Wellness Program
Take part in our wellness programs and earn rewards for staying healthy. Redeem those rewards to avail renewal discounts.
Star Comprehensive Insurance Policy
The Star Comprehensive Insurance Policy is a robust health insurance plan offering extensive health insurance coverage to meet all your healthcare needs. This health insurance policy includes hospitalisation, pre- and post-hospitalisation expenses, outpatient treatments, and more, ensuring you are well
IRDAI UIN: SHAHLIP26044V092526
HIGHLIGHTS
Plan Essentials
PED Buy-Back
On payment of additional premium, the waiting period for Pre-Existing Diseases can be reduced from 3 years to 1 year this is an optional cover.
Bariatric Surgery
Expenses incurred on hospitalisation for Bariatric surgical procedures are covered up to the limits mentioned in the policy clause.
Delivery Benefit
Both Normal and C-section delivery (including pre and post-natal) expenses are covered up to the limits mentioned in the policy clause.
Outpatient Cover
Outpatient consultation and outpatient treatment (Dental & Ophthalmic) expenses are covered up to the limits mentioned in the policy clause.
Cumulative Bonus
For Sum Insured of Rs. 5 lakhs, Cumulative Bonus is calculated at 50% of the basic Sum Insured after every claim free year up to a maximum of 100%. For Sum Insured Rs. 7,50,000/- or above, Cumulative Bonus is calculated at 100% of the basic Sum Insured.
Automatic Restoration of Sum Insured
On exhaustion of the basic Sum Insured during the policy period, 100% of the Sum Insured will be restored once in the policy year that can be utilised for illness or disease for which claims were already made.
Personal Accident Cover
Worldwide personal accident cover is provided in case of accidental death or permanent total disablement of the insured person during the policy period at no additional premium.
Hospital Cash
A cash benefit for each completed day in the hospital is provided up to the limits mentioned in the policy clause for a maximum of 7 days per hospitalisation and 120 days per policy period.
Detailed List
Understand what’s included
IMPORTANT HIGHLIGHTS
Policy Type
This policy can be availed either on an Individual or Floater basis.
Entry Age
Any person aged between 18 and 65 years can avail this policy. Dependent children are covered from the 91st day onwards up to 25 years.
In-Patient Hospitalisation
Hospitalisation expenses incurred for a period of more than 24 hours on account of illness, injury or accidents are covered.
Pre-Hospitalisation
Pre-hospitalisation medical expenses incurred up to 60 days before the date of admission to the hospital are covered.
Post-Hospitalisation
Post-hospitalisation medical expenses up to 90 days from the date of discharge from the hospital are covered.
Room Rent
There is no capping on room rent (Private Single A/C room), Boarding and Nursing expenses under this policy.
Road Ambulance
The policy covers ambulance charges for admission to the hospital, shifting from one hospital to another hospital for better facilities and from hospital to the residence.
Air Ambulance
Air ambulance expenses are also covered up to Rs. 2,50,000/- per hospitalisation, to the maximum of Rs. 5,00,000/- per policy period.
Mid-Term Inclusion
The newly married spouse and newborn baby can be included in the policy by paying an additional premium. The waiting periods will be applicable from the date of inclusion of new joiners.
Day Care Procedures
Medical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered.
Modern Treatment
Modern treatment expenses are payable to the extent of the limits mentioned in the policy clause.
Hospital Cash
A cash benefit for each completed day in the hospital is provided up to the limits mentioned in the policy clause for a maximum of 7 days per hospitalisation and 120 days per policy period.
Domiciliary Hospitalisation
Expenses incurred for domiciliary hospitalisation, including AYUSH, which is taken for a period of more than three days on the advice of a Medical Practitioner are covered.
Delivery Expenses
Delivery expenses including the Caesarean section (both pre-natal and post-natal) are covered up to the specified limits subject to the maximum of two deliveries.
New Born Cover
The hospitalisation expenses for the new born baby are covered up to the specified limits based on the opted Sum Insured.
Vaccination Expenses
Vaccination expenses for the new born baby are covered up to the specified limits based on the opted Sum Insured.
Automatic Restoration of Sum Insured
Upon exhaustion of the basic Sum Insured during the policy period, 100% of the Sum Insured will be restored once in the policy period.
Co-payment
This policy is subjected to co-payment of 10% 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 years and above.
Bariatric Surgery
Hospitalisation expenses incurred for Bariatric surgical procedures are covered up to the limits of Rs. 2,50,000/- and Rs. 5,00,000/- which are inclusive of pre and post-hospitalisation expenses.
