Star Health Insurance

Star health insurance is India’s first standalone health insurance company, starting its operations in 2006 have flourished like a palm tree in less time. Star Health and Allied Insurance Company Ltd. specialize in providing health insurance at low-cost rates to its customers, especially Health Insurance, Overseas Mediclaim Policy, and Personal Accident. The insurer has more than 8800 plus hospitals offering cashless payment facility, with more than 340 plus branches across the globe.

Star Health is immensely popular through its affordable and relatively cheaper health insurance plans in comparison with other company's plan.

Star Health Insurance offers excellent plans that give extended coverage to all the medical costs of individuals, family, children, senior citizens, and parents.

All the expenses of hospitalization, health check-ups, medical tests, ambulance, a second opinion from an expert, critical illness treatment, treatment at home, organ transplantation, ayurvedic treatment, diabetes cover, etc. are duly covered in the majority of Star Health Insurance plans.

Highlights of Star Health Insurance

Why to Buy Star Health Insurance?

• Incurred Claim Ratio: The Incurred Claim ratio of a company determines the percentage of claims accepted and paid. The ratio should be between 60% to 100% as guided by the IRDA. When we talk about Incurred Claim settlement ratio of Star Health Insurance stands at 60.4%
• Customer Satisfaction Ratio: The customer plays an integral role in the development of the company, which why priorItizing them is of prime importance. On the other hand, Star Health insurance with an army of satisfied customers has paid Rs 2552.30 crores for the claim settlement. Also, 90% of cashless claims are attended and cleared within a time gap of 2 hours.
• Quick and Smooth Claim Service: Star Health has established a breathtaking record of claim settlement where it settled 6,34,692 claims very smoothly and without any obstruction for the current financial year. This shows how much Star Health insurance customer care is persevered in providing fast solutions and thus ensuring customer satisfaction.
• Award Titles Earned: Starting from the current list of awards bagged by the Star Health in health insurance category are Health Insurance Provider of the Year – Silver Award, Best Health Insurance Provider of the year 2018-19 by Business Today, Health Insurance Company of the Year 2017 by Finteleket and many more to roll down.
• Cashless Treatment Facility: When the insured meet any accident or illness for which he/she needs immediate medical attention through hospitalization, then this facility becomes active. Star Health Insurance completely bears all the expenses flowing out of hospitalization.
• 8,800+ Network Hospitals All over India: Star Health has the largest network of hospitals in contrast to the other health insurance players in the market. A policyholder can avail any of the nearest local hospitals for the cashless hospitalization for any illness, or accident on the permission of Star Health insurance.
• Lifelong Renewals: Policyholder is provided with the option to renew the existing policy along with carrying all the benefit earned in the previous policy year. Star Health Insurance gives you the flexibility to renew the policy online with convenience and lesser efforts.
• Specialized Coverage for Parents and Children: The health insurance plans introduced by the Star Health brings complete coverage plan exclusively for senior citizens or parents and children that covers diseases and medical expenses related to them.
• Discounts and Rewards on Renewal: When a policyholder applies for the renewal on the passing of one or two or third policy as per the policy term is chosen, he/ she will get discounts or bonuses.
• Online Facility: Star Health insurance promotes the usage of electronic form for the convenience of customers and to enhance the customer experience in the claim settlement. Where is this facility useful? This facility can be utilized to raise a query about the claim procedure and the benefits earned in a policy, knowing the claim status, submitting the claim online, renewal of the policy, online filling of the form, expert advice, etc.

Types of Star Health Insurance Plans

Star Health Insurance offers a variety of plans for the family as well as individuals. Some plans have wide range of sum insured like Senior Citizens Red Carpet, Family Health optima (Rs 3 lakhs to Rs 25 lakhs) etc.

While sum insured available under some plans is limited to one definite amount i.e. Star Care Micro for Rs 1 lakhs and Star Special Care for Rs 3 lakhs.

List of plans by Star Health Insurance:

Star Comprehensive Insurance Policy

The most popular health insurance plan introduced by the Star Health, which is the topmost choice of customers due to the high amount of coverage with affordable premium rates.

What medical benefits are given?

• Room charges, boarding expenses, nursing expenses in which a maximum coverage Rs 5,000/- per day for 3/4 lakhs of the sum insured and single private A/C room for sum insured more than 5 lakhs.
• Cost coming through availing services by surgeon, anesthetist, medical practitioner, consultants.
• Expenses using medical facilities such as anesthesia, blood, oxygen, operation theatre charges, pacemaker, medicine, and drugs etc.
• Ambulance service in case the insured need immediate transportation to a nearby hospital. A maximum of Rs 750 is given per hospitalization.
• Pre and Post-hospitalization expenses for which insured spend a considerable amount of money are covered up to a certain limit.
• Air Ambulance facility available on the chosen sum insured and can be used up to 10% of sum insured.
• Ayush treatment
• Second Medical Opinion for those insured who are uncertain about the diagnosis results of a particular disease and desire to get professional advice for clear the suspicion.
• Donor expenses for organ transplantation where the insured is equipped with the organ and 10% of the sum insured can be used for the organ extraction from the donor’s body.
• Domiciliary hospitalization which is operated in home only if the treatment is carried for more than 3 days.
• Assisted Reproduction Treatment

Family Health Optima Insurance Plan

Star Family Health Optima Plan that satisfies the healthcare needs of the individuals and family through compensation of the medical expenses arising out of surgeries/treatments/diagnosis tests, health check-ups, etc.

