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When
a family member is ill, it is a traumatic time for the rest of the
family. Star Health provides Family Health Optima to protect all
members of a family from financial setbacks in the event of a serious
illness. The coverage is applicable equally to all members of the
family.
Family Health Optima Benefits
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Hospitalisation
Cover: This would protect the insured person for in-patient
hospitalisation expenses for a minimum of 24 hours. These expenses
include room boarding expenses to a maximum of Rs.1500 per day in
Class A cities, Rs.750/- in Class B cities or Rs.500/- in other
locations
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Nursing expenses
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Surgeon's fees,
Consultant's fees, Anesthetist and Specialist fees
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Cost of blood,
oxygen, diagnostic expenses, cost of pace makers etc
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Cost of
medicines and drugs
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Emergency
ambulance charges for transporting the covered patient to the
hospital up-to a sum of Rs.750/- per hospitalization and overall
limit of Rs.1500/- per policy period
Additional Benefits
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The sum insured
floats among the family members insured. In other words there is no
need to take insurance for each member separately for separate sum
insured
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Thus there is
considerable premium saving
Family Includes
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Family would
mean proposer, spouse, dependent children upto 25 years and those
who are economically dependent on their parents
Pre - and Post Hospitalisation cover
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Pre-hospitalisation
Medical expenses up to 30 days prior to the date of admission or
post-hospitalisation calculated at 7% of the hospitalisation
expenses (excluding room rent) subject to a maximum of Rs.5000 is
payable
Discount
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A discount of
10% on Premium is allowed on renewal of the policy if there is no
claim in the immediately preceding year of the policy. This discount
is not cumulative
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How much to pay? |
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A: Adult C: Children upto 25 yrs. NA: Not Available
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Sum Insured : Rs. 1,00,000 |
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5 Months - 45 Yrs |
46 Yrs- 55 Yrs |
56 Yrs- 60 Yrs |
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2A |
1765 |
NA |
NA |
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1A + 1C |
1515 |
NA |
NA |
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1A + 2C |
1640 |
NA |
NA |
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1A + 3C |
1785 |
NA |
NA |
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2A + 1C |
1890 |
NA |
NA |
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2A + 2C |
2025 |
NA |
NA |
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2A + 3C |
2165 |
NA |
NA |
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Sum Insured : Rs. 2,00,000 |
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5 Months - 35 Yrs |
36 Yrs- 45 Yrs |
46 Yrs- 55 Yrs |
56 Yrs- 60 Yrs |
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2A |
2890 |
3140 |
5535 |
6400 |
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1A + 1C |
2715 |
3005 |
5265 |
6120 |
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1A + 2C |
2835 |
3075 |
5410 |
6225 |
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1A + 3C |
3085 |
3415 |
5715 |
6645 |
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2A + 1C |
3295 |
3555 |
5925 |
6965 |
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2A + 2C |
3455 |
3675 |
6450 |
7360 |
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2A + 3C |
3625 |
4060 |
6795 |
7820 |
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Sum Insured : Rs. 3,00,000 |
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5 Months - 35 Yrs |
36 Yrs- 45 Yrs |
46 Yrs- 55 Yrs |
56 Yrs- 60 Yrs |
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2A |
3985 |
4360 |
7605 |
10030 |
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1A + 1C |
3710 |
3940 |
6930 |
9185 |
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1A + 2C |
3825 |
4110 |
7160 |
9725 |
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1A + 3C |
4125 |
4440 |
7630 |
10095 |
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2A + 1C |
4190 |
4830 |
7865 |
10625 |
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2A + 2C |
4310 |
5110 |
8400 |
11090 |
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2A + 3C |
4615 |
5320 |
8710 |
11755 |
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Sum Insured : Rs. 4,00,000 |
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5 Months - 35 Yrs |
36 Yrs- 45 Yrs |
46 Yrs- 55 Yrs |
56 Yrs- 60 Yrs |
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2A |
5195 |
5565 |
10510 |
13515 |
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1A + 1C |
4750 |
5070 |
9660 |
12730 |
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1A + 2C |
4910 |
5250 |
10150 |
13210 |
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1A + 3C |
5365 |
5725 |
10980 |
13755 |
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2A + 1C |
5295 |
5775 |
11270 |
14290 |
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2A + 2C |
5645 |
6240 |
11870 |
14890 |
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2A + 3C |
6025 |
6540 |
12585 |
15815 |
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Sum Insured : Rs. 5,00,000 |
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5 Months - 35 Yrs |
36 Yrs- 45 Yrs |
46 Yrs- 55 Yrs |
56 Yrs- 60 Yrs |
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2A |
5920 |
6525 |
12010 |
15855 |
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1A + 1C |
5370 |
5955 |
11550 |
15225 |
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1A + 2C |
5630 |
6285 |
11865 |
15645 |
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1A + 3C |
6035 |
6770 |
12390 |
16275 |
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2A + 1C |
6345 |
7045 |
12815 |
16750 |
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2A + 2C |
6875 |
7675 |
13210 |
17450 |
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2A + 3C |
7260 |
8195 |
13860 |
18105 |
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IT
Benefit
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Premium paid by
cheque for this insurance is eligible for relief under section 80D
of the IT Act
Claim Procedure
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Call 24 hour
help-line for assistance
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Inform ID number
for easy reference
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For planned
hospitalisation, please inform 48 hours prior to admission to the
hospital
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For emergency
hospitalisation, information to be given within 24 hours after
hospitalisation
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Cashless
facility can be availed at all network hospitals
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For treatment in
non-network hospitals, reimbursement of expenses will be effected on
submission of all medical documents
Exclusions
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Expenses
incurred for treatment of any illness/ disease/ condition, which is
pre-existing at the time of commencement of insurance
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Any expenses
incurred for treatment of illness/ disease/ sickness contracted by
the Insured Person during the first 30 days from the commencement of
the policy
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First Year
exclusions – Hernia, Piles, Hydrocele, Congenital Internal disease/
defect, Sinusitis, Gall Stone / Renal Stone removal / treatment
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Second Year
Exclusions – Hysterectomy for Menorrhagia or Fibromyoma, Cataract,
Knee Replacement Surgery (other than caused by an accident), Joint
Replacement Surgery (other than caused by an accident), Prolapsed
Intervertebral Disc (other than caused by an accident), Varicose
veins / ulcers
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Naturopathy
treatment
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Expenses, which
are purely diagnostic in nature with no positive existence of any
disease
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Expenses those
are mainly cosmetic in nature
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Expenses
incurred for treatment of diseases/illness/accidental injuries by
systems of medicines other than Allopathic
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Expenses
incurred for treatment of congenital disease/defects/anomalies
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For a detailed
list of exclusions please refer policy conditions
Eligibility
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Any person aged
between 5 months and 60 years residing in India, can take this
insurance
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