AYUSH Treatment
Expenses incurred for the treatment under Ayurveda, Unani, Sidha and Homeopathy systems of medicines in AYUSH Hospitals are covered up to the Sum Insured.
Outpatient Consultation
Outpatient expenses other than Dental and Ophthalmic treatments incurred in any Networked Facility are covered up to the limits mentioned in this policy.
Outpatient Consultation - Dental & Ophthalmic
Outpatient expenses incurred for Dental and Ophthalmic treatments are covered up to the limits mentioned in the policy clause. The insured person is eligible to avail this benefit after every block of three years.
Organ Donor Expenses
In-Patient hospitalisation expenses incurred for organ transplantation from the donor to the recipient insured person are payable provided the claim for transplantation is payable.
Preventive Health Check-up
We will arrange for a Preventive Health Check-up at Our Network Providers for the applicable package as per opted Sum Insured. For the updated and applicable list of tests available under such package, Insured Persons are required to check our website www.starhealth.in.
E-Domestic Second Medical Opinion
Access to a second medical opinion from a network doctor based on submitted medical records.
Star Wellness Program
Wellness program designed to motivate and encourage the healthy lifestyle of the insured person through various wellness activities. In addition, the earned wellness bonus points can be utilised for availing renewal discounts.
Instalment Options
The policy premium can be paid on a monthly, quarterly or half-yearly basis.
Home Care Treatment
Payable up to 10% of Sum Insured subject to maximum of Rs.5 lakhs in a Policy Year, for treatment availed by the Insured Person at home, only for the specified conditions.
Unlimited Tele-Consultation
Insured can avail unlimited number of Tele-consultations on Star Health mobile application or digital platforms.
AI-Driven Face Scan
The Insured Person can avail, AI-driven face scan facility by using Star Health mobile app to know the vital parameters such as heart rate, oxygen saturation, respiration rate up to two times per month per Insured Person in a Policy Year.
10% discount is available on 2nd year premium
12.5% discount is available on 3rd year premium
Star Wellness Program
This program intends to promote, incentivize and to reward the Insured Persons’ healthy life style through various wellness activities. The wellness activities as mentioned below are designed to help the Insured person to earn wellness reward points which will be tracked and monitored by the Company. The wellness points earned by the Insured Person(s) under the wellness program, can be utilized to get discount in premium.
This Wellness Program is enabled and administered online through “Star Health" Mobile App
Note: The Wellness Activities mentioned in the table below (from Serial Number 1 to 5) are applicable for the Insured person(s) aged 18 years and above only.
The following table shows the discount on renewal premium available under the Wellness Program:
| Wellness Points Earned | Discount in Premium |
|---|---|
| 200 to 350 | 2% |
| 351 to 600 | 5% |
| 601 to 750 | 7% |
| 751 to 1000 | 10% |
*In case of floater policy the weightage is given as per the following table :
| Family Size | Weightage |
|---|---|
| Self, Spouse | 1:1 |
| Self, Spouse and Dependent Children (up to 17 years) | 1:1:0:0:0 |
| Self, Spouse and Dependent Children (18 years and above) | 2:2:1:1:1 |
Note: In case of two year policy, total number of wellness points earned in two year period will be divided by two.
Each Insured Person will be given an Individual log-in facility, which will be linked to his/ her policy.