What medical costs and advantages it covers?

• Automatic refill of the sum insured if the insured have consumed the whole amount of sum insured through continuous claims. The refill can be raised up to 3 times by 100% each time.
• Additional Sum Insured for Road Traffic Accident (RTA) that caused wreckage to body parts and made the insured admitted to a hospital. A maximum of Rs 5 lakhs is allowed from the sum insured.
• In-Patient hospitalization for a disease or accident which need immediate treatment in a hospital under the regulation of medical practitioner which involves major expenses anesthesia, Blood, anesthetist, Medical Practitioner, Consultants and Specialist Fees, Surgeon fee, Oxygen, Operation Theatre charges, Pharmaceuticals.
• Air Ambulance Cover which is a transport service equipped with all the medical facilities and are offered if there is no availability of hospital nearby. Insured can claim up to 10% of the basic sum insured per year and applicable to Rs. 5 Lakhs of sum Insured.
• Pre and Post-hospitalization expenses are duly given certain limit and fixed days as depicted in the policy terms and conditions.
• Newborn Baby expenses like daily nutrition, vaccinations, medication, etc are covered up to Rs 50,000 or 10% of the sum insured, and the coverage will start from the 16th day after the birth is taken.
• Emergency Domestic Medical Evacuation is a feature that helps in transportation of insured from the hospital where treatment is taken currently to the hospital, which is recommended by the medical professional.
• Return of Mortal Remains where Rs 5,000 is given towards compensating the cost of return concerning the insured and delivery of same to the home of insured. The cost will include the cost of embalming, coffin charges, etc.
• During an emergency, the insured can avail treatment in preferred network hospitals as advocated by Star Health. There will be lump sum payment of 1% of the sum insured where the amount should not cross Rs 5,000 per policy year.
• Shared accommodation for any kind of treatment during in-patient hospitalization.
• Donor Expenses for Organ Transplantation as advice to the insured person by a medical expert.
• Health check-up cost is covered up to Rs 3,500 maximum for the highest sum insured. The health check-up cost is common to every individuals and may happen more than once in a year.
• Assisted reproduction treatment for the cases of subfertility and the maximum amount paid is Rs 1 lakh for sum Insured of Rs 5 lakhs and Rs 2 lakhs for sum insured of Rs 10 lakhs or above.
• AYUSH treatment where the treatment is related to Ayurveda, Unani, Siddha, and Homeopathy can be taken. The organization from where treatment is operated must be licensed under the Quality Council of India/National Accreditation Board on Health.
• Domiciliary hospitalization if the treatment is operated at home due to deficiency of bed or the medical condition of the insured is feeble.
• No medical examination is required for the policyholder below 50 years before the purchase of the policy.

Medi Classic Insurance Policy (individuals)

This plan helps to fix the health-related issues of individuals and family members under affordable cost. The motive behind this plan keeps your savings untouched by delivering timely coverage during emergencies treatment of any illness or accidents.

What medical costs and advantages it covers?

• All the expenses covered under the in-patient hospitalization are duly paid on passing the information of the same to the company. Expenses such as pharmacy bills, consultation fee, surgeon fee, doctor’s fees, blood, rooms service charges, nursing, operation theatre cost, etc. will get 1% of the sum insured on the happening of any of these incidents.
• Emergency ambulance facility for each hospitalization upto Rs 1500 per policy term.
• Non-allopathic treatment where the insured is subject to receive 25% of the sum insured chosen and the hospital from where treatment is taken must be under the regulation by government.
• Gradual restoration of the sum insured by 200% if all the benefits plus the sum insured have been utilized towards the claim settlement. For example, if you have opted for Rs 5 lakhs of the sum insured which is wholly consumed with benefits, then 200% of Rs 5 lakhs i.e. 10 lakhs will be paid.
• A cumulative bonus equal to 25% of the sum insured is credited to the benefit pool of Star Health Medi Classic plan. The bonus is given only when no claim is exercised by the insured in a policy year of health insurance.
• 101 daycare treatments that can be corrected within 24 hours by a medical professional.
• Coverage for family members of any age from a child of 91 days to an adult of 65 years. Parents can include their dependent child who does not earn and up to an age of 25 years.
• Saves your yearly tax payment on the annual salary and provides relief heavy tax payment.
• Out-patient treatment at any network hospitals, and if this facility is not availed during the policy year, the balance is carried forward on the upcoming renewal.

