Star Family health optima insurance plan is a popular health insurance policy to secure your growing family on a floater basis.
Let us have a look at Star Family Health Optima Insurance Plan Details
Brief about Star family health optima insurance plan
Star Family Health Optima Insurance Plan is a complete health insurance policy for the family. It covers medical expenses incurred due to any illness or injury. One policy covers the entire family.
To take this policy, you can submit your details and we will help you to know more about this policy, providing you with a complete easy customized information about the Star Family Health Optima Insurance plan details, brochure, premium chart and benefits.
For now, continue reading this post and then let us connect to discuss the same.
What are the highlights of Star Health Family Optima Insurance policy?
Affordable Premium
Floater policy at an affordable premium covers your entire family.
Extra Sum Insured
Extra sum insured (auto recharge) at no extra cost.
Health Check Up
For every claim free year, you will get a health check-up benefit.
Automatic Restoration
100% automatically restored sum insured for 3 times upon complete exhaustion.
Assisted Reproductive Treatment
The reimbursement of medical expenses incurred on assisted reproduction treatment will be provided. Available only for sum insured options of INR 5,00,000/- and above.
New Born Baby
The coverage for New born Baby starts from the 16th day after birth till the policy’s expiry date.
Donor Expenses
Donor expenses for organ transplantation where the insured person is the recipient.
Day-care procedures
Covers all day care procedures.
Grace Period A grace period of 120 days from the date of expiry of the policy is available for renewal.
What are the benefits of Star Family Health Optima Insurance Policy?
Section 1: Hospitalization
Firstly hospitalization cover protects the insured for in patient hospitalization expenses for a minimum period of 24 hrs.
These expenses includes firstly room rent (Single Standard A/C room), nursing and boarding charges. Covers Secondly Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist fees, Cost of Medicines and Drugs.
Ambulance Charges
Also, Road Ambulance charges for emergency transportation to hospital. With charges up to a sum of INR 750/- per hospitalization and overall limit of INR 1,500/- per policy period.
Moreover, Air Ambulance Benefit up to 10% of the basic sum insured per policy period. Available for sum insured of INR 5,00,000 and above only.
Pre and Post Hospitalization Expenses
Pre-hospitalization expenses up to 60 days prior to admission in the hospital and Post hospitalization expenses up to 90 days after discharge from the hospital. Covers Pre-existing diseases after 48 months.
Domiciliary Hospitalization
Coverage for Domiciliary hospitalization for a period exceeding three days. This will be like the care and treatment at a hospital. Based on the advice of the attending Medical Practitioner advice. It can be taken at home under any of the following circumstances:
- Patient’s condition is critical.
- Due to the non-availability of room in a hospital.
Section 2: Organ Donor Expenses and Cost of health check up
Organ transplantation expenses are covered. However the insured person should be the recipient. provided the claim for transplantation is payable and subject to the availability of the sum insured. This does not cover the donor screening and post donation complications. This cover is also subject to a limit of 10% of the sum insured or INR 1,00,000/- whichever is less.
After that, cost of Health checkup is payable after every claim free year provided the health check up is done at network hospitals and the policy is in force.
Section 3: Hospitalization expenses for treatment of new born baby
The coverage for New Born Baby starts from the 16 day after its birth till the expiry date of the policy and is subject to a limit of 10% of the Sum Insured or INR 50,000 whichever is less provided the mother is insured under the policy for a continuous period of 12 months without break. This is also subject to the availability of the sum insured.
Section 4: Emergency Domestic Medical Evacuation
Reimbursement of reasonable and necessary expenses incurred towards transportation of the insured person from the hospital where the insured person is currently undergoing treatment to another hospital for further treatment will be provided under the following conditions:
a. The medical condition of the Insured Person is under threat to life.
b. Further treatment facilities are not available in the current hospital.
c. The Medical Evacuation is recommended by the treating Medical Practitioner.
d. Claim for Hospitalization is admissible under the policy. As a result these are subject to limits mentioned in the table given below:
| Sum Insured | Limit per hospitalization |
|---|---|
| Up to INR 4,00,000/- | Up to INR 5,000/- |
| INR 5,00,000/- to INR 15,00,000/- | Up to INR 7,500/- |
| INR 20,00,000/- and INR 25,00,000/- | Up to INR 10,000/- |
Section 5: Compassionate travel and Repatriation of Mortal Remains
Under Compassionate travel, in the event of a life threatening emergency at a place away from the insured person’s usual place of residence as recorded in the policy, the Company will reimburse the transportation expenses by air incurred up to INR 5,000/- for one immediate family member (other than the travel companion) for travel towards the place where hospital is located, provided the claim for hospitalization is admissible under the policy. This benefit is available for sum insured options of Rs.10,00,000/- and above only.
