Star Health and Allied Insurance Company Limited is a standalone health insurance company which offers a range of health insurance plans. The company enjoys a good reputation in the Indian insurance market because of the range of plans offered, their coverage and ease of claim settlement. Star Health Family Health Optima is one such health insurance plan which offers a comprehensive scope of coverage for your family. You can buy this family floater policy to get coverage for all your family members under a single policy and enjoy affordable premiums without skimping on the coverage. Let’s have a look at Star Family Health Optima insurance plan details.
Key features of Star Family Health Optima Insurance Plan
Here are some of the key features of Family Health Optima insurance plan offered by Star Health –
- This is a family floater policy which can be taken to cover yourself, your spouse and dependent children
- No pre-entrance health check-ups are required till 50 years of age if you don’t have any adverse medical conditions when buying the policy
- The sum insured is increased by 25% in case of hospitalisation due to a road accident
- You can choose to pay the premium in instalments every month, quarter or half-year rather than in one lump sum
- The policy offers unique coverage benefits of medical evacuation, compassionate visit and repatriation of mortal remains
- Modern treatments are also covered by the policy up to specified limits
- You can avail lifelong renewability under the plan without any cover ceasing age
Star Family Health Optima Insurance Plan Details
Here are the eligibility details of Star Family Health Optima –
|Adults – 18 years to 65 yearsDependent children – 16 days to 25 years
|INR 1 lakh to INR 25 lakhs
|20% of every claim if the insured is aged 61 years and above
|Pre-existing waiting period
|Pre-acceptance health check-up
|Not required till 50 years of age
Star Family Health Optima Insurance Plan Review – Inclusions
The list of medical expenses covered by Star Family Health Optima insurance plan is as follows –
- Inpatient hospitalisation
Expenses incurred on hospitalisation for 24 hours or more are covered under this head. Such expenses include expenses incurred on boarding, nurse’s fee, surgeon’s fee, doctor’s fee, operation theatre charges, room rent, ICU room rent, cost of medicines, drugs, etc.
The plan has a sub-limit on admissible room rent which is as follows –
|Room rent limit
|INR 1 lakh and 2 lakhs
|Up to INR 2000/day
|INR 3 lakhs and 4 lakhs
|Up to INR 5000/day
|INR 5 lakhs and above
|Single Standard AC Room without sub-limits
- Pre-hospitalisation expenses
Expenses incurred before being hospitalised are covered under this head. Such expenses are covered for a period of 60 days before hospitalisation.
- Post-hospitalisation expenses
Expenses incurred after you are discharged from the hospital are covered under this head. Such expenses can be incurred on investigating and tracking your recovery after you are discharged. Such expenses are covered for a period of 90 days after being discharged.
- Modern treatments
Modern-day robotic treatments are covered under the plan subject to certain terms and conditions
- Ambulance cost
The cost incurred in hiring an ambulance to take you to the hospital would be covered. The limit of coverage is INR 750 per instance of hospitalisation and a maximum of INR 1500 per policy year
- Air ambulance cost
Star Family Health Optima plan also covers the costs incurred in hiring an air ambulance for transporting you to the hospital. This coverage is available if the sum insured is INR 5 lakhs and above. The coverage limit is up to 10% of the basic sum insured
- Day care treatments
Treatments which do not require 24-hour hospitalisation due to advanced technology are called day care treatments. Such treatments are also covered by Star Family Health Optima plan
- Domiciliary hospitalisation
If you take treatments are home because there are no vacant hospital beds or because you cannot be shifted to the hospital, the cost of such treatments would be covered if such treatments exceed 3 continuous days
- Organ donor cover
Under this head, the costs incurred in harvesting an organ from a donor for transplant would be covered. Coverage is allowed for up to 10% of the sum insured subject to a maximum of INR 1 lakh.
