Optima Plan by Star Health provides affordable
health insurance to the entire family, including spouse children, and dependent parents, aged 16 days - 25 years old. A person who lives in India between 18 and 65 years of age can buy this policy. You can renew your health plan for life after 65 years old. Each claim-free year under this policy is rewarded with a free health check-up. Upon exhaustion, the plan automatically restores the sum insured three times by 100%.
In addition, Star Health Optima offers a wide range of benefits, including coverage for hundreds of daycare procedures, pre-hospitalization and post-hospitalization, home hospitalization, organ donation expenses, newborn baby coverage from the sixteenth day, and so on. With a little more spending, policyholders can get a little more insurance coverage.
Features of Family Health Optima Plan
Star Health's Family Health Optima insurance plan has the following features:
- You, your spouse, and your dependent children can be covered under this family floater policy
- As long as you don't have any adverse medical conditions when you purchase the policy, you don't need to undergo any pre-entrance health checks until 50 years of age.
- In the event of a road accident that results in hospitalization, the sum insured is increased by 25%
- Instead of paying the premium in one lump sum, you can pay it in monthly, quarterly, or half-yearly installments
- A unique benefit offered by the policy is the ability to be evacuated, to receive a compassionate visit, or to have mortal remains repatriated
- As long as the policy specifies limits, modern treatments are also covered
- Under the plan, you can renew your coverage lifelong without having to reach a certain age.
Benefits of The Family Health Optima Plan
Star Family Health Optima also offers the following benefits along with being a comprehensive health insurance plan for your family:
- Your family members can all be insured for a single sum insured
- A high sum insured can be chosen without breaking the bank thanks to installment premiums
- Checking your health regularly is made easy by free annual health checkups
- In the event of a severe medical emergency, the sum insured restoration and recharge benefits ensure that you are not left without coverage
- There are no third-party administrators at the company, and all claims are settled internally. As a result, the claim process is smooth and settlements are easy
- It is easy to find a hospital for cashless claims with over 9900 hospitals in the network
- With Star Family Health Optima, you can port from any existing health insurance policy for free.
Inclusions Under Family Health Optima Plan
- Hospitalizations as inpatients - This head covers the expenses associated with hospitalization for 24 hours or longer. These expenses include boarding fees, nurses' fees, surgeons' fees, doctors' fees, operation theatre charges, room rent, ICU rent, medicines, and drugs, among others.
- Expenses associated with pre-hospitalization - Under this heading are covered expenses incurred before hospitalization. An allowance of 60 days is provided for such expenses before hospitalization.
- Costs associated with post-hospitalization - Under this head, you can claim expenses incurred after you leave the hospital. After you are discharged, such expenses can be incurred to investigate and track your recovery. After discharge, such expenses are covered for 90 days.
- Treatments of the modern age -There are certain terms and conditions attached to the plan's coverage of modern robotic treatments.
- Cost of ambulances - You would be covered for the cost of hiring an ambulance to take you to the hospital. Maximum coverage is INR 1500 per policy year and 750 per instance of hospitalization
- Cost of an air ambulance - You can also hire an air ambulance for transportation to the hospital under Star Family Health Optima. If the sum insured exceeds INR 5 lakhs, this coverage is available. You can get coverage up to 10% of your basic policy amount
- Treatments at day care centers - Modern technology allows day care treatments to be performed without 24-hour hospitalization. The Star Family Health Optima plan also covers these treatments
- Hospitalization in the home - The cost of such treatments would be covered if the treatment lasts for more than 3 consecutive days or if there are no vacant hospital beds available.
- Coverage for organ donors - An organ harvesting cost for transplantation would be covered under this head. There is a limit of Rs 1 lakh on the maximum amount of coverage at 10% of the sum insured.
- Health check-up - costs With a sum insured of INR 3 lakhs and above, you are entitled to free health checks every policy year. In order to be eligible for coverage, you need to get a checkup at a hospital that is part of the company's network. A maximum amount of coverage is allowed, which varies between INR 750 and INR 3500 depending on the sum insured
- Cover for a newborn baby - In the event that you have a child during the term of the policy, the newborn child would be covered from the 16th day of the policy until the end of the policy term. It is available for a maximum of INR 50,000 or 10% of the sum insured
- Evacuation of domestic medical emergencies - Emergency medical evacuation would be covered if the insured needed to change hospitals. Costs up to a specified limit would be covered. Depending on the sum insured, you can choose between INR 5000 and INR 10,000.
- Medical second opinion - A second medical opinion can be obtained free of charge from a panel of doctors affiliated with the health insurance company.
- Treatments for assisted reproduction- After 3 years of purchasing the policy, the insured would be covered for the cost of assisted reproductive treatments for pregnancy. A sum insured of 5 lakhs is covered up to INR 1 lakh, whereas a sum insured of more than 5 lakhs is covered up to INR 2 lakhs.
- Sum insured for accidents on the road - Hospitalisation following a road traffic accident would increase the sum insured under the policy by 25% of the basic sum insured. A maximum increase of INR 5 lakhs would be allowed.
Exclusions Under Family Health Optima Plan
Your entire family is covered with Star Family Health Optima. The plan does not cover some instances, however. In the policy, there are several exclusions, including the following:
- During the first 48 months of coverage, pre-existing illnesses are not covered
- In the first 24 months of the policy, certain illnesses are not covered, such as cataract surgery, fistula repair, gall bladder treatments, cyst removal, etc.
- Policyholders would not be covered for illnesses occurring within 30 days of purchasing the policy
- There is no coverage for weight management treatments
- Expenses associated with OPD treatments are excluded
- Surgical procedures, treatment of gender changes, infertility treatments, and treatments that are not proven are not included
- The insurance policy does not cover illnesses or medical expenses resulting from illegal activities, hazardous activities, substance abuse, intentional injuries, war, and nuclear perils.
- Plan coverage does not extend to maternity expenses.
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