Family Health Optima Insurance Plan
IRDAI UIN: SHAHLIP23164V072223
HIGHLIGHTS
Plan Essentials
Affordable Premium
This policy covers family members including self, spouse, up to 3 dependent children, parents and parents-in-law at an affordable premium.
Health Check-Up
Health check-up expenses incurred at Network Hospitals are covered up to the specified limits for every claim-free year.
Organ Donor Expenses
Expenses for organ transplantation where the insured person is the recipient are payable provided the claim for transplantation is payable.
Automatic Restoration of Sum Insured
On exhaustion of the limit of coverage during the policy period, 100% of the Sum Insured will be restored 3 times in the same policy year.
Recharge Benefit
On exhaustion of the limit of coverage, an additional indemnity is provided which can be utilised even for the same hospitalisation or for the treatment of disease / illness / injury for which claim was paid / payable under the policy.
Assisted Reproduction Treatment
Expenses incurred for proven Assisted Reproduction Treatments as listed in the policy clause are covered up to the specified limits.
Hospitalisation expenses for the treatment of New Born Baby
Cover starts from 16th day after birth and subject to a limit of 10% of the Sum Insured or Rupees Fifty Thousand, whichever is less, provided the mother is insured under the policy for a continuous period of 12 months without break.
Medical Examination
All people above 50 years of age and those with adverse medical history are required to undergo pre-acceptance medical screening at the Company designated centres. At present 100% of the cost of medical screening will be borne by the company.
Policy Term
Policy can be taken for 1 year or 2 years
Wellness
Wellness Reward programme
DETAILED LIST
Understand what’s included
IMPORTANT HIGHLIGHTS
Policy TypeThis policy provides benefits only on a Floater basis. |
Entry AgeAny person aged between 18 and 65 years can avail this policy. Dependent children are covered from the 16th day onwards up to 25 years. |
Family SizeThis policy provides wide coverage to family members including self, spouse, dependent children (maximum 3), parents and parents-in-law. |
In-Patient HospitalisationHospitalisation expenses incurred for a period of more than 24 hours on account of illness, injury or accidents are covered. |
Pre-HospitalisationIn addition to in-patient hospitalisation, the medical expenses incurred up to 60 days before the date of admission to the hospital are also covered. |
Post-HospitalisationPost-hospitalisation medical expenses up to 90 days from the date of discharge from the hospital are covered. |
Shared AccommodationExpenses incurred on occupying a shared accommodation by the insured person are covered up to the limits mentioned in the policy clause. |
Road AmbulanceAmbulance charges for the transportation of insured person by private ambulance are covered up to Rs. 750/- per hospitalisation and Rs. 1500/- per policy period. |
Air AmbulanceAir ambulance expenses are covered up to 10% of the Sum Insured for the entire policy period. |
Automatic Restoration of Sum InsuredUpon exhaustion of the limit of coverage during the policy period, 100% of the Sum Insured will be restored 3 times in the same policy year. |
Cumulative BonusFor Sum Insured options Rs. 3,00,000/- and above, Cumulative Bonus is available at 25% of the expiring Sum Insured in the second year and additional 10% of the expiring Sum Insured for the subsequent years. The maximum allowable bonus shall not exceed 100% |
Additional Sum Insured for Road Traffic Accident (RTA)If the insured person meets with a Road Traffic Accident resulting in an in-patient hospitalisation, then the Sum Insured shall be increased by 25% subject to a maximum of Rs.5,00,000/-. |
Assisted Reproduction TreatmentThe Company will reimburse medical expenses incurred on Assisted Reproduction Treatment, where indicated, for sub-fertility 1. Waiting period of 36 months from the date of first inception of this policy is applicable. 2. Maximum liability of the Company for such treatment shall be limited to Rs.1 lakh for sum insured of Rs.5 lakh and Rs.2 lakhs for sum insured of Rs.10 lakhs and above for every block of 36 months. |
Hospitalisation Expenses for Treatment of New Born BabyCover starts from 16th day after birth and subject to a limit of 10% of the Sum Insured or Rupees Fifty Thousand, whichever is less, provided the mother is insured under the policy for a continuous period of 12 months without break. Note : Exclusions No.1(Code Excl 01), Exclusion No.2(Code Excl 02), Exclusion No.3(Code Excl 03) and the above sublimit will not apply for treatment related to Congenital Internal disease/defects for the new born. |
AYUSH TreatmentExpenses incurred for the treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in AYUSH hospitals are covered. |
Emergency Domestic Medical EvacuationExpenses incurred towards the transportation of the insured person from the treating hospital to another hospital for treatment are covered as per the limits mentioned in the policy clause. |