- Cost of health check-ups
Free health check-ups are allowed under the policy every policy year if you choose a sum insured of INR 3 lakhs and above. The check-up should be done at the company’s networked hospital for availing coverage. There is a limit to the coverage allowed which ranges from INR 750 to INR 3500 depending on the sum insured chosen
- New born baby cover
If you have a child during the policy tenure, the new born child would be covered from 16th day till the end of the policy tenure. This cover is available for up to 10% of the sum insured subject to a maximum of INR 50,000
- Emergency domestic medical evacuation
If the insured needs a change of hospital, the policy would cover the cost of emergency medical evacuation to transport the insured from one hospital to another. This cost would be covered up to specified limits. The coverage limit ranges from INR 5000 to INR 10,000 depending on the sum insured chosen
- Compassionate travel
If the insured is hospitalised in a hospital away from his residence and is suffering from a life threatening illness, the policy would cover the cost of travel of one immediate family member. The cover is available if you choose a sum insured of INR 10 lakhs or above and the coverage limit is INR 5000
- Repatriation of mortal remains
If a hospitalisation claim is incurred and the insured dies in the hospital, the cost of transporting the remains of the insured from the hospital to his/her residence would be covered. This cover is allowed for up to INR 5000 per policy period
- Treatment in preferred network hospitals
If the insured seeks treatment at a preferred hospital mentioned by the insurance company, a lump sum additional benefit would be paid under the policy for admission to such hospital. This benefit would be calculated @1% of the sum insured subject to a maximum of INR 5000
- Shared accommodation
If the insured chooses shared accommodation, a daily hospital cash benefit would be paid if the sum insured is INR 3 lakhs and above. The daily benefit would be INR 800/day for sum insured levels between INR 3 lakhs and INR 15 lakhs and INR 1000/day for higher levels.
- AYUSH treatments
The policy covers the costs incurred on non-allopathic alternative treatments like Ayurveda, Unani, Siddha and Homeopathy. Coverage for AYUSH treatments would be allowed as per the following table –
|Sum insured level
|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
|Up to INR 20,000
- Sum insured levelCoverage limit
INR 1 lakh to 4 lakhsUp to INR 10,000INR 5 lakhs to INR 15 lakhsUp to INR 15,000INR 20 lakhs and INR 25 lakhsUp to INR 20,000
- Second medical opinion
The insured and avail a second medical opinion from a panel of the insurance company’s doctors free of cost during the policy tenure.
- Assisted reproductive treatments
If the insured requires assisted reproductive treatments for pregnancy, the cost of such treatments would be covered after 3 years of buying the policy. The coverage limit is INR 1 lakh if the sum insured is INR 5 lakhs and INR 2 lakhs if the sum insured is higher.
- Additional sum insured for road traffic accidents
In case of hospitalisation following a road traffic accident, the sum insured under the policy would be increased by 25% of the basic sum insured for additional claims. The maximum increase allowed would be limited to INR 5 lakhs
- Automatic sum insured restoration
If you choose a sum insured of INR 3 lakhs and above, the sum insured would be automatically restored to the original amount if it is used up in a policy year. This facility is available three times in a policy period and the sum insured is restored 100% in every claim.
- Cataract treatments
Coverage for cataract surgeries is available under the plan subject to limits. The limits range from INR 12,000 to INR 50,000 per eye per instance of claim depending on the sum insured chosen.
- Recharge benefit
If the sum insured gets exhausted in a policy year, you can get additional sum insured under this benefit. This additional amount can be used for the same hospitalisation or for another hospitalisation but cannot be carried forward if unutilized. The recharge benefit is available for sum insured of INR 3 lakhs and above and the benefit limit is as follows –
|Sum insured level
|INR 3 lakhs
|INR 4 lakhs
|INR 1 lakh
|INR 5 lakhs and above
|INR 1.5 lakhs
- Cumulative bonus
If you choose a sum insured of INR 3 lakhs and above and you don’t make a claim in the first policy year, the sum insured would be increased by 25% in the next policy year. Thereafter, for every claim-free year, you would get a no claim bonus of 10% increase in the sum insured. The maximum increase allowed would be limited to 100% of the basic sum insured.
Star Family Health Optima Insurance Plan Review – Exclusions
Star Family Health Optima allows a comprehensive scope of coverage for your entire family. However, there are some instances which are not covered by the plan. These are called exclusions and common exclusions under the policy are as follows –
- Pre-existing illnesses are not covered within the first 48 months of the policy
- Specific illnesses, like cataract, fistula, gall bladder treatments, cysts, etc. are not covered within the first 24 months of the policy
- Illnesses within the first 30 days of buying the policy would not be covered
- Weight management treatments are not covered
- OPD treatments and their expenses are excluded
- Cosmetic surgeries, gender change treatments, infertility treatments and unproven treatments are excluded
- Illness or medical expenses incurring due to illegal activities, participation in hazardous activities, substance abuse, intentional injuries, war and nuclear perils would not be covered
- Maternity related expenses are not covered by the plan
Star Health Family Health Optima Benefits
Besides being a comprehensive health insurance plan for your family, Star Family Health Optima also offers the following benefits –
- You can choose a single sum insured to cover all the members of your family
- The feature of instalment premiums makes the policy affordable and allows you to choose a high sum insured without hurting your pockets
- Free annual health check-ups allow you to monitor and track your health regularly
- The features of sum insured restoration and recharge benefit ensure that you do not run out of coverage even in a severe medical emergency
- The company has no third party administrators and the claims are settled on an in-house basis. This makes the claim process smooth and allows you easy claim settlements
- With more than 9900 hospitals networked with the company, you can easily find a hospital for cashless claims
- You can port to Star Family Health Optima from an existing insurance policy free of cost
How to buy Star Family Health Optima Insurance Plan?
Star Family Health Optima Insurance Plan is available for online purchases. You can visit the company’s website https://www.starhealth.in/, choose the plan and provide your coverage details to get the premium amount. Pay the premium online and you can buy the plan online instantly.
Alternatively, you can buy Star Family Health Optima through Turtlemint as well. Turtlemint is partnered with Star Health and offers its products for online purchases. Just visit https://www.turtlemint.sanity.turtle-feature.com/health-insurance/ and provide your coverage details. You would be able to view a range of health insurance plans for your family. You can even compare and buy the best policy by paying the premiums online.
How to renew Star Family Health Optima Insurance Plan?
Renewal of an existing Star Family Health Optima plan can be done online through the company’s website. Just visit https://www.starhealth.in/customerportal/instant-renewal and provide your policy number and date of birth of the proposer. Your existing policy details would be shown with the renewal premium. Pay the renewal premium online and you would be allowed to renew the policy instantly without any hassles.
If you have bought your policy through Turtlemint, you can also renew it through Turtlemint’s portal. Log into your online Turtlemint account and choose the policy. Pay the renewal premium online and your policy would be instantly renewed.
If you do not pay your renewal premium on time, the policy would lapse and the coverage would cease. However, Star Family Health Optima allows you a grace period of 120 days from the policy expiry date. If you pay the premium within the grace period, the coverage would be renewed and you would be able to avail the renewal benefits of the policy.
Free-look period is then period which is allowed to you to cancel and exit from the policy after buying it if you don’t want to continue with the coverage. Star Family Health Optima allows a free-look period of 15 days from the policy issuance date within which you can cancel the policy and get your premiums refunded.
In case the actual room rent is more than the room rent sub-limit, your inpatient hospitalisation claim would be reduced proportionately. The insurance company would pay a lower amount of claim and you would have to pay the additional amount from your pocket.
Co-payment means paying a part of the claim from your pocket while the insurance company pays the rest. Under Star Family Health Optima there is a co-payment ratio of 20% for senior citizens. So, if you are aged 61 years and above and you incur a claim, 20% of the claim should be paid by you.
No, Star Family Health Optima does not need pre-entrance health check-ups till 50 years of age. However, if you have any adverse medical condition then a medical check-up would be required even if you are below 50 years of age.