Senior Citizens Red Carpet Health Insurance Policy

Star Health Senior Citizens Red Carpet cater to the senior citizens or the parents who are retired and want to secure their lives from daily health expenditures.

What medical costs and advantages it covers?

• Lifelong renewals until the age of maturity arrives.
• All kinds of daycare procedures are covered that are treated without any long duration of hospitalization.
• Covers in-patient hospitalization expenses which last for more than 24 hours for particular illness listed by the company for coverage.
• Coverage for pre-existing diseases that are present in the insured’s body before the policy purchase.
• A discount of 10% is allowed on the premium if the medical test report of the policyholder is submitted like Stress Thallium Report, Sugar (blood and urine), creatinine, Blood urea and BP Report, etc. However, Star Health Insurance does not mandate these medical tests.
• Pre-hospitalization expenses because of an illness for a time period of 30 days before the insured acceptance in the hospital for treatment.
• Post-hospitalization expenses after the treatment of illness and which is recommended by the doctor. The expenses duly accepted by the Star Health Insurance are surgeon/consultant fees, medicines, nursing charges, and drugs expenses, diagnostic charges. A total sum of Rs 5,000 to 10,000 based on the sum insured chosen is given for expenses incurred.
• Emergency ambulance service to the network or non-network hospital will be given to the insured for quick and comfortable arrival to the hospital for emergency treatment. Maximum coverage of Rs 3,000 is given in a policy period. The minimum is Rs 1,200 per policy period. The coverage will be in accordance with the sum insured chosen.
• 50% of the sum insured is guaranteed for the payment of expenses such as, cost of pacemaker, blood, oxygen, operation theatre charges, anesthesia etc.
• 25% of the sum insured is provided towards the payment of specialist's fees, anesthetist, medical practitioner, consultants, and surgeon.
• Out-patient consultation for any minor illness in any network hospitals from a doctor where Rs 200 is given for each consultation. The consultation limit per person per policy year will depend upon the coverage amount opted and the kind of cover chosen i.e. individuals basis policies and family floater policies.
• Cost Health check-ups for the sum insured of Rs 5 lakhs or more. The coverage provided for the same will be between Rs 1,000 to 2,500 per policy year under individuals basis. For floater basis policies, the minimum and the maximum coverage allowed is Rs 3,500 to 4,500 for sum assured more than or equal to Rs 10 lakhs.

Star Super Surplus (Floater) Insurance Policy

A Star Health Plan that provides security from many diseases while covering all your daily medical costs that can slowly drain your savings if timely attention is not given. Once you buy this health insurance plan, you will feel worried and will save a lot in tax payments and medical costs.

Star Super Surplus is divided into two variants such as

• Silver Plan: consultant’s fee, Covers pre and Post-hospitalization, boarding and nursing expenses, pre-existing diseases, surgeon’s, room, etc.
• Gold Plan: Covers all the medical cost mentioned under the silver plan plus delivery expenses, organ donor expenses, emergency ambulance charges, air ambulance, recharge benefit, medical second opinion, etc. The details of each Star Health plan benefit is specified in the below section, kindly refer for further consideration.

What medical costs and advantages it covers?

Benefits under Silver Plan:

• Room rent, boarding, nursing expenses subject to a maximum of Rs. 4,000 per day under in-patient hospitalization.
• anesthetist and specialist's fees, Surgeons fees, consultant's fees for the same illness for which the hospitalization has been necessitated.
• Expenses like cost of pacemakers, blood, oxygen, operation theatre charges,anesthesia, drugs and other related expenses are covered and dedicated some percentage of sum assured for settlement as mentioned in the policy schedule.
• Pre-hospitalization medical expenses upto 30 days that may arise before the insured go for the in-patient treatment of an illness/ ailment.
• Post-hospitalization that is covered upto 60 days following the release from the hospital after the treatment is carried out and the patient is in sound condition to move out of the custody of the hospital.
• Treatment of cataract and diseases related to replacement of bones, cysts, thyroid diseases, diseases of ent, biliary diseases, hernia, diseases related to female sexual organs, eyes chambers, etc. are covered under this star health insurance plan and the policyholder has to wait for 24 months to get coverage.

