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Star Health Insurance Coverage

Different health insurance plans from Star health insurance have different inclusions. Some of the common inclusions are mentioned below

In-patient hospitalization:

Star health insurance covers the hospitalization expenses of insured including Room rent, boarding charges, ICU charges, Doctor Charges etc., up to the sum insured mentioned under the policy. The in-patient hospitalization requires insured to get admitted in the hospital for treatment for more than 24 hours. The in-patient hospitalization charges cover a big chunk of treatment cost of the insured customer.

Pre hospitalization expenses:

The cost of treatment incurred by the customer before getting admitted to a hospital as in-patient treatment for treatment is known as pre hospitalization expense. Pre hospitalization expenses for up to 30 days would be paid by Star Health Insurance Company to the customers in case there is an inpatient claim admissible under the policy.

Post hospitalization expenses:

The cost of treatment incurred by the customer after getting treatment as an inpatient is known as post hospitalization expense. The cost of treatment including medicines, diagnostic tests, etc. after getting discharged from the hospital is paid up for a certain number of days. The post hospitalization expenses are paid up to 60 days from the date of discharge from hospital.

Room rent & ICU Charges:

Star health insurance plans cover the room rent and ICU charges as a part of inpatient hospitalization cover. There are certain sub limits for which these charges are provided by the insurance company. Room rent, ICU charges and Nursing charges would be covered up to a percentage of sum insured in the Star Health insurance plans.

Day Care Treatments:

Day Care treatments are those treatments which require less than 24 hours to be operated. Due to the advancement of technology there are many diseases or illnesses which are treated within a few hours and these are covered under the day care treatment section. The maximum coverage under the day care treatment section would be the sum insured or actual whichever is less. It is important to check the list of day care treatments covered under the health insurance plan before purchasing the same.

Daily Allowance:

Daily allowance is an amount given to the customer if the hospitalization exceeds a certain number of days. The daily allowance is given up to 5 days per hospitalization. The daily hospitalization amount is different from that of the inpatient charges paid to the customer. There would be many expenses which were to be made from the pocket of the insured customer at the time of hospitalization and such expenses can be covered under this daily allowance section of the Star Health Insurance Company

Health check-up facility:

Star health insurance provides health check-up facility to the members covered in the health insurance policy. The number of health check-ups and the sub limits are specified in the policy terms and conditions. Health check-ups can be availed at the network diagnostic centers of the Star Health Insurance Company at free of cost. The health check-up facility is provided as an add-on to the customers who do not claim during the policy period.

Domiciliary hospitalization:

Domiciliary hospitalization is the expenses incurred by the customer for getting the treatment at home on the advice of a doctor. The cost of treatment incurred for treatment at home is covered by Star Health Insurance Company under their health insurance plans. Domiciliary hospitalization is permitted only in two scenarios: In case the treating doctor has recommended availing the domiciliary treatment as shifting the patient to the hospital may endanger his/her life and there are no beds available in the patients place of residence due to the spread of pandemic.

Alternative Treatments:

Alternative treatments are medical treatments such as Ayurvedic, Siddha, Homeopathy, Unani and Yoga which are recognised by the Government of India as alternative treatment for diseases. The sum insured covered under this section is mentioned in the policy terms and conditions. Star Health Insurance Company covers the treatment costs incurred in case of Alternative treatments such as Ayurvedic, Siddha, Homeopathy, Unani and Yoga.

Organ Donor Cover:

Organ donor cover includes the cost of operating expenses to carry out organ replacement activity. The cost of harvesting and transplanting the organ to the insured customer is covered by Star Health Insurance Company in their health insurance plans. It also pays the organ donor costs as well in addition to the cost of insured.

No Claim Bonus:

No claim bonus of up to 150% on the sum insured is provided to the customer for each claim free year which is one of the highest percentages in the insurance industry. Star Health Insurance Company provides no claim bonus to the customers in case of every claim free year as a percentage increase in the sum insured. The no claim bonus would increase each claim year and the total sum insured would be addition of the base sum insured and the no claim bonus under the health insurance plan.

Recharge of Sum Insured:

Sum insured would be recharged or reinstated if the base sum insured is exhausted in a policy year. This option can be availed once in a policy year and the recharged sum insured can be utilised to treat different diseases or illnesses. With Unlimited recharge option you can get your sum insured recharged unlimited number of times as there would be no limit on the number of times the sum insured can be reinstated. Recharge of sum insured would be done after the sum insured is utilised partially or completely depending on the type of health insurance plan chosen by the customer.

Maternity & Baby Cover:

Maternity and New born baby cover are available under the Star health insurance plans which cover the cost of delivery and other costs related to new born baby. These are available as base covers as well as add-ons depending on the health insurance plan selected by the customer. The maternity and baby cover limit can be selected by the customer from the different options available. Normal and Caesarean sum insured options can also be selected by the customer at the time of purchasing the health insurance policy.

Second Opinion:

The insured customer can go for a second option from any doctor in the World enlisted under the panel of doctors with the Star Health Insurance Company related to the treatment and the cost of that would be borne by the insurance company. The second opinion would be available to the customer free of cost and the opinion can be taken without any effect on the no claim bonus at the time of renewal.

Sum Insured Range:

There are different sum insured options available to the customers. The sum insured ranges from Rs.50K to Rs.1 Cr depending on the type of health insurance plan. Higher the sum insured, higher would be the premium to be paid by the customer. The sum insured range would depend on the product selected by the customer and the premium would vary accordingly. There are more than 15 health insurance plans which provide different sum insured options to the customers to choose from.

Co-payment:

Co-pay is the amount of claim that has to be borne by the customer in case of claim during the policy year. Each and every claim would be subjected to a co-pay amount to be paid by the insured customer before the insurance company settles the remaining amount. Most of the health insurance policies of Star Health Insurance Company have a co-payment section in which the co-pay ranges from 10% to 20% depending on the type of health insurance plan selected by the customer. The co-pay also helps in reducing the premium to be paid by the customer and in turn makes the customer a part in claim settlement process by passing over a bit of responsibility to the customer.

Wellness Benefits:

Star Health insurance offers Wellness program to promote, incentivize and to reward the insured person’s healthy lifestyle through various wellness activities. The wellness activities are designed to help the insured person to earn wellness reward points which will be tracked and monitored by the company. These wellness points can be utilized to gain extra discount in the premium to be paid by the customer. The maximum discount that can be availed under this benefit would be 10% where the number of points ranges between 751 and 1000.

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