*Please refer the Illustrations to understand the calculation of discount in premium, weightage and the calculation in case of two year policy
The wellness services and activities are categorized as below:
| Sr. No. | Activity | Maximum number of Wellness Points that can be earned under each policy in a policy year |
|---|---|---|
| 1. | Manage and Track Health | |
| a) Online Health Risk Assessment (HRA) | 50 | |
| b) Preventive Risk Assessment | 200 | |
| 2. | Affinity to Wellness | |
| a) Participating in Walkathon, Marathon, Cyclothon and similar activities | 100 | |
| b) Membership in a health club (for 1 year or more) | 100 | |
| 3. | Stay Active – If the Insured member achieves the step count target on “Star Health” mobile app | 200 |
| 4. | a) Weight Management Program (for the Insured who is Overweight / Obese) | 100 |
| b) Sharing Insured Fitness Success Story through adoption of Star Wellness Program (for the Insured who is not Overweight / Obese) | 50 | |
| 5. | a) Chronic Condition Management Program (for the Insured who is suffering from Chronic Condition/s - Diabetes, Hypertension, Cardiovascular Disease or Asthma) | 250 |
| b) On Completion of De-Stress & Mind Body Healing Program (for the Insured who is not suffering from Chronic Condition/s - Diabetes, Hypertension, Cardiovascular Disease or Asthma) | 125 | |
| Additional Wellness Services | ||
| 6. | Online Chat with Doctor | |
| 7. | Medical Concierge Services | |
| 8. | Period & Fertility Tracker | |
| 9. | Digital Health Vault | |
| 10. | Wellness Content | |
| 11. | Health Quiz & Gamification | |
| 12. | Post-Operative Care | |
| 13. | Discounts from Network Providers |
1. Manage and Track Health:
a) Completion of Health Risk Assessment (HRA):
The Health Risk Assessment (HRA) questionnaire is an online tool for evaluation of health and quality of life of the Insured. It helps the Insured to introspect his/ her personal lifestyle. The Insured can log into his/her account on the website www.starhealth.in and complete the HRA questionnaire. The Insured can undertake this once per policy year. On Completion of online HRA questionnaire, the Insured earns 50 wellness points. Note: To get the wellness points mentioned under HRA, the Insured has to complete the entire HRA within one month from the time he/she started HRA Activity.
b) Preventive Risk Assessment:
The Insured can also earn wellness points by undergoing diagnostic / preventive tests during the policy year. These tests should include the five mandatory tests mentioned below. Insured can take these tests at any diagnostic centre at Insured’s own expenses.
- If all the results of the submitted test reports are within the normal range, Insured earns 200 wellness points.
- If the result of any one test is not within the normal range as specified in the lab report, Insured earns 150 wellness points.
- If two or more test results are not within the normal range, Insured earns 100 wellness points only.
Note: These tests reports should be submitted together and within 30 days from the date of undergoing such Health Check-Up.
| List of mandatory tests under Preventive Risk Assessment |
|---|
| 1. Complete Haemogram Test |
| 2. Blood Sugar (Fasting Blood Sugar (FBS) + Postprandial (PP) [or] HbA1c) |
| 3. Lipid profile (Total cholesterol, HDL, LDL, Triglycerides, Total Cholesterol / HDL Cholesterol Ratio) |
| 4. Serum Creatinine |
2. Affinity towards wellness:
Insured earns wellness points for undertaking any of the fitness and health related activities as given below. List of Fitness Initiatives and Wellness points:
| Initiative | Wellness Points | |
|---|---|---|
| a. | Participating in Walkathon, Marathon, Cyclothon and similar activities | 100 |
| - On submission of BIB Number along with the details of the entry ticket taken to 100 participate in the event. | ||
| b. | Membership in a health club (for 1 year or more) - In a Gym / Yoga Centre / Zumba Classes / Aerobic Exercise/ Sports Club/ Pilates Classes/ Swimming / Tai Chi/ Martial Arts / Gymnastics/ Dance Classes | 100 |
| Note: In case if Insured is not a member of any health club, he/she should join into club within 3 months from the date of the policy risk commencement date. Insured person should submit the health club membership. | ||
3. Stay Active:
Insured earns wellness points on achieving the step count target on “Star Health” mobile app as mentioned below:
| Average number of steps per day in a policy year | Wellness Points |
|---|---|
| 100 |
| 150 |
| 200 |
Note:
| |
4. Weight Management Program:
a) This Program will help the Insured persons with Over Weight and Obesity to manage their Body Mass Index (BMI) through the empanelled wellness experts who will guide the Insured in losing excess weight and maintain their BMI.
- On acceptance of the Weight Management Program, Insured earns 50 wellness points.
- An additional 50 wellness points will be awarded in case if the results are achieved and maintained as mentioned below.
| Sr. No. | Name of the Ailment | Values to submitted | Criteria to get the Wellness points |
|---|---|---|---|
| 1. | Obesity (If BMI is above 29) | Height & Weight (to calculate BMI) | Achieving and maintaining the BMI between 18 and 29 |
| 2. | Overweight (If BMI is between 25 and 29) | Height & Weight (to calculate BMI) | Reducing BMI by two points and maintaining the same BMI in the policy year |
| - Values (for BMI) shall be submitted for every 2 months (up to 5 times in each policy year) | |||
b) Incase if the Insured is not Overweight / Obese, the Insured can submit his/her Fitness Success Story through adoption of Star Wellness Activities with us. On submission of the Fitness Success Story through adoption of Star Wellness Activities, Insured earns 50 wellness points.
