Health 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

How to buy this insurance?

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