Star Health and Allied Insurance Company Limited is an independent health insurance company offering a range of health insurance plans. The company enjoys a good reputation in the Indian insurance market for its variety of tariffs, coverage and ease of claims settlement. Star Health Family Health Optima is one such health plan that offers comprehensive coverage for your family. You can take out this family floater policy to cover all your family members in a single policy and enjoy affordable premiums without skimping on coverage. Let's take a look at the details of Star Family Health Optima Insurance Plan.
Key Features of Star Family Health Optima Insurance Plan
Here are some of the key features of Star Health's Family Health Optima insurance plan:
- This is family floater insurance that can cover you, your spouse and your dependent children
- Up to the age of 50, no preliminary health checks are required, provided that there are no adverse health conditions at the time of the conclusion of the contract
- In case of hospitalization due to a traffic accident, the sum insured increases by 25%
- You have the option to pay the premium in monthly, quarterly or semi-annual installments instead of a lump sum
- The policy offers unique coverage such as medical evacuation, medical assistance and repatriation of remains
- Modern treatments are also covered by insurance up to certain limits
- You can avail a lifetime renewal under the plan without the cover ending on the expiry date
Details of Star Family Health Optima Insurance Plan
Following are the Terms and Conditions of Star Family Health Optima –
|entry age||Adults - 18 years to 65 years. Dependent children – 16 days to 25 years|
|insurance amount||INR 1 Lakh bis INR 25 Lakh|
|term of the policy||1 year|
|additional payment||20% of each claim if the insured is 61 years or older|
|Existing waiting time||48 Entertainment|
|Health check before admission||Not required until age 50|
Star Family Health Optima Insurance Plan Review - Inclusions
The list of medical expenses covered by Star Family Health Optima insurance is as follows:
- Hospital stay
Expenses resulting from hospitalization of 24 hours or more are covered by this title. These expenses include accommodation expenses, nurse, surgeon, doctor's fees, operating room expenses, room rent, intensive care unit room rent, medicine, drug expenses, etc.
The plan provides for a lower limit on the permitted room rental, which is as follows:
|insurance amount||Room rental restriction|
|INR 1 Lakh and 2 Lakhs||Up to INR 2,000/day|
|INR 3 Lakhs και 4 Lakhs||Up to INR 5,000/day|
|INR 5 lakhs and above||Standard single room with air conditioning without lower limits|
- Costs of pre-hospital care
Pre-hospital expenses are covered under this title. These costs are covered for a period of 60 days prior to hospitalization.
- post-hospital costs
Expenses incurred after you leave the hospital are covered under this title. Such costs may be incurred to examine and monitor your recovery after your discharge. These costs will be covered for a period of 90 days after rejection.
- Modern treatments
Advanced robotic treatments are covered under the plan under certain conditions
- Ambulance costs
The cost of hiring an ambulance to take you to hospital is covered. Coverage limit is INR 750 per hospitalization and maximum INR 1500 per policy year
- Cost of rescue flight
The Star Family Health Optima plan also covers the expenses incurred in hiring an ambulance for transport to the hospital. This cover is available when the sum assured is INR 5 lakhs and above. The sum insured is up to 10% of the basic sum insured
- day care treatments
Treatments that do not require a 24-hour hospital stay due to advanced technology are known as day care treatments. Such treatments are also covered under the Star Family Health Optima plan
- stay at home in the hospital
If you receive treatment at home because there are no free hospital beds or you cannot be transferred to hospital, the cost of this treatment will be covered if it exceeds three consecutive days
- Organ Donation Insurance
This title would cover the costs involved in removing an organ from a donor for transplantation. The insurance cover is up to 10% of the sum insured but not more than INR 1 lakh.