5. Chronic Condition Management Program:
a) This Program will help the Insured suffering from Diabetes, Hypertension, Cardiovascular Disease or Asthma to track their health through the empanelled wellness experts who will guide the insured in maintaining/ improving the health condition.
- On acceptance of the Chronic Condition Management Program, Insured earns 100 wellness points
- The Insured has to submit the test result values for every 3 months maximum up to 3 times in a policy year
- If the test result values are within +/- 10% range of the values given below, for at least 2 times in a policy year, an additional 150 wellness points will be awarded.
- These tests reports to be submitted within 1 month from the date of undergoing the Health Check-Up
| Sr. No. | Name of the Ailment | Test to be submitted | Values Criteria to get the additional Wellness points |
|---|---|---|---|
| 1. | Diabetes(Insured can submit either HbA1c test value (or) Fasting Blood Sugar (FBS) Range and Postprandial test value) | HbA1c | ≤ 6.5 |
| Fasting Blood Sugar (FBS) Range and Postprandial test value | 100 to 125 mg/dl below 160 mg/dl | ||
| 2. | Hypertension | Measured with - BP apparatus | Systolic Range - 110 to 140 mmHg Diastolic Range - 70 to 90 mmHg |
| 3. | Cardiovascular Disease | LDL Cholesterol and Total Cholesterol / HDL Cholesterol Ratio | 100 to 159 mg/dl ≤ 4.0 |
| 4. | Asthma | PFT (Pulmonary Function Test) | FEV1 (PFC) is 75% or more FEV1/ FVC is 70% or more |
b) In case if the Insured is not suffering from Chronic Condition/s (Diabetes, Hypertension, Cardiovascular Disease or Asthma) he/she can opt for “De-Stress & Mind Body Healing Program”. This program helps the Insured to reduce stress caused due to internal (self-generated) & external factors and increases the ability to handle stress.
- On acceptance of De-stress & Mind Body Healing Program Insured earns 50 wellness points.
- On completion of De-stress & Mind Body Healing Program Insured earns an additional 75 wellness points.
Note: This is a 10 weeks program which insured needs to complete without any break.
6. Online Chat with Doctor:
Insured can consult qualified healthcare professionals at their convenience. The Doctor Chat feature allows Insured to “Chat” with qualified Doctors, available from Monday to Friday between 9.00 AM and 6.00 PM to help Insured with advice and quick consultations including on Diet & Nutrition and Second Medical Opinion. They do not prescribe any medications or diagnose any health issues.
7. Medical Concierge Services:
The Insured can also contact Star Health to avail the following services:- Emergency assistance information such as nearest ambulance / hospital / blood bank etc.
8. Period & Fertility Tracker:
The online easy tracking program helps every woman with their period health and fertility care. The program gives access to trackers for period and ovulation which maps out cycles for months. This helps in planning for conception prevention and tracks peak ovulation if planning pregnancy.
9. Digital Health Vault:
A secured Personal Health records system for Insured to store/access and share health data with trusted recipients. Using this portal, Insured can store their health documents (prescriptions, lab reports, discharge summaries etc.), track health data add family members.
10. Wellness Content:
The wellness portal provides rich collection of health articles, blogs, tips and other health and wellness content. The contents have been written by experts drawn from various fields. Insured will benefit from having one single and reliable source for learning about various health aspects and incorporating positive health changes.
11. Health Quiz & Gamification:
- The wellness portal provides a host of Health & Wellness Quizzes. The wellness quizzes are geared towards helping the Insured to be more aware of various health choices.
- Gamification helps in creating fun and engaging health & wellness experiences. It helps to create a sense of achievement in users and increases motivation levels.
12. Post Operative Care:
It is done through follow up phone calls (primarily for surgical cases) for resolving their medical queries.
13. Discounts from Network Providers:
The Insured can avail discounts on the services offered by our ` network providers which will be displayed in our website.
Terms and conditions under wellness activity
- Any information provided by the Insured in this regard shall be kept confidential.
- There will not be any cash redemption against the wellness reward points.
- Insured should notify and submit relevant documents, reports, receipts etc for various wellness activities within 1 month of undertaking such activity/test.
- No activity, report, document, receipt can be submitted in the last month of each policy year.
- For services that are provided through empanelled service provider, Star Health is only acting as a facilitator; hence would not be liable for any incremental costs or the services.
- All medical services are being provided by empanelled health care service provider. We ensure full due diligence before empanelment. However Insured should consult his/her doctor before availing/taking the medical advices/services. The decision to utilize these advices/services is solely at Insured person’s discretion.