Benefits under Gold Plan:

• All the expenses pointed above are duly covered along with some additional benefits that distinguish it from the Silver Plan.
• Emergency ambulance charges up to Rs 3000 per hospitalization for transporting the insured patient to the hospital
• Air Ambulance facility covered up to 10% of the sum insured each policy period where the sum insured amount purchased should be Rs 10 lakhs and over it.
• Medical Second Opinion for specific diseases that are covered under the plan and which requires the second consultation from a professional doctor specialized in the evaluation and treatment of that particular diseases. The doctors from the second opinion can be taken must be selected from the company's portal of medical practitioners.
• Delivery expenses including Caesarean section Delivery (including prenatal, post-natal expenses and lawful medical termination of pregnancy) and up to Rs 50,000 is given per policy period. The maximum number of 2 deliveries are covered.
• Organ donation expenses may arise for organ transplantation in which the insured is availing the organ transplantation and expenses that are occurred during the process of extraction and equipment of organ in the insured body. Also, take note that donor screening expenses and post-donation complications of donors are not included in the coverage.
• Recharge of sum insured for the lost and completely consumed coverage amount. The recharge will be according to a certain limit for the rest of the policy period as interpreted in the table. The increased sum insured can be used for the same illness or different illness/accident during the policy term.
• Waiver of deductibles which will cut the cost-sharing for the payment of a fraction of claim amount by the insured. This is applicable only after the completion of 6 policy years and the policyholder has to opt for it.

Star Health Gain Insurance Policy

A kind of health insurance that fulfills the health demands of both individuals and families of different ages with different medical necessities.

What medical costs and advantages it covers?

• Ambulance charges up to Rs 750 per hospitalization and Rs 1500 per policy period.
• Pre-hospitalization expenses that are bound to occur before the actual hospitalization for any listed illness and are covered up to 30 days ending on the arrival date of admission to hospital.
• Post-hospitalization expense cover that is necessary for further recovery of diseases for which in-patient hospitalization is availed. This cover is valid for up to 60 days, starting from the date of discharge.
• Daycare procedures expenses for certain disease that does not require more than 24 hours of doctor supervision. Some of the diseases mentioned under the plan are eye problems, gynecology operations, neurology related illness, oncology related problems, operations on skin, tongue operations, orthopedics surgeries, etc.
• Special coverage for treatment of Cataract where the maximum limit of coverage amount is according to the sum insured chosen.

• Sum insured	Coverage per policy period
  Rs 1/2 lakhs	Rs 12,000
  Rs 3 lakhs	Rs 35,000
  Rs 4 lakhs	Rs 45,000
  Rs 5 lakhs	Rs 60,000

• operation theatre charges, anesthesia, anesthetist, medical practitioner, consultants, specialist fees, blood, oxygen, diagnostic materials, cost of medicines, Surgeon, cost of pacemaker, drugs that constituted in-patient hospitalization costs and covered up to a certain limit.
• Expenses like room rent charges, boarding, nursing expenses are covered and given a coverage equal to 1% of the sum insured.
• Out-Patient treatment that covers the expenses incurred for availing treatment from any specialized doctor from any networked facility present all over India.

Star Care Micro Insurance Policy

Micro health insurance that covers all your hospitalization expenses under one sum assured and one premium rate throughout the policy term. In this star health plan, the premium will change according to the members included and the age of the insured members. The plan is applicable for both individuals and family floater policies.

What medical costs and advantages it covers?

• One sum insured of Rs 1 lakh and the cost of the premium is highly affordable.
• Pre-hospitalization expenses up to 30 days prior to the reception of the insured person to the network hospital for cure of any illness/ ailments/ accident.
• Post-hospitalization up to 60 days applicable from the date of dispensation from the treating hospital. The insured will receive 7% of the hospitalization expenses (exclusive of room charges) but total payout should not exceed Rs 3,000 in a policy period. The treatment for which hospitalization becomes mandatory should be for a period of more than 24 hours.
• 405 daycare treatments are covered and is allowed a settlement of treatment amount after claim is raised.
• Cost of medicines and drugs recommended for the cure of the illness.
• Emergency ambulance charges for quick and easy transportation of the insured to the hospital for immediate medical assistance of a doctor. The insured will get Rs 500 per hospitalization whereas the total limit of Rs 1000, which can be availed during a policy period.
• Hospital cash for hospitalization in any of the government hospital and will be paid for a maximum of 14 days. The cash amount equal Rs 1000 is provided on a daily basis to the insured up to specific limits.
• Higher coverage for ICU charges upto Rs 2,000 per hospitalization and a maximum of Rs 10,000 for each policy period.
• boarding, Room, nursing expenses provided as 0.75% of the sum insured purchased. The coverage is available in both private room or shared accommodation, as selected.
• cost of pacemaker, blood, Surgeon, consultants and specialist fees, anesthesia, anesthetist, oxygen, operation theatre charges,medical practitioner, etc are compensated with regard to the defined limit by the company.
• Treatment for special diseases which includes Medical Management of major illnesses medical administration of any other illness, cataract, serious injuries caused by accidents, major surgeries, and other surgeries. A coverage floating between Rs 7,500 to Rs 40,000 is given on happening of any of the illnesses.
• No pre-policy medical examination and policyholder can feel relaxed from incurring cost over a variety of medical tests.
• Pre-existing disease coverage where the insured has to comply with the waiting period as framed by Star Health Insurance.

