MEDICLASSIC - FAMILY HEALTH OPTIMA

 
When a family member is ill, it is a traumatic time for the rest of the family. Star Health provides Family Health Optima to protect all members of a family from financial setbacks in the event of a serious illness. The coverage is applicable equally to all members of the family.

Family Health Optima Benefits

  • Hospitalisation Cover: This would protect the insured person for in-patient hospitalisation expenses for a minimum of 24 hours. These expenses include room boarding expenses to a maximum of Rs.1500 per day in Class A cities, Rs.750/- in Class B cities or Rs.500/- in other locations
  • Nursing expenses
  • Surgeon's fees, Consultant's fees, Anesthetist and Specialist fees
  • Cost of blood, oxygen, diagnostic expenses, cost of pace makers etc
  • Cost of medicines and drugs
  • Emergency ambulance charges for transporting the covered patient to the hospital up-to a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period

Additional Benefits

  • The sum insured floats among the family members insured. In other words there is no need to take insurance for each member separately for separate sum insured
  • Thus there is considerable premium saving

Family Includes

  • Family would mean proposer, spouse, dependent children upto 25 years and those who are economically dependent on their parents

Pre - and Post Hospitalisation cover

  • Pre-hospitalisation Medical expenses up to 30 days prior to the date of admission or post-hospitalisation calculated at 7% of the hospitalisation expenses (excluding room rent) subject to a maximum of Rs.5000 is payable

Discount

  • A discount of 10% on Premium is allowed on renewal of the policy if there is no claim in the immediately preceding year of the policy. This discount is not cumulative

 

How much to pay?

 

A: Adult     C: Children upto 25 yrs.     NA: Not Available

 

Sum Insured : Rs. 1,00,000

 

5 Months - 45 Yrs

46 Yrs- 55 Yrs

56 Yrs- 60 Yrs

2A

1765

NA

NA

1A + 1C

1515

NA

NA

1A + 2C

1640

NA

NA

1A + 3C

1785

NA

NA

2A + 1C

1890

NA

NA

2A + 2C

2025

NA

NA

2A + 3C

2165

NA

NA

 

 

 

Sum Insured : Rs. 2,00,000

 

5 Months - 35 Yrs

36 Yrs- 45 Yrs

46 Yrs- 55 Yrs

56 Yrs- 60 Yrs

2A

2890

3140

5535

6400

1A + 1C

2715

3005

5265

6120

1A + 2C

2835

3075

5410

6225

1A + 3C

3085

3415

5715

6645

2A + 1C

3295

3555

5925

6965

2A + 2C

3455

3675

6450

7360

2A + 3C

3625

4060

6795

7820

 

 

 

Sum Insured : Rs. 3,00,000

 

5 Months - 35 Yrs

36 Yrs- 45 Yrs

46 Yrs- 55 Yrs

56 Yrs- 60 Yrs

2A

3985

4360

7605

10030

1A + 1C

3710

3940

6930

9185

1A + 2C

3825

4110

7160

9725

1A + 3C

4125

4440

7630

10095

2A + 1C

4190

4830

7865

10625

2A + 2C

4310

5110

8400

11090

2A + 3C

4615

5320

8710

11755

 

 

 

Sum Insured : Rs. 4,00,000

 

5 Months - 35 Yrs

36 Yrs- 45 Yrs

46 Yrs- 55 Yrs

56 Yrs- 60 Yrs

2A

5195

5565

10510

13515

1A + 1C

4750

5070

9660

12730

1A + 2C

4910

5250

10150

13210

1A + 3C

5365

5725

10980

13755

2A + 1C

5295

5775

11270

14290

2A + 2C

5645

6240

11870

14890

2A + 3C

6025

6540

12585

15815

 

 

 

Sum Insured : Rs. 5,00,000

 

5 Months - 35 Yrs

36 Yrs- 45 Yrs

46 Yrs- 55 Yrs

56 Yrs- 60 Yrs

2A

5920

6525

12010

15855

1A + 1C

5370

5955

11550

15225

1A + 2C

5630

6285

11865

15645

1A + 3C

6035

6770

12390

16275

2A + 1C

6345

7045

12815

16750

2A + 2C

6875

7675

13210

17450

2A + 3C

7260

8195

13860

18105

 

 

 

IT Benefit
  • Premium paid by cheque for this insurance is eligible for relief under section 80D of the IT Act

Claim Procedure

  • Call 24 hour help-line for assistance
  • Inform ID number for easy reference
  • For planned hospitalisation, please inform 48 hours prior to admission to the hospital
  • For emergency hospitalisation, information to be given within 24 hours after hospitalisation
  • Cashless facility can be availed at all network hospitals
  • For treatment in non-network hospitals, reimbursement of expenses will be effected on submission of all medical documents

Exclusions

  • Expenses incurred for treatment of any illness/ disease/ condition, which is pre-existing at the time of commencement of insurance
  • Any expenses incurred for treatment of illness/ disease/ sickness contracted by the Insured Person during the first 30 days from the commencement of the policy
  • First Year exclusions Hernia, Piles, Hydrocele, Congenital Internal disease/ defect, Sinusitis, Gall Stone / Renal Stone removal / treatment
  • Second Year Exclusions Hysterectomy for Menorrhagia or Fibromyoma, Cataract, Knee Replacement Surgery (other than caused by an accident), Joint Replacement Surgery (other than caused by an accident), Prolapsed Intervertebral Disc (other than caused by an accident), Varicose veins / ulcers
  • Naturopathy treatment
  • Expenses, which are purely diagnostic in nature with no positive existence of any disease
  • Expenses those are mainly cosmetic in nature
  • Expenses incurred for treatment of diseases/illness/accidental injuries by systems of medicines other than Allopathic
  • Expenses incurred for treatment of congenital disease/defects/anomalies
  • For a detailed list of exclusions please refer policy conditions

Eligibility

  • Any person aged between 5 months and 60 years residing in India, can take this insurance

Back