- We reserve the right to remove the wellness reward points if found to be achieved in unfair manner.
- Star Health, its group entities, or affiliates, their respective directors, officers, employees, agents, vendors, are not responsible or liable for, anyactions, claims, demands, losses, damages, costs, charges and expenses which a Member claims to have suffered, sustained or incurred, by way ofand / or on account of the Wellness Program.
- Services offered are subject to guidelines issued by IRDA from time to time.
ILLUSTRATION OF BENEFITS:
Lets look how the Insured can avail discount on premium through the “Star Wellness Program”
Scenario – 1
| ||
|---|---|---|
| Sr.No | Name of the wellness activity taken up during the policy year | Wellness Points Earned |
| 1 | Completed Online Health Risk Assessment (HRA) | 50 |
| 2 | Submitted Health Check-Up Report (two test results are not within normal values) | 100 |
| 3 | Participated in Walkathon | 100 |
| 4 | Attended to Gym | 100 |
| 5 | Achieved 10,000 average number of steps per day during the policy year | 200 |
| 6 | Shared his fitness success story | 50 |
| 7 | Managed Diabetes through Chronic Condition Management Program | 250 |
| Total Number of Wellness Points earned | 850 | |
| Based on the number of Wellness Points earned Ramesh is eligible to get 10% discount on renewal premium. | ||
ILLUSTRATION OF BENEFITS:
Lets look how the Insured can avail discount on premium through the “Star Wellness Program”
Scenario – 2
Suresh and Lakshmi enrolled under the Star wellness program and completed the following wellness activities. | |||
|---|---|---|---|
| Sr.No | Name of the wellness activity taken up during the policy year | Wellness Points Earned by Ramesh | Wellness Points Earned by Lakshmi |
| 1 | Completed Online Health Risk Assessment (HRA) | 50 | 50 |
| 2 | Submitted Health Check-Up Report | 200 | 200 |
| 3 | Participation in Marathon | 100 | 0 |
| 4 | Attended to Gym | 100 | 100 |
| 5 | Achieved 10,000 average number of steps per day during the policy year | 200 | 200 |
| 6 | Suresh accepted the Weight management program and reached 27 BMI Lakshmi accepted the Weight management program and reached 23 BMI | 100 | 100 |
| 7 | Suresh Managed Diabetes & Hypertension through Chronic Condition Management Program; Lakshmi has completed De-stress & Mind Body Healing Program | 250 | 125 |
| Total Number of Wellness Points earned | 1000 | 775 | |
| No of wellness points based upon weightage - 1:1 | 500 (1000X1/2) | 388 (775X1/2) | |
| Total Number of Wellness Points earned by Suresh and Lakshmi = 888 (500+388) Based on the no of Wellness Points earned, Suresh & Lakshmi are eligible to get 10% discount on renewal premium | |||
ILLUSTRATION OF BENEFITS:
Lets look how the Insured can avail discount on premium through the “Star Wellness Program”
Scenario – 3 A 27 year old Individual Umesh buys Star Comprehensive Insurance Policy (Individual Sum Insured) for two year period, with Sum Insured 25 Lacs, let’s understand how he can earn Wellness Points by doing different wellness activities. Umesh has declared that his Body Mass Index (BMI) is 24 and he is not suffering with any Chronic Condition. Umesh enrolled under the Star Wellness Program and completed the following wellness activities. | |||
|---|---|---|---|
| Sr.No | Name of the wellness activity taken up during the policy year | Wellness Points Earned in the First Year | Wellness Points Earned in the Second Year |
| 1 | Completed Online Health Risk Assessment (HRA) | 50 | 50 |
| 2 | Submitted Health Check-Up Report | 200 | 200 |
| 3 | Participated in Walkathon | 100 | 100 |
| 4 | Attended to Yoga Classes | 100 | 100 |
| 5 | Achieved 10,000 average number of steps per day during the policy year | 200 | 200 |
| 6 | Submitted his fitness success story | 50 | 50 |
| 7 | Completed De-stress & Mind Body Healing Program | 125 | 125 |
| Total Number of Wellness Points earned | 825 | 825 | |
| Total Number of Wellness Points earned by Umesh = 1650 (825+825) Calculation of Wellness Points as per two year policy condition = 825 (1650/2) | |||
| Based on the number of Wellness Points earned, Umesh is eligible to get 10% discount on renewal premium. | |||
Waiting Period
1. For Pre-Existing Diseases - 36 months
2. For Specific Diseases/Procedures - 24 months
3. Initial Waiting Period - 30 days (Except for Accidents)
Modern Treatments
Coverage for Modern Treatments please click here.