Star Family Delite Insurance Policy (Available On Family Floater Basis)

This plan is only available on a family floater basis where you can include your spouse and dependent children under the coverage. Star Family Delite is perhaps the best family health insurance plan whose purpose is to take care of the medical needs of various family sizes.

What medical costs and advantages it covers?

• Ambulance charges cover in case of emergency transfer to the network hospital and which are paid according to some limit.
• Pre-Hospitalization cost occurring prior to entry in the hospitals located nearby and will be covered up to 30 days. Insured is liable to show all the expenses through documents properly organized with signatures and dates of the events occurred.
• Post-hospitalization cost paid by Star Health as 7% of the gross hospitalization expense excluding room rent. The maximum coverage limit appointed for the payment of this cost is Rs 5000 and will be covered up to 60 days after the discharge of insured.
• Daycare Procedures are covered like cardiac diseases /ailments, cataract, dental surgery, tonsillectomy, infectious diseases, radiotherapy, serious accidental injuries, joint replacement, etc. are covered.
• Payment of coverage for daycare treatment will be from Rs 4500 to Rs 1,25,000 for sum insured of Rs 3 lakhs and for sum insured of Rs Rs 2 lakhs, the coverage limit is between Rs 3000 to Rs 1,10,000 per policy period.
• Expenses such as:
• 1. blood, oxygen, cost of pacemakers, Anesthesia.
  2. Operation theatre charges, ICU charges (up to 1.5% of sum insured).
  3. Medicines and drugs.
  4. Fees of surgeons, consultant, anesthetist, and specialist.
  5. boarding, Room rent, nursing expenses are provided 1% of sum insured.
• One sum insured for whole of the family where you don’t have to pay higher premiums for including each family member as there will be one premium for all the members.
• Emergency ambulance facility for the evacuation of the insured person to the hospital who may have suffered accidental injuries or any minor/ major illness. The maximum limit of Rs 1500 is reserved for this benefit from the sum insured where Rs 750 is given for each hospitalization.

Star Criticare Plus Insurance Policy

A health plan that comes with special coverage for critical illnesses/diseases that are injurious to health. There is no maturity age or exit age in the plan and is subject to regular renewals.

What medical costs and advantages it covers?

• Includes room rent allowances, boarding and nursing expenses in which 2% of the sum insured, and the maximum amount in rupees is equal to Rs 4,000 per day is covered.
• Fees for availing the services of a surgeon, consultant, anesthetist, and specialist.
• Cost of medicines and drugs to recover quickly from an illness.
• Emergency ambulance cost covered up to Rs 750 per hospitalization, where the gross limit for a policy period is Rs 1,500 for transferring the insured patient to the hospital.
• Non-allopathic treatment covered up to 25% of the sum insured, and the maximum limit for a policy period is Rs 25,000. The treatment uses conventional methods that still exist and give amazing results.
• Pre-hospitalization medical expenses applicable for 30 days before the actual hospitalization occurs.
• Post-hospitalization expenses where amount equal to 7% of the expenses (excluding room charges) is calculated on a lump sum basis and is given to the insured. The maximum coverage payable is Rs 5000 per hospitalization.
• The policyholder has the option to include family members and can avail 5% discount for adding up to 2 members. Also, 10% discount will be given if more than two members are involved in Star Criticare Plus plan.
• The major diseases are covered, such as:
• 1. The first investigation of cancer, chronic kidney disease, brain tumor.
  2. Major organ transplant for the first time.
  3. Cerebrovascular stroke causing hemiplegia.
  4. Acute Myocardial Infarction resulting in left ventricular ejection fraction of more than 25%.
  5. Established irreversible coma.
  6. Irreversible Paraplegia.
  7. Irreversible Quadriplegia.

Diabetes Safe Insurance Policy

A diabetes centric health insurance plan that gives financial support to the person who is suffering from Type I or Type II Diabetes Mellitus, which can cause dangerous effects on the body of a policyholder.

Star Health Diabetes Safe Plan Comes In Two Different Plans:

• Plan A: Under this health plan, the insured will get coverage for diabetes from the first day of the policy without a long waiting period. Als, there is no need to appear for medical examination to become eligible to purchase the health insurance policy.
• Plan B: This plan involves a waiting period of 12 months, where insured infected with diabetes has to wait for availing the treatment at a network hospital. This plan mandates the requirement for a pre-policy check-up before moving a step ahead to buy the policy.

What medical costs and advantages it covers?

