedule carefully if this is the option you have been quoted.
Read it from the insurer
We summarise. The policy wording is the contract, and it is the only document that settles a dispute. These links go to the insurer's own pages.
Understand the terms before you commit
A plan page tells you what this policy does. These explain why each term matters and what it costs you when it is missing.
Other Care Health plans we have read
Care Health files these separately, and the terms differ between them. If you are choosing within the range, compare the waiting periods and the exclusions rather than the sum insured.