Premium Illustration
Benefit/Premium illustration for Individual and Floater basis please click here.
Personal Accident Cover
Dependent Children and persons above 70 years of age can be covered under Accidental Death and Permanent Total Disablement up to the sum insured of Rs.10,00,000.
Pre-Acceptance Medical Screening
Only for Buyback PED (Optional Cover).
Free Look Period
The Free Look Period shall be applicable on new individual health insurance policies and not on renewals or at the time of porting/migrating the policy. The Policyholder shall be allowed free look period of thirty days from date of receipt of the policy document whether electronically or otherwise to review the terms and conditions of the policy. If the Policyholder is not satisfied with any of the terms and conditions and has not made any claim, the Policyholder has the option to cancel his/her policy. This option is available in case of policies with a term of one year or more. The Policyholder shall be entitled to a refund of the premium paid subject only to a deduction of a proportionate risk premium for the period of cover and the expenses, if any incurred by the Insurer on medical examination of the proposer and stamp duty charges.
Note: Renewal premium, terms and conditions are subject to change as per the extant Guidelines.
STAR HEALTH
Why Choose Star Health Insurance?
As a Health Insurance specialist, we extend our services from offering tailor-made products to fast in-house claim settlements. With our growing network of hospitals, we ensure easy access to fulfill your medical needs.
Diagnostic Centres
Get access to 1,635 diagnostic centres across India with home pickup of lab samples and health checkups at your doorstep.
E-Pharmacy
Order medicines online at a discounted price. Home delivery and store pick-ups are available across 2780 cities.
24*7 Customer Service
Call us at 1800-425-2255 for claim intimation, telehealth services, and to clear your queries.
In-house Claim Settlement
We’re the first Standalone Health Insurance company to settle the claims without any TPA but with a qualified in-house team.
Claim Settlement
90% of our claims are settled under cashless within 2 hours and 92% of claims are settled under reimbursement within 7days.
Hospitals
We got you covered under our valuable service providers, an agreed network and network hospitals for quality treatment.
Awards
We’ve been awarded for innovative product, best claim settlement and service provider from reputed survey organisations.
Network Hospitals
Hospitals in agreement with Star Health provide seamless cashless facilities. The approval process is quick and comfortable.
Agreed Network Hospitals
Hospitals that have agreed with Star Health to provide cost-effective package rates for surgical and medical procedures.
Valuable Service Providers
These hospitals are identified by Star Health and have been specially recognised for their efforts, services and quality.
Non-Network Hospitals
For getting treatments in non-network hospitals(not in agreement with Star Health), you can avail reimbursement claims.
Excluded Providers
Hospitals, where claims are not admissible. But life-threatening situations/accidents expenses are payable up to stabilisation.
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Star Comprehensive Insurance Policy
Star Health Insurance presents the Star Comprehensive Insurance Policy with a pragmatic approach for your lifelong protection. This plan was specially created for individuals between the ages of 91 and 65 years.
This policy offers several benefits for individuals. It covers all day care procedures, outpatient visits, consultations, adding a newly married spouse or newborn, organ donor expenses, accidental coverage, and other major medical treatments. All of this is included under one sum insured, with lifelong renewal available.
The article is a complete guide to what is comprehensive health insurance, its key benefits, importance and more.
What is a Comprehensive Health Insurance Plan?
A comprehensive health insurance plan covers a wide range of medical needs and provides financial protection during emergencies. It can be renewed for life. This plan lets you and your loved ones get coverage together, and you can share the sum insured.
There are many comprehensive medical insurance policy benefits. Let’s discuss the health comprehensive insurance policy inclusions and exclusions here. Many comprehensive health plans include health checkups and daycare procedures. A comprehensive health insurance plan is suitable for many people based on their needs. We shall have a brief look at the comprehensive health insurance policy.
Benefits of the Star Comprehensive Insurance Policy
A comprehensive health policy comes with broader coverage. It offers coverage for in-patient hospitalisation costs along with pre and post-hospitalisation expenses. The benefits of the Star Comprehensive Insurance Policy are listed below:
- Hospitalisation expenses like boarding charges, room charges, cost of nursing, anaesthetist’s fee, specialist’s fees, cost of drugs, surgeon’s fee, and medicines can be claimed.
