Star Health Comprehensive Insurance Policy can be availed by any individual. This is one of the best insurance policy from Star Health Insurance. Comprehensive inusarance policy has got lot of benefits and details are listed below.
- Various option on sum insured
- Individual, family and senior citizens
- Floater sum insured
- Co Payment
- Pre and Post Hospitalization
- Room Rent
- Actual Expenses
- Day Care procedures
- OP Consultation
- Delivery Expenses
- New Born Baby Coverage
- Dental & Eye
- Hospital Daily Expenses
- Health Check up Costs
- Bariatric Surgery Coverage
The following are the sum insured options for comprehensive health insurance policy:
- INR 5,00,000
- INR 7,50,000
- INR 10,00,000
- INR 20,00,000
- INR 25,00,000
Eligibility and Restrictions in the comprehensive Health Insurance Policy:
Star health comprehensive insurance policy can be availed by any Individual( Male or female) who attained the age of 3 months and up to 65 years, are eligible to take this policy. Apart from the individuals even the family can also opt for this policy. Family means 2 adults i.e. self, spouse and 3 children on a floater sum insured.
Floater Sum Insured:-
For example a family consist of 2 adults and 3 children has taken a policy for Rs 5,00,000 and one of the family member has utilized the sum insured for Rs 2,00,000 and balance can be used for all the members.
There is no cap on the individual family member on the amount of usage. All the family members can use any amount or one member can use entire amount up to the sum insured i.e. Rs 5 laks in our example.
It is 10 % between the age group of 61 – 65 years. The co payment here means that the insured person has to bear 10% of the hospital expenses and the balance will be paid by company. However it will not be applicable to an individual who takes the policy before attaining the age of 61 years.
Another advantage in this Star health Comprehensive Insurance Policy is life time renewal and air ambulance. In order to claim air ambulance it is 10 % of the sum insured is eligible for a policy of Rs 7,50,000 and above per policy period i.e 1 year
Road Ambulance Expenses are reimbursed as follows.
|Sum Insured||Limit per policy period|
|Rs 5,00,000||Rs 2,000|
|Rs 7,50,000||Rs 3,000|
|Rs 10,00,000||Rs 3,500|
|Rs 15,00,000||Rs 4,000|
|Rs 20,00,000||Rs 4,500|
|Rs 25,00,000||Rs 5,000|
Pre & Post Hospitalisation:–
In this policy the insurer gets 30 days pre hospitalization expenses and 60 days post hospitalization expenses reimbursed without limits.
There is no limit on the room rent. It is said that room means a single standard air conditioned room.
This mean that all the actual expenses incurred on ICU expenses, Doctor fees, Nursing expenses, diagnostic tests, Medicines, Operation theatre charges, Blood, Oxygen and implants are paid at actual in the comprehensive health insurance.
Day Care Procedures:-
There are about 405 procedures are reimbursed at actual.
There are some limits on this. Viz.
|Sum Insured||Limit ( Other Than Dental & Opthalmic)|
|Rs 5,00,000||Rs 1,200|
|Rs 7,50,000||Rs 1,500|
|Rs 10,00,000||Rs 2,100|
|Rs 15,00,000||Rs 2,400|
|Rs 20,00,000||Rs 3,000|
|Rs 25,00,000||Rs 3,300|
There is a restriction on this expenses, in order to claim delivery expenses one has to wait for 36 months for the first delivery and then 24 months for the second delivery from the date of first delivery. However the expenses are reimbursed as follows.
|Sum Insured||For Normal Delivery||For Cesarean|
|Rs 5,00,000||Rs 10,000||Rs 15,000|
|Rs 7,50,000||Rs 20,000||Rs 40,000|
|Rs 10,00,000 & Above||Rs 25,000||Rs 40,000|
New Born Baby Coverage:-
The new born baby is covered from the day 1 onwards and there is an amount of Rs 1,000 is paid towards vaccination. The baby is covered as follows.
|For Rs 5 lakhs sum insured||The coverage is Rs 50,000|
|For Rs 7.5 Lakhs and above sum insured||The coverage is Rs 1,00,000|
Note: This is an additional benefit to the insurer.
Dental and Eye (Ophthalmic Treatment):-
As an outpatient, the insurer is eligible for dental & ophthalmic treatment also. The insurer can claim once in a block of 3 years, irrespective of the claim is made or not. But there is a condition to it that the insurer should renew the policy continuously for 3 years.
Hospital Daily Expenses:–
This another advantage in the star health comprehensive insurance policy. The attendant’s expenses will be reimbursed on per day basis, which are as follows.
|Sum Insured||Per Day Expenses|
|Rs 5,00,000||Rs 500|
|Rs 7,50,000 and Rs 10,00,000||Rs 750|
|Rs 15,00,000 and Rs 20,00,000||Rs 1,000|
|Rs 25,00,000||Rs 1,500|
Restriction: Maximum up to 7 days in excess of 1 day. That means only 6 days expenses reimbursed.
Health Check Up Costs:-
The insurer is eligible for health check up costs also. In order to claim this benefit the insurer should not claim for 3 years.
|Rs 5,00,000||Rs 5,000|
|Rs 7,50,000 and Rs 10,00,000||Rs 7,500|
|Rs 15,00,000||Rs 12,000|
|Rs 20,00,000||Rs 12,000|
|Rs 25,00,000||Rs 12,000|
Bariatric surgery Coverage from star health comprehensive insurance policy
Bariatric surgery means weight loss procedure with operation where the natural procedures are not helped the patient or failed. This is mainly for reducing the obesity or excess weight.
The expenses are reimbursed on bariatric surgery for a maximum of Rs 2,50,000 during the policy period. In order to get coverage the waiting period is 36 months. The insurer can claim this benefit only under cashless.
Comprehensive Health Benefits of star health comprehensive insurance policy
- Restoration benefit
- No claim bonus
- Floater Basis
- Paying of Health screening expenses
- Reimbursement of donor expenses for organ harvesting
- Domiciliary hospitalization
- Recharge benefit
- Reimbursement of health check up after 3 years
- Free look period
- Cash less Hospitalization
- Tax benefit
- 24 X 7 call center support
- In house claim settlement of all the bills
- Facility for maintaining personal health records in electronic format
- No third party administrator ( TPA)
- More than 6000 hospitals in India
There are many other benefits in the start health comprehensive insurance policy like restoration, Personal accident coverage, second medical opinion, no claim bonus etc.,