• Treatment expenses arising due to hospitalization solely for diabetes at network hospitals.
• Hospitalization Expenses arising due to accident or any other specified diseases which is not related to diabetes.
• Complete recovery of the lost basic sum insured where amount analogous to 100% of the sum insured is given to the policyholder keep the health insurance active.
• In-patient hospitalization costs for diabetes, non-diabetic diseases, and accidents that cover:
• 1. Room (single standard a/c room), boarding and nursing charge during the stay in hospital
  2. Surgeon’s fees, consultant’s fees, or anesthetist’s fee for treatment of the disease.
  3. oxygen, diagnostic expense, Cost of blood and all other treatment material that are extremely required for completion of treatment.
  4. drugs, or pharmacy bills, Expenses of medicines are covered.
• All daycare procedures covered as there are no limitations on the number of daycare treatments that can be availed during a policy term.
• Emergency Ambulance charges equivalent to Rs 2000 each policy period to help the insured person at the time of immediate hospitalization.
• Pre-hospitalization expenses not exceeding the time of 30 days ending on the date of hospitalization.
• Post-hospitalization up to 60 days after discharge letter has been granted by the treating hospital. The total payout is equal to 7% of the hospitalization expenses or a maximum of Rs 5000 per hospitalization, whichever is lower.
• Expenses included only for diabetes:
• 1. Donor expenses for kidney transplantation surgery where expenses associated in-patient treatment of organ donors are included.
  2. Dialysis expenses of Rs 1000 per sitting payable up to 24 months, commencing from the month in which the need for dialysis is recommended, provided policy is in force.
  3. Cost of equipping artificial limbs that are devastated due to dismemberment. A coverage of 10% of the sum insured, and the claim has been accepted by Star Health Insurance.
  4. Expenses forming out of cardiovascular disease, renal illness, diseases of the eye (excluding cataract), foot ulcer, diabetic peripheral vascular diseases and other complications of diabetes are duly covered and paid on making a claim.
• Out-patient expenses where the facility is availed at any networked institution.
• Expenses of fasting/post-prandial and HbA1C tests taken for one time every six months. The maximum amount can be claimed is Rs 750 per event and Rs 1500 for each policy period.
• Other expenses like medical consultation, other diagnostics, medicines, and drugs up to the limits given below per policy period.

Star Cardiac Care Insurance Policy

Star Health Cardiac Care offers two pan option through which coverage is offered:

• Gold Plan: Covers cardiac ailments, accidental injuries, and noncardiac ailments. The cover is available for surgical intervention and medical management.
• Silver Plan: Covers cardiac ailments, accidental injuries, and noncardiac ailments. The cover is available for surgical intervention.

What medical costs and advantages it covers?

• A person who has undergone any of the below-illustrated surgeries/treatment are eligible to avail the coverage:
• 1. Percutaneous Transluminal Coronary Angioplasty (PTCA)/Coronary Artery.
  2. Bypass Graft (CABG) within 7 years period prior to the proposal.
  3. Atrial Septal Defect (ASD) or Ventricular Septal Defect (VSD) which has been fixed by a treatment.
  4. Treatment of Patent Ductus Arteriosus (PDA).
  5. RF ablation practiced for correction of prevailing cardiac condition.
  6. Went for an angiogram where no intervention has been medically suggested after the whole process of treatment.
• All day care procedures covered as there are no limitations on the number of daycare treatments that can be availed during a policy term.
• Emergency ambulance charges equivalent to Rs 1,500 each policy period and Rs 750 per hospitalization to help the insured person at the time of immediate hospitalization.
• Room, boarding, and nursing expenses as a part of in-patient hospitalization are covered. The maximum coverage that can be taken is Rs 5,000 per day for a better experience during the treatment.
• Pre-hospitalization expenses not surpassing the time limit of 30 days ending on the date of hospitalization.
• Post-hospitalization up to 60 days after discharge letter has been granted by the treating hospital. The total payout is equal to 7% of the hospitalization expenses or a maximum of Rs 5000 per hospitalization, whichever is lower.
• Out-patient expenses availed at any hospitals, day care centers, clinics, diagnostic centers that are in connection to Star Health Insurance. A minimum of Rs 500 is paid per event whereas the maximum of Rs 1500 per policy period.
• Expenses for treatment of Cataract are payable up to Rs 20,000 per hospitalization and Rs 30,000 for the entire policy period.
• Personal accident cover for the insured person who will get coverage if any uninvited accident happened and caused bodily injury which is external and visible. The accident has caused the death of the insured person within 12 calendar months from the date of the event happened.

Star Cancer Care Gold (Pilot Product)

This plan was constructed due to increasing cases of cancer among the population of India. As there are very less health insurance plans that cover cancer.

What medical costs and advantages it covers?