- health inspection costs
Free medical check-ups are available under the policy every year when you opt for a sum assured of INR 3 lakhs and above. In order to be able to benefit from the insurance coverage, the examination should be done at the company's partner hospital. There is an upper limit on the cover allowed ranging from INR 750 to INR 3,500 depending on the amount of insurance chosen
- Blanket for newborns
If you have a child during the insurance period, the newborn child is insured from the 16th day until the end of the insurance period. This insurance cover is available for up to 10% of the sum insured, but with a maximum amount of INR 50,000
- Emergency medical evacuation at home
If the insured needs to change hospitals, the policy will cover the cost of an emergency medical evacuation to transport the insured from one hospital to another. These costs will be borne up to certain limits. The cover limit is between INR 5,000 and INR 10,000 depending on the Sum Assured selected
- Nice trip
If the insured is hospitalized outside their country of origin and suffers from a life-threatening illness, the policy will pay the travel expenses of an immediate family member. The cover is available when you opt for a sum assured of INR 10 lakhs or more and the cover limit is INR 5000
- repatriation of human remains
If there is a right to hospitalization and the Insured dies in hospital, the cost of transporting the Insured's body from the hospital to his place of residence will be covered. This cover is allowed up to INR 5,000 per policy period
- Treatment in preferred network hospitals
If the insured seeks treatment at a hospital of his choice specified by the insurance company, the policy will pay a flat-rate supplementary allowance for admission to that hospital. This allowance will be calculated at 1% of the Sum Assured, subject to a maximum of INR 5,000
- Shared apartment
If the insured chooses to be accommodated together, a daily hospital allowance will be paid if the sum assured is INR 3 lakhs and above. The daily benefit is INR 800/day for Sum Assured between INR 3 and 15 thousand and INR 1000/day for higher Sum Assured.
- AYUSH treatments
The policy covers costs incurred for non-allopathic alternative therapies such as Ayurveda, Unani, Siddha and Homeopathy. Insurance cover for AYUSH treatments will be allowed as per the table below –
|insurance amount||coverage limit|
|INR 1 Lakh bis 4 Lakhs||Up to INR 10,000|
|INR 5 Lakhs bi INR 15 Lakhs||Up to INR 15,000|
|INR 20 Lakhs και INR 25 Lakhs||Up to INR 20,000|
- Insurance amount coverage
INR 1 Lakh to 4 Lakhs Up to INR 10,000 INR 5 Lakhs to INR 15 Lakhs Up to INR 15,000 INR 20 Lakhs and INR 25 Lakhs to INR 20,000
- Second medical opinion
The insured can obtain a free second medical opinion from a committee of doctors of the insurance company during the validity of the policy.
- Assisted reproductive treatments
If the Insured requires assisted reproduction treatments during pregnancy, the cost of these treatments will be covered for three years after the policy is taken out. The cover limit is INR 1 lakh if the sum insured is INR 5 lakh and INR 2 lakh if the sum insured is higher.
- Additional insurance amount in case of traffic accidents
If you are hospitalized as a result of a road accident, the sum assured for the policy is increased by 25% of the basic sum assured for further benefits. The maximum increase allowed will be limited to INR 5 lakhs
- Automatic recovery of the sum insured
If you opt for a sum assured of INR 3 lakhs and above, the sum assured will automatically revert to the original sum if it is exhausted in a policy year. This option is available to you three times per policy term and the sum assured is 100% refundable in case of claim.
- cataract treatments
Cataract surgery cover is available under the Plan subject to certain limits. The limits are between INR 12,000 and INR 50,000 per eye per claim, depending on the sum assured chosen.
- supplemental benefit
If the Sum Assured is used up in an insurance year, you can get an additional Sum Assured as part of this service. This extra amount can be used for the same hospitalization or another hospitalization, but cannot be carried over if not used. Recharge power is available for a sum assured of INR 3 lakhs and above and the power limit is as follows:
|insurance amount||coverage limit|
|INR 3 Lakhs||75.000 INR|
|INR 4 Lakhs||INR 1 Lakh|
|INR 5 lakhs and above||INR 1,5 Lakhs|
- Cumulative Bonus
If you opt for a sum assured of INR 3 lakhs and above and do not make any claim in the first policy year, the sum assured will increase by 25% in the subsequent policy year. After that, you will get a non-claim bonus of 10% on the sum assured for every claim-free year. The maximum allowable increase will be limited to 100% of the basic sum assured.