- Pre-hospitalisation charges for a maximum of 60 days before the date of hospitalisation.
- Post-hospitalisation charges are for a maximum of 90 days from the date of discharge from the hospital.
- Includes the AYUSH hospitalisation charges like Homoeopathy, Siddha, Ayurveda, and Unani, which are payable below this comprehensive health insurance policy up to the limit as specified under the policy.
- The road ambulance transportation expenses during emergency conditions are covered.
- Medical consultation expenses incurred by outpatients in a network facility for other than dental and ophthalmic treatments up to the limits mentioned can be claimed.
- Being a member of the comprehensive health plan, you can benefit from domiciliary hospitalisation.
- The insured can file a claim for accidental death and permanent total disability only for the specified person under the policy.
- Once every 3 years, the dental/ophthalmic OPD treatment is covered under the policy.
- Hospital cash benefits for a maximum of 7 days per hospitalisation and 120 days for the policy period. However, claims under this section will not lower the sum insured.
- The policy provides cover for delivery and newborn babies, subject to the self and spouse being covered after the completion of the 24-month waiting period.
- The newborn baby is covered from day one, subject to the admissible/ claimed under the policy for delivery.
- The policy provides optional coverage for buyback PEDs, subject to payment of additional premiums and medical screening.
- The policy provides a Health Check Up benefit for every claim-free year up to the limit specified in the policy.
- This policy can be applied to individual or floater modes.
- The policy provides cover for Air Ambulance, subject to the terms and conditions, with limits as specified in the policy.
What is included in the Star Comprehensive Health Insurance Plan?
There are many things included under the Star Comprehensive Health Insurance plan. Post-hospitalisation expenses for up to 90 days after being discharged from the hospital.
- Pre-hospitalisation charges and expenses for up to 60 days prior to getting admitted and Post Hospitalisation Expenses incurred up to 90 days could be claimed.
- It includes hospitalisation expenses such as room charges, nursing costs, boarding charges, anaesthetist's fee, specialist's fees, surgeon's fees, cost of drugs, pacemakers, and medicines.
- AYUSH hospitalisation expenses like Homoeopathy, Ayurveda, Unani and Siddha are payable below this plan.
- The normal and cesarean delivery costs could also be claimed.
- It includes newborn babies and vaccination expenses.
- It also includes emergency road ambulance transportation charges.
- Organ donor charges are also covered.
- During emergencies, air ambulance charges are covered as well.
- Domiciliary hospitalisation charges are also included under this policy.
- Health checkup facilities expenses are included below this plan.
- Also, the accidental death and permanent total disability claims could be claimed by the insured person.
- Dental/ophthalmic OPD treatment charges are covered once every 3years.
- Bariatric surgery charges could be claimed after the completion of the waiting period of 3 years.
- The second medical opinion availed from the Star Health Insurance network of doctors can be reimbursed.
- The advantage of hospital cash is that it is offered for up to 7 days in case of hospitalisation.
Exclusions of the Star Comprehensive Health Insurance Plan
Star Comprehensive Health Insurance Plan has some exclusions.
- Cost of Change of Gender treatments.
- Obesity Treatment Costs.
- Pre-existing conditions till the completion of the waiting period of 3 years
- Expenses related to hazardous or adventure sports-related injuries
- Expenses related to unproven treatments
- Infertility and sterility treatment Charges.
- Charges for Venereal diseases and STDs (Other than HIV)
- Costs of Nuclear weapons and war-related perils.
- Expenses for the treatment of endocrine disorders.
- There are some factors that help you choose comprehensive health insurance in India.
How to choose comprehensive health insurance in India?
There are many factors that help choose health insurance in India. While you select comprehensive medical insurance in India, you could consider the following factors:
- Claim settlement ratio: Always choose health insurance with a High Claim Settlement Ratio. A high claim settlement ratio denotes the insurer's reliability and efficiency in settling claims.
- Network of hospitals: Prefer network hospitals in your place for better access to quality healthcare. For that, see the list of network hospitals under the list of health insurance providers.
- Coverage Offered: 3.To choose the right coverage, start by looking at your healthcare needs and pick a plan that covers most of them in one policy.
- Sum insured: Analyse the sum insured by various health insurance plans. If you go for a sum insured lower than what is needed for you, it may not be correct for you.
Ensure that the sum insured is adequate to cover your medical expenses. - Co-payment: Some of the plans only have a mandatory co-pay clause, which requires the policyholders to pay a percentage of every claim.