Under Repatriation of Mortal Remains, following an admissible claim for hospitalization under the policy, reimbursement up to INR 5,000/- per policy period payable towards the cost of repatriation of mortal remains of the insured person (including the cost of embalming and coffin charges) to the residence of the Insured as recorded in the policy.
Section 6: Treatment in preferred network hospitals and Shared Accommodation
When it comes to treatment in preferred network hospitals, in case of a medical contingency, if the insured seeks advice from Star Health – they may suggest an appropriate hospital from the network for treatment. Where the insured can undergo treatment in the suggested hospital, an amount calculated at 1% of Basic Sum Insured subject to a maximum of INR 5,000/- per policy period is payable as lump sum.
In case of in-patient hospitalization, if the Insured person occupies, a shared accommodation then amount as per table given below will be payable for each continuous and completed period of 24 hours of stay in such shared accommodation.
Section 7: AYUSH Treatment
In detail, the Inpatient Hospitalisation expenses incurred on treatment under Ayurveda, Unani, Sidha and Homeopathy systems of medicines in a Government Hospital or in any institute recognized by the government and/or accredited by the Quality Council of India/National Accreditation Board on Health as in patient is payable up to the limits mentioned in the Schedule of Benefits.
Section 8: Option for Second Medical Opinion
The Insured Person is given the facility of obtaining a Second Medical Opinion in electronic mode from a Doctor in the Company’s network of Medical Practitioners – Medical records can be sent to the mail id e_medicalopinion@starhealth.in
Section 9: Assisted Reproduction Treatment
The Company will reimburse medical expenses incurred on Assisted Reproduction Treatment subject to the awaiting period of 36 months from the date of first inception of this policy with the Company for the insured person. The maximum liability of the Company for such treatment shall be limited to INR 1,00,000/- for Sum Insured of INR 5,00,000/- and INR 2,00,000/- for Sum Insured of Rs.10,00,000/- and above for every block of 36 months and payable on renewal
For the purpose of claiming under this benefit, in- patient treatment is not mandatory.
Automatic Restoration of Basic Sum Insured, Recharge Benefit shall not be applicable for this benefit. To be eligible for this benefit both husband and spouse should stay insured continuously without break under this policy for every block. This coverage is available only for sum insured options of Rs.5,00,000/- and above.
Section 10: Additional sum insured for Road traffic accident
In case of a road traffic accident resulting into hospitalization, the basic sum insured will be increased by 25% subject to a maximum of INR 5,00,000/- and the limits mentioned in the policy in force.
How is the bonus added in Family health optima insurance policy?
On a claim free year of Insurance, there is a Bonus applied for the basic sum insured options of INR 3,00,000 and above.
After the policy is bought, the second year the benefit of bonus of 25% of the expiring basic sum insured is applicable. From the third year onwards, additional 10% of the expiring basic sum insured is applied. The maximum allowable bonus shall not exceed 100%.
What is the eligibility for this policy?
Persons between 18 years and 65 years of age at the time of entry can take this Insurance. Dependent children can be covered from 16th day of its birth till expiry of the policy, maximum age limit for the dependent children is 25 years. There is no upper age limit for continuous renewals. Family for the purpose of this policy means self, spouse and dependent children from 16 days to 25 years.
General Terms of the policy?
Co-Payment: 20% of each and every claim for persons above 60 years at entry level and their subsequent renewals.
Tax Benefit: Amount paid by any mode other than by cash for this insurance is eligible for relief under Section 80D of the Income Tax Act.
Free look period:
At the time of inception of the policy, the Insured will be allowed a period of 15 days from the date of receipt of the policy to review the terms and conditions of the policy and to return the policy if not acceptable
Guaranteed Lifetime Renewals
Beyond 65 years life long renewals are offered under this policy.
Pre-Acceptance Medical Screening
Persons above 50 years will be required to undergo pre-acceptance medical screening at the Company nominated centres. Cost of screening is currently borne by the company.
Pre-Existing Diseases/Illness are covered after 48 months of continuous Insurance without break with any Indian Insurance Company. NOTE: Renewal premium, terms and conditions are subject to change with prior approval from IRDAI.
What are the STAR advantages?
Firstly, No third-party administrator, direct in-house claim settlement.
Secondly, Faster & hassle-free claim settlement.
Most importantly, Network of more than 9900+ hospitals across India.
Need more details? Get in touch with us by entering your details below and we will tell you how you can take this plan.
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