• Room rent (Single standard a/c), boarding, nursing expenses.
• consultants, anesthetist, medical practitioner,Fees of surgeon, specialist for taking consultation/advice for particular diseases.
• operation theatre charges, blood, oxygen, medicines, Anesthesia and drugs are included.
• Emergency Ambulance cost for transporting the Insured person to the hospital up to a sum of Rs 1500 per hospitalization and Rs 2000 per policy period.
• Pre-hospitalization expenses up to 30 days prior to the reception of the insured person to the network hospital for cure of any illness/ailments/accident.
• Post-hospitalization up to 60 days applicable from the date of dispensation from the treating hospital.
• A lump sum amount equal to Rs 1,50,000 for sum insured Rs 3 lakhs and Rs 2,50,000 for sum insured Rs 5 lakhs is paid for recurrence/metastasis and second cancer indemnity.
• Covers surgical and interventional therapy where 1 lakh is given for 1,50,000.
• Indemnity cover of Rs 50,000 to Rs 1 lakh will be given for non-surgical and non-interventional therapy of cancer.

Star Special Care

A plan that manages the medical cost of a child who has been detected with the symptoms of Autism disorder that results in an inability to communicate effectively in public and speech impairment.

What medical costs and advantages it covers?

• All the expenses concerning the treatment of Autism disorder are covered which include:
• 1. Services of room, boarding, nursing expenses up to Rs 5,000 per day as granted by the hospital.
  2. Shared accommodation expenses for which Rs 500 per day is allotted and maximum of Rs 2000 that can be utilized for the whole tenure of hospitalization. Also, a sum equal to Rs 10,000 will be provided for each policy period.
  3. The cost incurred for treatment or consultation from a surgeon, anesthetist, medical practitioner, consultants, specialist.
  4. medicines, blood, operation theatre charges, surgical appliances,oxygen, Anesthesia and drugs etc.
  5. Emergency ambulance upto a sum of Rs 750 per hospitalization and overall limit of Rs 1,500 per policy period.
  6. Post Hospitalization will cover an amount analogous to 7% of hospitalization expenses or up to 60 days after discharge from the hospital.

Star Net Plus

A health insurance product that provides coverage for HIV that has toxic effects on the health of an individuals and can create death like circumstances. This plan is perfect for people who are carrying HIV and are fighting to eliminate its roots.

What medical costs and advantages it covers?

The benefits are sectioned into 2 parts:

Section 1 (HIV Section)

• Covers in-patient hospitalization costs for the insured person who carries the symptoms of Human Immune Virus.
• The sum insured taken will be paid in lump sum on raising a claim where you will not need any bills and reimbursements.
• If the insured person has reached the stage of AIDS can get coverage without displaying proofs like medical bills, receipts, vouchers, etc.

Section 2 (Medical Section)

• Room (single standard a/c room), Boarding and nursing charge during the stay in hospital.
• Surgeon’s fees, consultant’s fees or anesthetist’s fee that arises for treatment of the disease.
• radiotherapy, oxygen, operation theatre charges, diagnostic expense, surgical appliances,Cost of blood, x-ray, dialysis, chemotherapy and all other treatment material that becomes important during operation.
• Expenses linked to pharmaceuticals, drugs as administered and suggested by the treating medical professional to rectify the disease.
• Ambulance services during medical emergencies where insured require immediate transportation to the nearest hospital for treatment of illness/accident. A maximum of Rs 750 is payable on each hospitalization and Rs 1,500 is given in a policy year as ambulance charges.
• Post-hospitalization expenses valid for up to 60 days starting from the date of discharge from the hospital. A sum amounting to 7% of total hospitalization costs will be reimbursed and can be used up to Rs 5000 per policy period.
• Pre-hospitalization medical charges that may arise before the admission of the patient to the nearest hospital for 30 days.

Combo Plans by Star Health Insurance

• Star First Delite
• Star First Care
• Star First Comprehensive
• Star First Classic
• Star First Optima
• Health Insurance for Corporates

Star Health Travel Insurance

• Star Travel Protect Insurance Policy
• Star Corporate Travel Protect Insurance Policy
• Star Student Travel Protect Insurance Policy

Star Health Personal Accident Insurance

• Accident Care Individual Insurance Policy
• Student Care

Eligibility Criteria

Claim Process of Star Health Insurance

Cashless Claim Settlement Process

• Reach the insurance desk of the network hospitals and display your health identity card issued at the time of Star Health plan purchase.
• The doctors of the network hospitals will examine the identity of insured and
• The policyholder has to fill the preauthorization form to get approval for the cashless treatment. The company will verify the details with the network hospital.
• After acceptance of the claim, the insured can easily enjoy a cost-free treatment by providing relevant documents for treatment.
• The cashless claim is settled only on the disclosure of following documents submitted through attending network hospital:
• 1. Discharge Summary and related bills
  2. Cash memos, along with evidence of valid prescription.
  3. Pathological Test Reports as submitted by the pathologist plus a note from the treating medical expert who has advised for the tests.
  4. Certificate of Surgeon declaring the treatment carried out, surgeon bills and receipts.
  5. Medical Practitioner’s certificate for confirmation that insured is completely healthy and fit.
• On the availability of the above documents, Star Health insurance company will pay the total claim amount.

