Established in 2006 with a vision to become the largest and most preferred health insurance company in India, Star Health and Allied Insurance Co Ltd is a joint venture between ICICI Ventures Fund Management, TATA Capital Growth Fund, Oman Insurance Company, UAE and Alpha TC Holdings Pte. Ltd., Singapore. Today, it is Indias first standalone company in the health insurance industry. There are 3 major sections: Health Insurance, Overseas Mediclaim Policy and Personal Accident plans that are available with the company which has its presence with more than 290 branch offices pan India.
With a belief in using the resources to focus on providing excellence in service, design products and use core competency of innovation to deliver the best to their customers, Star Health has become one of Indias most trusted specialist company for health insurance. The company offers wide range of plans and insurance policies single-mindedly dedicated to the health sector. Also, health insurance policies, medi-claim and overseas travel insurances plans are a part of companys offerings keeping in mind the comfort and suitability of its nation-wide clients and customers.
Family Health Optima Plan
It is a single policy with a wide coverage for whole family at an affordable premium. This plan offers extra sum insured (auto recharge) at no extra cost, up to 30% of the sum insured. It covers health checkup costs of upto Rs 3500/- for every claim free years and all day care procedures.
Automatic restoration of entire Sum Insured by 300%.
New-born baby cover from 16th day.
Donor expenses for organ transplantation.
Domiciliary Hospitalization Expenses for treatment exceeding 3 days
Highlights of Family Health Optima Plan
It offers automatic restoration of entire Sum insured by 100%.
It covers expenses for new-born baby from 16th day.
It covers Domiciliary hospitalization treatments
What does the plan cover?
The coverage is inclusive of the following:
In-patient care: patient hospitalisation expenses for a minimum of 24 hrs including room rent, nursing and boarding charges.
Ambulance costs: Ambulance charges for emergency transportation upto a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period.
Pre and post hospitalization: Pre Hospitalisation expenses 60 days prior to admission in the hospital. Post Hospitalisation expenses upto 90 days after discharge from the hospital.
Daycare procedure: Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees, Anesthesia, Blood, Oxygen, Operation Theatre charges, Cost of Pacemaker, Cost of Medicine and drugs etc.
Donor expenses: Donor expenses for organ transplantation.
What is not covered?
The coverage has the following exclusions:
Any pre-existing ailment/disease that will only be covered after 4 consecutive years of completion of the policy
Any illnesses/ surgery/ diagnosis within the first 30 days of the policy start date besides those arising out of injuries
Damage because of self-inflicted harm (resulting from suicide, attempted suicide)
Fee of spectacles/contact lenses, dental treatment
Medical charges incurred for treatment of AIDS
Tests and treatment referring to infertility and in vitro fertilization
Some treatments like non-infective arthritis, joint replacement, etc., which can be covered only after the completion of two consecutive coverage years.
|Premium Chart for Zone 1 (Excluding Tax)|
|Zone 1 : Mumbai, Thane, Delhi including Faridabad, Gurgaon, Ghaziabad and Noida, Ahmedabad, Baroda Surat|
|25 LACS||20 LACS||15 LACS||10 LACS||5 LACS||4 LACS||3 LACS||2 LACS||1 LAC||Age in years / S.I. (in Rs.)||Plan|
Cashless Claim Process:
Approach the insurance desk of hospital and show the ID card for identification purpose.
Network hospital would verify your identity and submit pre authorization form to us.
The doctor will assess the documents and process the claim as per terms of the policy.
A field doctor will be assigned to make the hospitalisation simple for you.
Reimbursement process for pre and post hospitalisation expenses:
The Mediclaim Policy allows reimbursement of medical expenses incurred towards the ailment for which hospitalisation was necessitated prior to hospitalisation and up to a certain number of days after discharge.
To claim pre hospitalisation expenses: Any expenses incurred on Out Patient treatment which leads to In-Patient hospitalization 30 days prior to the date of hospitalization is settled as Pre hospitalization. All original bills have to be produced.
Pre & Post hospitalization expenses will be settled on Actual Basis.
Reimbursements in case of treatment in non-network hospitals:
Star Health should be contacted within 24 hours from the time of admission with following details:
Star Health id card number,
Nature of illness
Name & address of the Hospital/Nursing Home/Clinic, Room Number
The claim will be registered by customer care and a claim number will be provided to the Policyholder. This claim form must be filled fully and sent to Star Health office along with the necessary documents.
Completely filled claim form
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/FIR in case of accident cases.
Treating doctor's certificate
Q1. What is a Health Card?
It is a card that comes along with the Health Policy. It is similar to an Identity card. This card would entitle you to avail cashless hospitalization facility at any of our network hospitals. A health card mentions the contact details and the contact numbers of the TPA. In case of a medical emergency, you can call on these numbers for queries, clarifications and for seeking any kind of assistance. Moreover, you need to display your health card at the time of admission into the hospital. Remember, health card is not a debit or credit card that can be used to make payments.
Q2. Is a medical checkup necessary before buying a Health policy? A medical checkup is necessary for a new health insurance policy for customers above the age of 50 years. Medical checkup is not required only for Senior Citizen's red carpet Policy offered to people between 60 years to 75 years..
Q3. Does any health policy cover the treatment for existing disease also? Normally health plans exclude treatment of any pre existing disease / condition. At Star the treatment of any such pre existing disease/ condition is covered after 48 months of continuous renewals with Star.
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