Special Care Gold, Star Health And Allied Insurance Company Limited
IRDAI UIN: SHAHLIP23182V012223
HIGHLIGHTS
Plan Essentials
Entry Age
Any person aged between 18 and 65 years can avail this policy. Dependent children are covered from newborn to 17 years of age.
Pre-Policy Medical check-up
No Pre-Policy Medical check-up is required to avail this policy. However, previous medical records including the details of treatment should be submitted along with the proposal.
AYUSH Treatment
Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines are covered up to 50% of the Sum Insured.
Modern Treatment
Expenses incurred for modern treatments either as inpatient hospitalisation or day care procedures such as Deep Brain stimulation, Intra Vitreal injections, Robotic Surgeries, etc., are covered up to 50% of the Sum Insured.
Instalment Options
The policy premium can be paid on a quarterly or half-yearly basis with a loading of 3% and 2%, respectively. It can also be paid on an annual basis.
DETAILED LIST
Understand what’s included
IMPORTANT HIGHLIGHTS
Unique PlanSpecially designed policy for the persons with a disabilities as per The Rights of Persons with Disabilities Act, 2016 Or / and for individuals with HIV/AIDS as defined under the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017. |
Policy TypeThis policy provides benefits only on an individual basis. |
Policy TermThe policy can be taken for a term of 1 year. |
Sum InsuredThe Sum Insured options under this policy are Rs.4,00,000/- and Rs. 5,00,000/-. |
ELIGIBILITY
Disability CoverThe coverage under this policy is available for persons with the following disability/disabilities as defined under the Act and any subsequent additions/modifications to the list in the Act.
Disability for the purpose of this policy means a person with 40% or more of a specified disability as Certified by the Certifying authority as per the Disability Act 2016.
1. Blindness 2. Muscular Dystrophy
3. Low vision 4. Chronic Neurological conditions
5. Leprosy Cured persons 6. Specific Learning Disabilities
7. Hearing Impairment (deaf and hard of hearing) 8. Multiple Sclerosis
9. Locomotor Disability 10. Speech and Language disability
11. Dwarfism 12. Thalassemia
13. Intellectual Disability 14. Haemophilia
15. Mental Illness 16. Sickle Cell Disease
17. Autism spectrum disorder 18. Multiple Disabilities including deaf/ blindness
19. Cerebral Palsy 20. Acid Attack victim
21. Parkinson's disease |
HIV CoverThis policy is available for individuals with HIV/AIDS as defined under the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017. Individuals diagnosed as HIV/AIDS by a duly qualified Medical Practitioner with a CD4 count above 350 will only be eligible for cover under this policy. |
HOSPITALISATION CARE (INCLUDING DISABILITY AND HIV/AIDS COVER)
In-Patient HospitalisationHospitalisation expenses incurred for more than 24 hours of hospitalisation are covered. |
Room RentRoom, boarding and nursing expenses all inclusive as provided by the Hospital/Nursing Home are covered up to 1% of the Sum Insured per day. |
ICU ChargesIntensive Care Unit (ICU) charges/Intensive Cardiac Care Unit (ICCU) charges all inclusive as provided by the Hospital/Nursing home are covered up to a maximum of 2% of the Sum Insured per day. |
Pre-HospitalisationIn addition to in-patient hospitalisation, the medical expenses incurred up to 30 days before the date of admission to the hospital are also covered. |
Post-HospitalisationPost-hospitalisation medical expenses including consultation fees, diagnostic charges, medicines and drugs as recommended by the Hospital / Medical Practitioner are covered up to 60 days from the date of discharge from the hospital. |
Emergency Road AmbulanceAmbulance charges are covered up to the maximum of Rs. 2000/- per hospitalisation. |
Day Care ProceduresMedical treatments and / or surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered. |
Cataract TreatmentExpenses incurred for Cataract treatment are covered up to Rs. 40,000/- per eye in one policy year. |
Co-paymentEach and every claim under this policy shall be subject to a Co-payment of 20% applicable to the claim amount admissible and payable as per the terms and conditions of the policy. |
Waiver of Co-paymentWaiver of co-payment is available on payment of additional premium as per terms & conditions. |
LUMPSUM COVERAGE FOR HIV/AIDS
Lumpsum Coverage for HIV/AIDSIn case the CD4 count of the insured is/goes below 150, then the Company will pay 100% of the Sum Insured or the balance Sum Insured available under the policy, whichever is lower, as a lumpsum amount to the insured. This payment will trigger after a waiting period of 90 days from the commencement date of the policy.
Note: The claim mentioned above shall be payable once in the lifetime of the insured person and shall not be necessarily linked to an in-patient hospitalisation claim made under the policy. |
WAITING PERIOD
Pre-existing DiseasesI) Applicable for Diseases other than Disability/HIV/AIDS: The expenses related to the treatment of pre-existing diseases and their direct complications are covered after a waiting period of 48 months of continuous coverage after the date of inception of the first policy with the insurer.
II) Applicable for HIV/AIDS: The expenses related to the treatment of HIV/AIDS and its direct complications are covered after 90 days of continuous coverage from the date of inception of the first policy with the insurer.
III) Applicable for Disability: The expenses related to the treatment of pre-existing disability and its direct complications are covered after 24 months of continuous coverage after the date of inception of the first policy with the insurer. |
Specific DiseaseThe expenses related to the treatment of listed conditions, surgeries and treatments are covered after a waiting period of 24 months of continuous coverage after the date of inception of the first policy with the insurer. |
Initial Waiting PeriodThe expenses related to the treatment of any illness within 30 days from the first policy commencement date are excluded except for claims arising due to an accident. |
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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