Outpatient Care vs Health Edge Policy Health Insurance Plan 2026 | PolicyX

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Most health insurance plans inadequately cover OPD (Out-Patient Department) expenses for an insurance holder. However, Star Outpatient Care is a unique plan designed to help policyholders with these expenses. The Star Outpatient Care Insurance Policy provides financial support for outpatient medical expenses such as doctor consultations, diagnostics, and pharmacy bills.

While health insurance plans largely cover hospitalization expenses, they often fall short in providing satisfactory OPD coverage. OPD expenses include doctor visits, consultations at clinics or hospitals, or any medical facility for diagnosis as advised by your doctor. When not covered by health insurance, such expenses can put a financial strain on your savings. Over 50% of medical expenses incurred by policyholders in India are OPD expenses. Star Outpatient Care is a unique health insurance plan that considers all such expenses and covers OPD costs for an insured individual when needed.

Star Outpatient Care is available in three variants: Silver, Gold, and Platinum. It offers different sum insured options ranging from INR 25,000 to INR 1 Lakh, along with varying benefits. The Star Outpatient Care Insurance Policy covers individuals for a tenure of one year and can be availed by individuals between 18 and 50 years of age.

PLAN DETAILS

Outpatient Care

Health Edge Policy

Product Type Individual and Family Health Insurance Individual and Family Health Insurance
Key Features
(Key features of the plan)
  • Plan Variants Available
  • Dental & Ophthalmic Treatment
  • Lifelong Renewal Benefit
  • Avail Global Treatment
  • Multiple Discounts
  • 18 Optional Covers
OPD Details
(In some policies, OPD (Out patient department) expenses are also covered.)
Covered Covered
Room Rent
(A limit of room rent cover during hospitalization if any)
Not Covered Covered
Domicillary Hospitalization
(It is the expenses incurred on treatment of the patient at home)
Not Covered Not Covered
Pre-hospitalization
(Expenses before the insured is hospitalized)
Not Covered Covered
Post-hospitalization
(Expenses after discharge from the hospital)
Not Covered Covered
Day Care Treatment Covered
(Day care treatments refers to the treatments that do not necessarily require 24hrs of hospitalization like MRI.)
Not Covered Covered
Hospital_network
(Number of Hospital Network in city)
14000 6000
Organ Donor Expenses
(Expenses incurred on organ donor in case of organ transplants)
Not Covered Not Covered
Hospital Daily Allowance
(Some plans offer daily allowance to take care of expenses like food, etc)
Not Covered Covered
Ambulance Charges
(Expenses incurred on ambulance charges)
Not Covered Covered
Maternity Benefits
(All Hospitalization cost covered at the time of pregnancy.)
Not Covered Covered
New Born Baby Covered
(Newborn babies can be covered under the insurance plan after a certain period)
Not Covered Not Covered
Health Checkup
(An added benefit of one time full health checkup of policy holder.)
Not Covered Covered
Sub Limit
(Sub-limit is a monetary capping that applies on specific diseases like cataract)
Not Applicable Not Covered
Co-pay
(Mentioned %, if any is to be borne by Insured and rest will be borne by insurer)
Not Applicable Covered
Plan Entry Age 31 Days to 50 years 18 to 65 Years
Plan Premium Entry Age and S/A 7865 6305
Plan Waiting Period 30 30
Plan Coverage - Individual/Family Floater
Plan Sample Premium - 6305
Plan Brochure Brochure URL Brochure URL
Policy Term upto 3 years 1/2/3 year
ICU Charges Not Covered Covered
Covid-19 Treatment Not Covered Covered
Cataract Not Covered Covered
Automatic Restoration Not Covered Covered
Ayush Treatment Covered Covered
Modern Treatment Not Covered Covered
E Consultation Not Covered Covered
Air Ambulance Not Covered Not Covered
Global Coverage Not Covered Covered
Claim Ratio 99.06 -
Solvency Ratio 2.21 2.03
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