Compassionate TravelThe air transportation expenses incurred up to Rs. 5000/- are payable for an immediate family member to travel to the hospital in case of hospitalisation of the insured person for life-threatening emergency times, at the place away from insured’s usual place of residence. |
Second Medical OpinionThe Insured person can avail a Second Medical Opinion from a Doctor in the Company's network of medical practitioners. |
Modern TreatmentModern treatment expenses are payable up to the limits mentioned in the policy clause. |
Recharge BenefitAvailable up to the limits. |
Day Care ProceduresMedical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered. |
Domiciliary HospitalisationExpenses incurred for domiciliary hospitalisation, including AYUSH on the advice of a medical practitioner for a period exceeding three days are covered. |
Organ Donor ExpensesExpenses incurred for organ transplantation are covered up to a limit of 10% of the Sum Insured subject to the maximum of Rs. 1,00,000/- whichever is less. |
Repatriation of Mortal RemainsThe expenses incurred for the repatriation of mortal remains of the insured person are covered up to Rs. 5,000/- per policy period. |
Cataract TreatmentExpenses incurred for Cataract treatment are covered up to the limits mentioned in the policy clause. |
Treatment in Valuable Service ProvidersIf the treatment is undergone in a hospital suggested by the Company, then a lump-sum of 1% of the Sum Insured subject to a maximum of Rs. 5,000/- per policy period is payable. |
Health Check-UpHealth check-up expenses incurred at Network Hospitals are covered up to the specified limits for every claim-free year. |
Co-PaymentThis policy is subjected to co-payment of 20% of each and every claim amount for fresh as well as renewal policies for insured persons whose age at the time of entry is 61 year and above. |
Instalment OptionsPremium can be paid Quarterly and Half Yearly. Premium can also be paid Annually and Biennially (once in 2 years). Note: If Instalment Facility is opted for 2 year term policies, the full premium applicable for 2 year terms should be paid in quarterly or half yearly within the expiry of the first year. |
Upfront Discount5% discount for filling the lifestyle and habits related questionnaire at the inception of this policy. |
Please refer to the Policy Documents to know the policy details and Terms & Conditions.
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I have been using Mediclaim services for the last 7-8 years. I had tried other companies. But, I satisfied with the service Star Health Insurance has provided me, they also have friendly support personnel.
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Indore
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Thiruvananthapuram
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I have been with Star Health Insurance for the past 8 years, and have applied for two claims in that time. Both claims got settled, and I received good support from the company during my hospitalisation.
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Bengaluru
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Chennai
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Star Health Insurance helped me a lot when I was in need. I was covered under Star’s Comprehensive policy, which provided me cashless treatment at their network hospital during my Angioplasty surgery.
Shaila Ganachari
Mumbai
Get InsuredI have been using Mediclaim services for the last 7-8 years. I had tried other companies. But, I satisfied with the service Star Health Insurance has provided me, they also have friendly support personnel.
Sudhir Bhaiji
Indore
Get InsuredMy friend told me to buy health insurance from Star Health Insurance. That helped me during my son’s illness. Their cashless treatment facility was very helpful at the time. I truly appreciate their service and support.
Tiji K Oommen
Thiruvananthapuram
Get Insured
Tiji K Oommen
Thiruvananthapuram
My friend told me to buy health insurance from Star Health Insurance. That helped me during my son’s illness. Their cashless treatment facility was very helpful at the time. I truly appreciate their service and support.
Vanishree
Bengaluru
I have been with Star Health Insurance for the past 8 years, and have applied for two claims in that time. Both claims got settled, and I received good support from the company during my hospitalisation.
Ramachandran
Chennai
My family has been with Star Health Insurance since 2006. Our claim, which we applied during last month, was handled without any hassle. We are happy that we are part of such service providers.
Shaila Ganachari
Mumbai
Star Health Insurance helped me a lot when I was in need. I was covered under Star’s Comprehensive policy, which provided me cashless treatment at their network hospital during my Angioplasty surgery.
Sudhir Bhaiji
Indore
I have been using Mediclaim services for the last 7-8 years. I had tried other companies. But, I satisfied with the service Star Health Insurance has provided me, they also have friendly support personnel.
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