Star Health Family Health Optima Plan
Overview
Commencing operations in 2006 as Indias first Standalone Health Insurance provider, Star Health and Allied Insurance Co Ltd is providing sterling services in Health, Personal Accident and Overseas Travel Insurance etc. Awarded for “Best Health Insurance provider of the year 2018” – Business Today, Money Today financial awards 2018 – 2019 and Awarded as “India’s leading Insurance Company of the year – Dun & Bradstreet BFSI Summit & Awards 2019. Star health offers a wide range of products from floater schemes, senior citizen coverage plans and products for Diabetes/Heart/HIV patients also. It has a Pan India presence with 550+branch offices, Cashless treatment at 9900+ hospitals across India, Star health also provides 24 X 7 FREE medical advice and expert Doctor consultation. You also get Hassle-free in-house claim settlement without intervention of TPA. Star Health efforts have always been on service excellence and product innovation with a focus on delivering the best to the customers
Highlights For
Family Health
Optima
Cumulative Bonus
Additional Sum Insured for Road Traffic Accident (RTA)
Recharge Benefit (Provided once during the policy period)
Coverage for New Born Baby (provided if mother is insured for 12 months without break)
Features
Sub-limits
Room Rent
Room rent for in-patient hospitalisation
Organ Donor
The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.
Pre-Hospitalisation : 60 days
The amount of expenses incurred during this period prior to hospitalisation such as diagnostic tests, doctor fees, medicines, etc. for investigiation purpose are also payable by the insurer
Post Hospitalisation : 90 days
The amount of expenses incurred during this period after discharge from hospitalisation for the purpose of recovery such as follow-up tests, doctor fees, medicines, etc. are also payable by the insurer
Pre existing Disease cover : upto sum insured
Coverage for all Pre-Existing Diseases covered after a certain specified waiting period with continuous renewal.
Waiting Period- Initial : 30 days
No claims are accepted within this period except due to accidents/ injury.
Waiting Period- Specific : 2 Years
Listed specific illness
Waiting Period- PED : 48 months
No pre-existing ailment related claims are accepted within this period.
Room Rent : 3L & 4L is covered Up to Rs.5,000/- , above Single Standard A/C Room is covered
Room rent for in-patient hospitalisation
ICU Charges : Not available
Charges for ICU hospitalisation
Co pay : Not available
% of the claim that the policyholder needs to pay out-of-pocket
Restore Benefit/ Recharge/ Refill : Automatic Restoration of Sum Insured 3 times during the policy period, 100% each time
If the sum insured is exhausted due to hospitalisation expenses of one or more members, there is an automatic restoration of the sum insured for related or unrelated ailments.
Health Check up : Covered
Free annual health check-up for all insured members according to the list of tests specfied in the policy document.
No Claim Bonus : 25% of Sum Insured after first year if claim free and additional 10% for the subsequent years, maximum allowable bonus is 100%
% of the sum insured that rises every claim free year.
Video/telephone consultation : Not available
E-consultation with expert doctors empanelled with the insurer for a second opinion.
Domiciliary hospitalization : Covered
Home care treatment where there are no beds in the hospital or paitient is not in a condition to be moved to the hospital, This treatment is provided under the supervision of a registered medical practitioner.
Ambulance : Covered
Transportation of the patient to the hospital and back home
Convalescence benefit : Not available
A specific fixed amount of money paid as a recovery benefit for extended hospitalisation.
Organ Donor : Up to 10% of Sum Insured or maximum of Rs.1,00,000/-
The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.
Bariatric cover : Not available
Expenses related to obesity-related conditions such as high BP, sleep apnea, arthiritis asthma, etc.
Daycare : Not available
Covers in-patient hospitalisation expenses where the stay is <24 hours under a specified list of treatments
AYUSH : Covered
Alternative treatment coverage such as ayurvedic, unani, sidha and homeopathy which leads to hospitalisation.
Congenital Coverage : Not available
Covers medical expenses related to diagnosis and treatment of heriditary and internal congenital ailments/ conditions/ traits that exist from birth.
Modern Treatments : Yes,upto sum insured
All advanced treatment with upgrade in technology.
Health Management/ Wellness : Not available
Benefits provided for staying fit and managing health
Maternity Benefit : 1. Medical treatment expenses traceable to childbirth 2. Expenses towards miscarriage
All expenses related to childbirth or legal medical termination of pregnancy, usually upto a specified limit.