Star Family Health Optima Insurance Plan Review - Exclusions
Star Family Health Optima offers comprehensive insurance coverage for your entire family. However, there are certain situations that are not covered by the plan. These are known as exclusions and the general exclusions under the Policy are as follows:
- Pre-existing conditions are not insured within the first 48 months of insurance
- Certain medical conditions such as cataracts, fistulas, gallbladder operations, cysts, etc. not covered within the first 24 months of the policy
- Illnesses within the first 30 days after taking out the policy are not insured
- Weight control treatments are not covered
- OPD treatments and their cost are excluded
- Excludes cosmetic procedures, gender reassignment treatments, infertility treatments and unproven treatments
- Illness or medical expenses arising from illegal activities, participation in dangerous activities, substance abuse, intentional injury, war and nuclear hazards are not covered
- Expenses related to maternity are not covered by the scheme
Star Health Family Health Optima Benefits
Apart from being a comprehensive health insurance plan for your family, Star Family Health Optima offers the following benefits:
- You can choose a single sum insured that covers all your family members
- The installment premium option makes the policy affordable and allows you to choose a high sum assured without breaking the bank
- With free annual health checks, you can regularly monitor and monitor your health status
- Sum assured reinstatement and reload benefits ensure that you don't run out of insurance cover even in the event of a serious medical emergency
- The company has no third party administrators and claims settlement is done internally. This ensures a smooth claims process and allows you to settle claims easily
- With more than 9900 hospitals affiliated with the company, you can easily find a cashless claims hospital
- You can transfer an existing insurance policy to Star Family Health Optima for free
How do I purchase the Star Family Health Optima Insurance Plan?
Star Family Health Optima Insurance Plan is available for online shopping. You can visit the company's websitehttps://www.starhealth.in/Select the plan and enter your insurance details to get the premium amount. Pay the premium online and you can buy the plan directly online.
Alternatively, you can purchase Star Family Health Optima through Turtlemint. Turtlemint partners with Star Health and offers its products for online purchase. Visit onlyhttps://www.turtlemint.com/health-insurance/and enter your insurance information. You can look at a number of health insurance plans for your family. You can even compare and buy the best policy by paying premiums online.
How do I renew my Star Family Health Optima Insurance Plan?
Renewal of an existing Star Family Health Optima plan can be done online through the Company's website. Visit onlyhttps://www.starhealth.in/customerportal/instant-renewaland provide your social security number and the applicant's date of birth. Your existing insurance details will be displayed along with your renewal premium. Pay the renewal premium online and you can renew the policy instantly and easily.
If you purchased your contract through Turtlemint, you can also renew it through the Turtlemint portal. Log in to your Turtlemint online account and select the policy. Pay the renewal premium online and your policy will be renewed immediately.
If you do not pay the renewal premium on time, the policy will expire and the cover will lapse. However, Star Family Health Optima grants you a grace period of 120 days from the policy expiry date. If you pay the premium within the grace period, the cover will be renewed and you will be able to avail the policy renewal benefits.
The free look period is the period during which you can cancel and exit the policy after purchase if you no longer wish to continue coverage. With Star Family Health Optima, you have 15 days from the policy issue date to cancel the policy and get your premiums back.
If the actual room rent is above the lower room rent limit, your hospital entitlement will be reduced accordingly. The insurance company would pay a lower amount of damage and you would have to pay the excess out of pocket.
Copay means you pay part of the damage out of pocket, while the insurance company covers the rest. Star Family Health Optima has a 20% participation rate for seniors. So if you are 61 or over and there is a claim, you will have to pay 20% of the claim.
No, Star Family Health Optima does not require pre-enrollment health screenings until age 50. However, if you suffer from an adverse medical condition, a medical examination is required, even if you are under 50 years of age.