- Comparison of Many Health Plans: Do proper research and compare various health insurance policies to choose the one that matches your needs. You could compare the plans based on things like benefits, sum insured and add-ons.
- Premiums: Check the premium amount and deductibles related to the health insurance plans. You could pay your health insurance premiums according to your entry age.
- Lifetime renewability: Choose health insurance plans with lifetime renewability so you stay covered as you get older and may need more medical care.
- Insurer reviews and customer ratings: When you buy health insurance, just review the insurer reviews and customer ratings. Check for the reputation and credibility of the insurance company prior to buying a health insurance plan.
- Claim Settlement Time: Check each health insurer's claim settlement time prior to investing in the health plan for yourself. Opting for an insurer with a high claim settlement ratio helps with reliable claim processing.
- Cumulative bonuses: You get a cumulative bonus for having claim-free policy years. You can have the advantage of this bonus by raising your sum insured while you renew the health policy.
- Higher sub-limits: Choose a health insurance plan that has higher or no sub-limits for most categories of expenses. Additionally, they may have to choose from sub-limits, co-payments or voluntary deductibles to minimise the cost of high premiums.
- Policy Exclusions and Limitations: It is necessary to consider the exclusions and limitations when you choose a health insurance policy.
- Pre-existing ailments: Ensure that all the pre-existing ailments are disclosed and see the coverage for the same. Know about the waiting period for pre-existing diseases in the policy chosen.
- Choose Family Floater Plans: If you wish to buy insurance for the whole family, then select a family floater plan rather than buying individual health policies. Select the appropriate plan based on the people to be insured.
Tax Benefits from Buying a Star Comprehensive Insurance Policy
With respect to the premium payment by any mode other than cash, the insured person is eligible for relief under Section 80D of the Income Tax Act of 1961.
HELP CENTRE
Confused? We’ve got the answers
We’re Star Health. We offer the coverage that’s designed to help keep you healthy. It's the care that comes to you, and stays with you.
Star Comprehensive Insurance Policy is available with high-sum insured options that range from Rs 5 lakh to Rs 1 crore.
Yes, a premium payment facility is available for installation. This premium can be paid in instalments, either monthly, quarterly, or half-yearly. This could be paid in a lump sum for the entire policy term.
This comprehensive health insurance coverage minimises out-of-pocket expenses by offering cashless treatment in more than 11,000 network hospitals.
A co-payment is not needed until 60 years of age, and 10% is applicable to claims beginning at 61 years.
The cost of comprehensive health insurance in India is based on many things like the age of the insured, the coverage type, and the insurance provider. Here are some of the factors that affect the comprehensive health insurance costs.
i) Age
The insured person's age is one of the factors that determines the cost of health insurance. For example, a person in his/her 30's year old ay pay around less, while a person above 60 may pay around higher per year.
ii) Plan Coverage
The type of coverage in your plan you select will affect the cost.
iii) Insurance Provider
The insurance provider you select will also affect the cost.
The comprehensive health insurance premium is generally calculated by measuring various things like coverage, the insured person's age, the sum insured, the number of dependents, and soon. But these factors could differ from person to person, thus two people with a same health insurance plans could be charged various premiums.
A comprehensive health insurance meaning explains that it is a policy that provides extensive coverage for different medical expenses, far beyond just hospitalisation costs. These plans usually include inpatient and outpatient treatments, ambulance charges, pre- and post-hospitalisation care, daycare procedures, annual health check-ups, and even expenses associated with organ donation and alternative treatments such as the AYUSH.
An individual needs a comprehensive health insurance policy for financial safety against increasing medical costs and access to quality healthcare without financial constraints. The comprehensive insurance health-wise maintains the peace of mind by meeting the financial stress during a medical emergency. This plan comes with broad coverage for various treatments and emergencies.
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Health Insurance Coverage for pre-existing medical conditions is subject to underwriting review and may involve additional requirements, loadings, or exclusions. Please disclose your medical history in the proposal form for a personalised assessment.
The information provided on this page is for general informational purposes only. Availability and terms of health insurance plans may vary based on geographic location and other factors. Consult a licensed insurance agent or professional for specific advice. T&C Apply. For further detailed information or inquiries, feel free to reach out via email at marketing.d2c@starhealth.in
The information provided on this page is for general informational purposes only. Availability and terms of health insurance plans may vary based on geographic location and other factors. Consult a licensed insurance agent or professional for specific advice. T&C Apply. For further detailed information or inquiries, feel free to reach out via email at marketing.d2c@starhealth.in
