Star Special Care Gold Plan: Premiums & Benefits | PolicyX
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Star Health Special Care Gold Plan

The plan is designed to provide coverage to individuals diagnosed with ...Read More

Up to 1 Cr
Sum insured
1
No. of plans
850+
Pan India presence
99.06%
Claim settlement ratio
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🛡️ IRDAI Approved
⭐ 4.4/5 · 2,761 reviews
🏥 14,000+ hospitals
📊 2.21 solvency ratio
✅ 99.06% claim settlement

About Star Health Special Care Gold Plan

A quick read on what this Star Health Insurance plan covers and why it might be a fit for you.

A unique health insurance plan designed by Star Health Insurance to provide medical coverage to individuals with disabilities and HIV/AIDS. The Star Special Care Gold Insurance Policy is available only on an individual basis, not as a family floater policy. It is available to individuals between 18 and 65 years of age. Dependent children are covered from birth to 17 years of age. No pre-policy medical checkup is required before purchasing the plan. The Star Special Care Gold Plan provides insured individuals with a sum insured value of ₹4 Lakhs and ₹5 Lakhs, along with other features.

Plan at a glance

Eligibility, sum insured options and policy mechanics — pulled straight from the policy wording.

Entry age
18 to 65 Years
Plan type
Individual and Family Health Insurance
Sum insured options
₹4 L, ₹5 L
Waiting period
30 days
Renewability
NA
Policy term
1 year

*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.

Pros & cons

A quick honest summary — the strengths and the trade-offs.

Pros

  • Modern Treatment Available
  • Day Care Procedures Available
  • Ambulance cover
  • Room rent cover
  • Shared Accommodation cover

Cons

  • Obesity Treatment Unavailable
  • Hazardous Activities not covered
  • Cosmetic Surgery not covered

What's covered

Every CMS-driven coverage flag from the plan wording — only items with a published value render below.

Hospitalization

  • Room rent Covered
  • ICU charges Covered
  • Pre-hospitalization Covered
  • Post-hospitalization Covered
  • Domiciliary hospitalization Not covered
  • Day-care treatment Covered
  • OPD charges Not covered
  • Covid-19 treatment Covered
  • Cataract Covered

Bonuses & restoration

  • No-claim bonus Not covered
  • Automatic restoration of SI Not covered
  • Daily hospital cash Not covered

Family & special care

  • Maternity cover Not covered
  • New-born baby cover Not covered
  • IVF treatment Not covered
  • AYUSH treatment Covered
  • Organ donor expenses Not covered

Modern & preventive care

  • Modern treatment Covered
  • Road ambulance Covered
  • Air ambulance Not covered
  • E-consultation Not covered
  • Health check-up Not covered
  • Second medical opinion Not covered
  • Vaccination Not covered

Conditions & global

  • Co-payment Applicable
  • Sub-limits Not Applicable
  • Compassionate travel Not covered
  • Global coverage Not covered

Star Special Care Gold Insurance Policy Benefits

Insured individuals can avail of a multitude of benefits when investing in the Star Special Care Gold Insurance Policy, as mentioned below:

  • Caters To Individuals With Special Needs

    Star's Special Care Gold Plan is designed for individuals with disabilities such as blindness, muscular dystrophy, low vision, chronic neurological conditions, and hearing impairment. While most health plans in India do not cover such conditions under their base cover, Star Health Insurance provides medical care benefits to people with these conditions.

  • HIV/AIDS Cover

    Health insurance plans typically consider HIV/AIDS as an exclusion. However, Star Special Care Gold has included it under its health cover. This policy is designed specifically for individuals who have been diagnosed with HIV/AIDS. According to the insurance policy, individuals diagnosed with HIV/AIDS by a medical practitioner with a CD4 count above 350 are eligible for this policy.

  • Comprehensive Cover

    Star Special Care Gold offers comprehensive cover for policyholders with features like AYUSH treatment, in-patient hospitalization, pre and post-hospitalization, and emergency road ambulance.

  • Tax Benefits

    Policyholders are eligible for tax benefits under the Star Special Care Gold Insurance Plan under Section 80D of the Income Tax Act, 1961.

  • Waiver Of Co-Payment

    The Star Special Care Gold policy clause mandates a 20% co-payment, which applies to the claim amount. However, insured individuals can opt for a co-payment waiver by paying a minimal additional premium.

Star Health Insurance Network Hospital List

Star Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, Star Health Insurance ensures that you are medically secured, irrespective of the city you reside in.

Delhi Mumbai Bengaluru Chennai Kolkata Hyderabad Pune Ahmedabad Jaipur Lucknow

Know More About Network Hospitals →

Sample premium

Indicative premium examples — your actual quote depends on age, declared medical history, sum insured and add-ons.

Star Special Care Gold Premium Table

Premiums for a 30-year-old male with sum insured values of ₹4 Lakhs and ₹5 Lakhs (including GST) are listed below.

1. With 20% Co-payment

Sum Insured (In Rs.) 4 Lakhs 5 Lakhs
Premiums (In Rs.) 14,481 15,746

2. Waiver of 20% Co-payment

Sum Insured (In Rs.) 4 Lakhs 5 Lakhs
Premiums (In Rs.) 18,101 19,682

Inclusions & exclusions

What the plan pays for, and what it doesn't.

Exclusions

  • Permanent diseases or health conditions that are not included under the Star Special Care Gold plan are mentioned below:
  • Injuries or diseases caused by involvement in illegal activities
  • Hospitalization due to adventure sports
  • Change of gender treatments
  • Plastic surgeries or cosmetic treatments
  • Treatment for obesity
  • Certain diseases and treatments are covered under this plan after a specific period, as mentioned below:
  • Specific Ailments: 24 Months
  • Pre-existing Diseases: 48 Months

Who can buy this plan

Eligibility criteria pulled straight from the policy wording.

  • Entry Age: - 18 Years (Adults)
  • 0 Years (Children); Max Entry Age: 65 Years (Adults)
  • 17 Years (Children); Sum Insured: ₹4 Lakhs
  • ₹5 Lakhs; Waiting Period: 30 Days

Other features & benefits

  • Treatment of Seizures
  • Behavioral Therapy Cover
  • Speech Therapy Cover
  • Occupational Therapy Cover
  • Adeno Tonsillectomy

Star Health Special Care Gold Plan: FAQs

The 5 most-asked questions about Star Health Special Care Gold Plan, answered.

Star Special Care Gold Plan is a health insurance plan offering efficient medical care coverage to individuals with disabilities and health ailments like HIV/AIDS. This policy is available to individuals between the ages of 18 to 65 years and is available for a tenure of 1 year. The sum insured available are 4 and 5 Lakhs.
Yes, cataracts are covered under the Star Special Care Gold Plan up to a sub-limit of INR 40,000 per eye in one policy year.
The listed disabilities covered under the Star Special Care Gold Plan are as follows: Blindness Muscular Dystrophy Low Vision Specific Learning Disabilities Intellectual Disability Mental Illness and more
Yes, a 20% co-pay is applicable under the Star Special Care Gold Plan on all claims.
Yes, the co-pay can be waived off for policyholders on an additional premium charge as per the terms and conditions of the insurer.

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Written and reviewed by

PolicyX content is researched in-house and reviewed by an IRDAI-certified insurance specialist before publication.

Written by Anshika Ojha — Health Insurance Reviewed by Raj Kumar — Health Insurance
Last updated: 27 Dec 2023 · Originally published: 13 Sep 2024

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