Star Comprehensive Health Insurance Plan

If the cover amount along with accrued no-claim bonus amount gets exhausted during the year, then 100% of the cover amount will be restored for treatment of any illnesses only once in a policy year. This benefit can be availed for subsequent hospitalisation even for same illnesses which were made earlier. However, this benefit won’t be restored for modern treatments.

For example, Mr. Nitin purchased the Comprehensive Plan of Star Health in 2020 with a cover amount of Rs. 5 Lakhs. He made his first claim of Rs. 6 lakhs on being hospitalized for treatment of Liver disease in the year 2020. He will be paid Rs. 5 lakhs and he will have to bear the 1 lakh expense as his cover is exhausted. Now the restoration benefit will kick-in and the entire 5 lakhs cover is restored for any subsequent claim. 

In this plan the policyholder can avail single private A/c room, without any room rent capping. In-patient hospitalisation can be availed with no sub-limits on the room expenses.

Star Health Comprehensive plan offers their exclusive Disease management programme to its policyholders. It promotes healthy life through wellness programs and provides attractive premium discounts.

Under this plan, the policyholder can avail free health check up up to the sub limit as mentioned below with every claim free policy period. This benefit can be availed after the completion of the first policy year.  The cost incurred during this preventive check up will be reimbursed to the policyholder on presentation of invoices. The annual preventive health check-up is covered only if done in India.  There allowable health checkup costs are as mentioned below:

This plan provides cover on accidental death of the insured person up to the limit of cover amount. The company will pay the insured person as under:

Accidental Death of the Insured person: If there is an unfortunate demise of the insured person following the accident within 12 months from the date of accident, then the insurance company will pay 100% of the cover amount as compensation.

Permanent Total Disablement: If the accident causes permanent impairment (mentally or physically) then the insurance company will offer 100% payouts provided that the disability occurs within 12 months from the date of occurrence of accident.

Comprehensive plan of Star Health Insurance provides up to 100% increase in the cover amount with every claim free year. It means that if a policyholder doesn’t make any claim during the policy period then he/she is entitled to get a maximum of 100% increase in the cover amount.

Where the cover amount chosen by the policyholder is Rs. 5 Lakhs, then he/she is entitled to receive no claim bonus of 50% of the cover amount. This bonus can be accumulated maximum up to 100% of the cover amount.

Where the cover amount chosen by the policyholder is Rs. 7.5 Lakhs and more, then he/she is entitled to receive no claim bonus of 100% of the cover amount. This bonus can be accumulated maximum up to 100% of the cover amount.

In our example, Mr. Nitin had purchased a Comprehensive Health Insurance Plan with a cover amount of Rs. 10 Lakhs. He made no claims during a particular year. In that scenario, on renewal of  the policy, Mr. Nitin will receive Rs. 10 Lakhs as No Claim Bonus amount and the total cover amount available for claim purpose would be Rs. 20 Lakhs.

In this plan the policyholder has the option of reducing the waiting period for pre-existing diseases. One can pay an additional premium to reduce the waiting period. In the comprehensive plan the waiting period for pre-existing diseases is 3 years which can buyback by paying an additional premium.

Say, Mr. Nitin has had diabetes for 5 years. This will be considered under pre-existing disease and will have a waiting period of 36 months. However, if Mr. Nitin wishes to get the treatment and hospitalisation for ailments related to diabetes to be covered sooner, he can pay an additional premium i.e. 30% of the premium amount. Opting for this facility will reduce the waiting period from 36 months to 12 months.

This benefit is exclusive for newly married couples and also newborn babies are covered by paying an additional premium. Through this, the policyholder along with their spouse can intimate the insurer 60  days in advance before the date of marriage or newborn.

In this plan, if the policyholder opts for ambulance transportation to the nearest hospital or in case of transfer of hospitalisation for better medical treatment, or for any other medical emergency then the expenses incurred will be covered. The policyholder can opt for Air Ambulance transportation in case of life threatening situations. The expenses covered are up to Rs. 2,50,000 per hospitalisation, maximum up to Rs. 5,00,000

The plan covers all the expenses done by the insured person for 60 days of pre-hospitalisation. Not just pre but also the expenses incurred post 90 days of discharge from hospitalisation is taken care through this plan. Know more about what is pre & post hospitalisation expenses in health insurance plans.

Comprehensive Plan of Star Health provides coverage on expenses incurred on medical consultations as an outpatient at the network hospitals. The expenses covered in a policy period under for OutPatient Consultation are as follows:

However, there is a limit of Rs. 300 per consultation.

In case the policyholder is advised by the doctor to take medical treatment at their residency due to shortage of space at a hospital, then the medical expenses arising will be covered under this plan. Domiciliary treatments are the medical treatments that are provided to the policyholder at home instead of hospital.

However, under this plan, the domiciliary treatment won't cover medical treatment of a few illnesses such as Asthma, Bronchitis, chronic nephritis and Nephritic syndrome, diarrhea and all types of dysenteries including Gastroenteritis Diabetes and more.

Comprehensive plan of Star Health covers expenses incurred as in-patient hospitalisation for delivery of newborn and the initial treatment of the newborn baby. Vaccination expenses for the newborn baby are also covered as per the cover amount. All the expenses incurred for the newborn baby until one year is completely covered under this plan. However, this benefit can be availed only if the policyholder has completed a waiting period of 2 years at least.

The in-patient hospitalisation expenses incurred for organ transplant and transportation from the donor to the insured person can be claimed under this plan. Apart from these expenses, in case of complications, a Redo surgery / ICU admission or tests incurred during the process, coverage will be provided only for the insured person. Organ donor expenses are covered up to the limit of cover amount amount by the policyholder,

If the policyholder is hospitalized for more than 3 days, then the insurer provides a hospital cash benefit. For each day of hospitalisation, up to 7 days or 120 days during the entire policy period, hospital cash benefit can be availed.

Here is a short illustration to understand how much hospital cash can be availed under the Star Health Comprehensive Plan:

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Star Health Comprehensive Plan covers the expenses incurred on hospitalisation for complex surgeries and bariatric treatments during the policy period. There is a sub limit on the coverage provided on such treatments. The plan covers  maximum up to Rs. 2,50,000 and Rs. 5,00,000 for pre & post hospitalisation expenses. Treatment of such surgeries have a waiting period of 36 months and this benefit can be availed only if the policy is in force.

The policyholder gets the option to take a second medical opinion from any medical practitioner or doctor from the list of network hospitals of Star Health. This can be availed without any extra charge.

AYUSH stands for Ayurveda, Unani, Siddhi, and Homoeopathy treatments, which are covered under this plan. Expenses related to any of such treatments are covered up to the limit of cover amount chosen by the policyholder.

This plan promotes a healthy lifestyle by providing a wellness program to its policyholders. Under this program, the policyholder will receive a discount on the renewal premium on participating in wellness programs initiated by the health insurer. Below is illustration of the points earned and the discount against those reward points: