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Star Out Patient Care Insurance Policy

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IRDAI UIN : SHAHLIP22231V012122

HIGHLIGHTS

Plan Essentials

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Outpatient Cover

This policy is proposed to pay for the outpatient consultation, diagnosis and treatment expenses incurred at any Network Facility in India.
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Cover Options

Any individual or family (up to 6 members) can avail this policy. This policy has 4 Sum Insured options - Rs. 25,000/50,000/75,000/1,00,000.
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Plan Options

This policy has 3 plan options - Silver, Gold & Platinum, under which, the Pre-Existing Diseases are covered after 48, 24 and 12 months respectively.
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Non Allopathic Treatment

Outpatient medical consultation and treatment expenses incurred under AYUSH systems of medicine are covered.
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Diagnostics, Physiotherapy and Pharmacy

Expenses incurred towards Diagnostics, Physiotherapy and Pharmacy at Networked Facility are covered.
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Dental Cover

Dental treatment expenses for natural tooth or complications arising out of accidents are covered.
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Ophthalmic Cover

Expenses incurred towards Ophthalmic treatment out of accidental injuries are covered.
DETAILED LIST

Understand what’s included

IMPORTANT HIGHLIGHTS

Policy Type

This policy can be availed either on an Individual or Floater basis.

Policy Term

This policy can be availed for a term of one year.

Entry Age

Any person aged between 18 and 50 years can avail this policy. Dependent children are covered from the 31st day onwards up to 25 years.

Outpatient Consultation

Expenses incurred for outpatient consultation at any Network Facility in India are covered.

AYUSH Cover

Outpatient medical consultation and treatment expenses incurred under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicine are covered.

Diagnostics, Physiotherapy and Pharmacy

Expenses incurred towards Diagnostics, Physiotherapy and Pharmacy at Network Facility are covered.

Dental Treatment

Dental treatment expenses for natural tooth or teeth arising out of accidents incurred at any Networked Facility are covered.

Ophthalmic Cover

Expenses towards Ophthalmic treatment out of accidental injuries incurred at any Network Facility in India are covered.

Lifelong Renewal

This policy offers a lifelong renewal option.

Renewal Discount

The Insured Person is eligible for a discount of 25% on the premium at the time of renewal after every block of two continuous claim free years.
Please refer to the Policy Documents to know the policy details and Terms & Conditions.
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STAR OUT PATIENT CARE INSURANCE POLICY

 

Health Insurance with OPD cover

 

Buying a health insurance policy is usually not on the top of our priority list. It is often looked at as an unnecessary expense. Rarely do we understand the safety that health insurance policies offer. As humans, we certainly don’t expect to be admitted for major illnesses/diseases and often feel we don’t need a health insurance policy. But unfortunately, we do fall sick. These conditions would have certainly taken you to a clinic or a hospital from the common cold to the cough to diarrhea or allergies.

 

Did you know that OPD expenses in India account for over 60% of total health care costs? Yes, you read that right. And while paying Rs 500 per consultation may not seem like a lot, the cumulative expenses incurred over the year certainly cannot be taken for granted.

 

There could be various reasons for spending on health care, and one way to mitigate these expenses is by buying an insurance policy. You need not be hospitalised or require an in-patient stay to avail of the benefits provided by the policy.

 

Keeping all this in mind, we have devised the Star Out Patient Care Insurance Policy. This policy will help you overcome OPD costs, so you need not stress and worry if you happen to fall sick.

 

While you may need to be admitted to a hospital for some conditions, most illnesses do not require hospitalisation and treatments for such ailments fall under outpatient care. Outpatient care involves all treatment that a patient received without being admitted to the hospital. Eg. Consultation fees, vitamin supplements, antibiotics.

 

Just imagine the amount of money you could save on most common outpatient procedures like tests, scans, having a consultation in hospital with a specialist or getting a tooth filled at a dentist’s clinic, etc.

What is the Out Patient care policy?

  • Out-patient medical consultation
  • Non-allopathic treatment expenses
  • Diagnostics, physiotherapy and pharmacy expenses
  • Dental and ophthalmic treatment expenses

 

SubjectCriteria
Entry Age18 years to 50 years
Dependent Children – 31st day to 25 years
RenewalLifelong
Policy period1 year
Sum InsuredRs 25000 to 1 lakh
Discounts

Renewal discount  – 25% on the premium after every block of 2 continuous claim free years

5% - for purchase of policy online

Waiting PeriodsPED- 48/24/12 months (silver/Gold/Platinum respectively)Initial waiting period – 30 days (except for accidents) 

 

BenefitsCoverage limitDescription of cover
Out Patient ConsultationUp to S.I and bonus if anyCovers Outpatient expenses incurred at any networked facility in India.
Non-allopathic treatment expensesCoveredCovers non-allopathic treatment for those inclined to AYUSH treatments up to sum insured.
Diagnostics, physiotherapy and pharmacy expensesCoveredGet your expenses covered incurred on diagnostics, physiotherapy and pharmacy at any networked facility in India.
Dental and ophthalmic treatment expensesCoveredDental and Ophthalmic treatment expenses arising out of accident incurred at any Networked Facility in India is covered.

Anyone between the age group of 18 and 50 years can avail of this medical insurance. The holder can choose to opt for a family floater plan in which it is possible to cover Self, spouse and dependent children between the age of 31 days and 25 years.

Difference between Daycare treatment and OPD treatment

 

Day Care Treatments:

 

Generally, in order to make a claim against your health insurance, you must be hospitalized for a minimum of 24 hours. However, certain treatments are no longer require 24 hours of hospitalisation as they used to be due to technological advancements. In the past, for example, a patient receiving a cataract operation would be required to stay in the hospital for several days after surgery. As a result of technological advancement, surgery can now be performed on the same day as the patient is discharged from the hospital.

 

Such type of treatment falls under the policy definition of covered treatment if it is included in your policy.

 

OPD Treatments:

 

Outpatient Department, or OPD, treatment refers to the situation in which a patient may visit a doctor or medical practitioner for the purpose of seeking advice, tests, X-rays, investigations, diagnostics physiotherapy etc.

 

It might seem that Day Care and OPD treatments are similar because they involve a shorter amount of time.

 

Hospitalization is the most significant difference between the two. A Day Care procedure, even if it takes less time, is performed in a hospital and only then you will be able to claim your medical expenses under a Day Care treatment. Treatments for OPD do not require hospitalisation. The nature of OPD treatment is that it is possible to get the treatment without being admitted to a hospital or clinic.

 

A root canal treatment is a good example to understand the same. A root canal can be done either in a hospital or clinic without actually being admitted, and therefore falls under the OPD category. A dental surgery done in the event of an accident, however, may result in a day care treatment.

Why should you buy an Out Patient Care Insurance Policy?

The cost of medical care is rising at an unabated pace in India, and it makes health insurance a necessity than a choice. OPD treatments have become very normal today. Who isn’t visiting a doctor for fever, blood sugar test, ECG, x-rays, or frequenting a family physician or a consultant?

 

Usually, outpatient treatments come as an add-on to existing policies or benefit from accompanying a standard policy because every person has their requirements and needs when choosing a health insurance policy that suits their pocket. By having an OP cover and an in-patient cover, the person is completely covered. On the contrary, even a healthy person is more likely to visit a doctor for medical conditions, which are not serious enough for hospitalisation, for instance, tooth filling or a few appointments with your general practitioner. As age advances, regular health checkups become a part of life. If you are a person taking regular health check-ups, such expenses are covered under OP care. Unfortunately, the cost of dental treatments, diagnostic tests, periodic doctor consultation, preventive check-ups and medicines can range anywhere from a thousand to 1 lakh. Having said that, the outpatient cover will be more apt for a healthy person and for anyone who frequently visits the hospitals and clinics, and the expenses you incur no longer need to be paid from your pocket.

Here is a list of features that are unique to the Star Out Patient Care Insurance Policy

 

  • The plan covers all dental and ophthalmic treatment expenses, including expenses arising from accidental injuries at any Star Health network medical facility in India.
  • You can enjoy a discount of 25% of the premium after every block of two continuous claim-free years which means you will be given a discount of 25% on your premium when no claims are made for two successive years.
  • You can claim outpatient expenses on pre-existing diseases from the 2nd year (12 months waiting period), and you can submit multiple claims within the same year until the limit is reached.

Why choose Star Out Patient Care Insurance Policy?

 

  • Cash-less facility at Network Hospitals

 

We provide access to an ever-increasing network of hospitals where you can opt for cashless facility. Our aim is that you should have easy access to a network hospital near you in times of planned or unplanned medical expenses. Star Health Insurance has a network of over 14,000+ hospitals. For the complete list, visit here.

 

  • Online discount

 

You can enjoy a 5% discount for direct online purchases from starhealth.in . Renewal discount – 25% on the premium after every block of 2 continuous claim free years

 

  • Hassle-free claim process

 

Insurance processes can often be long and document-heavy. However, Star Health Insurance offers digital-friendly, zero-touch, quick and convenient options that work better for you during this pandemic situation.

 

  • Tax benefits

 

Individual and family members below 60 years can get Rs. 25,000 deductions from taxable income, and the deductible amount can extend up to Rs. 50,000 for senior citizens on premiums paid as per Section 80D of Income Tax Act, 1961. If two family members above the age of 60 are insured under one policy, then the deductible amount extends to Rs 1 lakh. In contrast, if there is one family member below the age of 60 and his parents are also insured under the same policy, then they can avail of a deduction of Rs 75,000.

FAQ's

Premiums Paid to the OPD Policies an Insured Person is eligible for relief under Section 80-D of the IT Act in respect of the premium paid by any mode other than cash.