Reimbursement Claim Settlement Process

The reimbursement of claims is applicable if the treatment is taken from a non-network hospital or for other medical expenses.

• The field doctor will be arranged by Star Health insurance to make the process of hospitalization convenient and effortless.
• After the discharge letter has been allotted, the insured have to make all the bill payments like hospital bills, pharmacy bills, etc. Also, the admitted insured person must compile all the original documents of treatment for the illness and all the expenses incurred over it.
• All the proofs of documents should be submitted to Star Health Insurance in addition to claim.
• After this, the claim settlement process will be done with subject to policy terms and conditions.

List of Documents for Reimbursement of claim

• Completely filled Claim Intimation Form (informing the company before the form is filled).
• Original bills, receipts, and discharge certificate/card from the hospital.
• Original bills from chemists supported by proper prescription.
• Receipt and investigation test reports from a pathologist supported by the note from attending medical practitioner/surgeon prescribing the test.
• Nature of operation performed and surgeon's bill and receipt.
• Self-declaration/MLC/First Information Report for the cases of accident.
• Attending doctor's certificate.
• If less than 15 beds, kindly furnish the hospital registration certificate.

Star Health Insurance Renewal Process

• Once the policy is purchased from Star health and allied insurance, the policyholder can apply to renew the existing health plan on the policy anniversary through submission of policy details like:
• 1. Policy number mentioned over the policy documents.
  2. Date of Birth which must be the same as the DOB mentioned at the time of purchase.
• The renewal can be done online directly on the website by filling the above details.

How To Calculate Star Health Insurance Premium?

The premium will be calculated based on a number of factors such as:

• Amount of sum insured opted: The first and foremost factor while purchasing star health insurance is the sum insured opted to meet the future medical expenses of the policyholder and his/her family.
• Age of the policyholder: The second factor for the calculation of premium is the age of the eldest member or the main applicant taking the coverage for the whole family. Whether under family floater or individuals policy, the premium will be decided by considering the age of the eldest insured person.
• Number of family members included: Another revolving factor is total members chosen to avail the coverage. Family members can be added to the policy under family floater basis. The maximum limit for including members is limited to 6/5/4 members according to the type of Star Health insurance plan opted. Only some star health plans offer coverage for family members.
• Individuals or family floater: The premium also depends upon the kind of coverage, whether it is individuals or family floater policy. Under family floater, as the count of members increases, the premium rate also increases. However, Star Health gives a discount on premium if more than 2 members are included.

Exclusions of Star Health Insurance

• Any injury illness arising due to involvement in wars, radioactivities, nuclear bombing,
• Expenses related to spectacles and contact lenses, hearing aids, crutches, wheelchairs, and such other aids are not covered.
• Any disease arriving during the first 30 days starting from the date of inception of the policy.
• Circumcision or cosmetic or plastic surgery or aesthetic treatment and all treatments for erectile dysfunction.
• Any hospitalization that is not recommended or mandatory by the medical practitioner.
• Surgical processes for the treatment of obesity, weight control, and endocrine disorders.

FAQs

1. What is the claim intimation period of Star Health Insurance?

The claims can be communicated by calling on the Star Health customer care toll-free number, which is readily available for 24 hours a day and can be reached any time.

2. In how much time Star Health Insurance must be informed about the hospitalization?

In star health plans, there are two types of hospitalization for which insured/family has to inform for claim acceptance.

• For planned hospitalization: The event of hospitalization must be briefed within 24 hours before admission to a network or a non-network hospital.
• For emergency hospitalization: The happening of the event within 24 hours after hospitalization.

3. In what time star health insurance processes the claim settlement?

The maximum amount of time taken by the Star Health Insurance to settle a reimbursement claim or any other specified claim is 30 days, which meets the regulations formed by the IRDA for health insurance claim settlement.

4. Is there any need for a medical check-up before purchasing Star Health Insurance?

The necessity of medical check-up will depend upon the age of the policyholder. The policyholder who is under 50 years of age is excluded from giving any health examination. However, the health check-up for a person above the age of 50 years is mandatory.

Under senior citizen policy, there is no requirement for health check-up between 60-69 years are excluded.

5. Can Star Health Insurance Cover Ayurvedic Treatment?

No, Star Health Insurance doesn’t offer coverage for Ayurvedic treatments.

6. What is the maximum number of claims that can be made in a policy year?

There is no limit imposed on the number of claims that can be raised but there is a maximum limit of sum insured that can be utilized per policy period.

7. What is the tax benefit of buying a health policy from Star Health Insurance policy?

All the premiums paid towards the health insurance policy are tax exempted under Section 80D of the Income Tax Act, 1961.

Claim Form

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Last updated on 09-07-2019

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