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Star Health Gain Insurance

Objective

This policy aims to provide for both, inpatient and outpatient treatment.


Suited for

Anyone between 5 months and 60 years can be covered under this policy. It can be bought either on an individual basis or as a floater for family.


Pros

This policy can be bought online. Premium paid towards the policy qualifies for deduction under section 80D of Income Tax Act.


Cons

It extends the cover only up to 60 years of age.
Constant premium leaves no choice of selecting a higher or lower OPD cover.


Our View

Before buying, one must know the limit of outpatient benefit and inpatient cover under the policy. Though the premium remains same, the coverage is modified to justify the premium cost of Rs 15,000. Also, the outpatient cover is pre-decided by the insurance company that decreases with age due to an outflow of same premium. Hence one should ensure the adequacy of cover while taking such a policy.


What does it do?

It covers outpatient treatment along with hospitalisation expenses. Outpatient treatment includes dental treatment, prenatal and postnatal care expenses. Pre-existing diseases that are denied inpatient cover for initial four years, are covered for outpatient treatment from day one.
The policy charges same premium from individuals or family floater policies irrespective of the family size. Instead of changing premiums, the policy modifies the cover under each policy. There is a cap on maximum outpatient benefit that can be availed by a policyholder and other insured members (in case of floater policy) during a policy year. It also covers pre and post hospitalisation expenses and ambulance charges.

Eligibility
Entry Age (years) 
Minimum5 months
Maximum60
Coverage TypeIndividual/ Family floater
Sum Insured (Rs) 
Maximum5 lakh
Minimum1 lakh
Policy Term (years)1
Tax BenefitPremium paid is eligible for tax benefit under section 80D of the Income Tax Act
Customer Service 
AddressStar Health and Allied Insurance Company Limited
Corporate Office: No.1, New Tank Street,
Valluvar Kottam High Road, Nungambakkam,
Chennai - 600034.
Mail to[email protected], [email protected]
Call to1800 425 2255/ / 044 2826 3300
SMSSTAR to 56677
Additions to the Plan
Scope Of Cover
Cashless facilityAvailable at empanelled network hospitals in India
Re-imbursementAvailable
Pre hospitalisationcovers medical expenses upto 30 days prior to the hospitalisation
Post Hospitalisationlumpsum calculated at 7% of the hospitalization expenses (excluding room charges) subject to a maximum of Rs.5,000 per occurrence
In-patient hospitalisationCovered
Room rent, boarding2% of Sum Insured subject to a maximum of Rs. 4,000 per day in Class A cities; 1% of Sum Insured subject to a maximum of Rs 3000 per day in class B cities and 1% of Sum Insured subject to a maximum of Rs 1000 per day in other cities
Nursing expenses, Cost of Blood, Oxygen, Pacemaker, cost of drugs and medicinescovered
Emergency AmbulanceRs 750 per hospitalisation upto maximum of Rs 1500 per policy period
Out-patient TreatmentCovered
Pre-existing diseasesCovered
dental expensesCovered
prenatal and postnatal careCovered
Exclusions and Waiting Period
for in patient cover
Pre existing diseasesCovered after 48 months
No claim periodAny disease contracted during the first 30 days of commencement of the policy
Waiting PeriodCertain diseases such as hernia, piles, sinusitis etc shall be covered after a waiting period of 1 year.Certain diseases such as Cataract, Joint/Knee Replacement surgery(other than caused by an accident), Varicose Veins, Ulcers etc. will be covered after a period of 2 yearsCosmetic or beauty related treatmentsNaturopathy treatment
for Out patient Coverno exclusions
Annual Premium Option for Individual
Age (in years)Sum Insured for Inpatient Treatment (in Rs)
1 lakh2 lakh3 lakh4 lakh5 lakh
Sum Insured for Outpatient Treatment (in Rs)
5mths-4587007750700062505750
46-557900635052003000NA
56-60750058003700NANA
Annual Premium (in Rs)13350
Premium is exclusive of service tax and cess
Annual Premium Option for Family
Sum Insured for Inpatient Treatment (in Rs)
Family SizeAge (in years)1 lakh2 lakh3 lakh4 lakh5 lakh
Sum Insured for Outpatient Treatment (in Rs)
2Adults5mths-3584007400675059005250
36-4584007400650055004900
46-55NA565040002000NA
56-60NA50002250NANA
1Adult+1Child5mths-3585007700695057505500
36-4585007500675057505250
46-55NA585045002400NA
56-60NA52002250NANA
1Adult+2Children5mths-3584507500690060005500
36-4584507250665057505000
46-55NA575044502250NA
56-60NA51502250NANA
1Adult+3Children5mths-3583507400665057505250
36-4583507200645055004750
46-55NA55004000NANA
56-6047502250NANANA
2Adults+1Child5mths-3582507250660057505000
36-4582507000615054504500
46-55NA52503750NANA
56-60NA45001500NANA
2Adults+2Children5mths-3582507000650055004650
36-4582507000595050003750
46-55NA50003500NANA
56-60NA42501500NANA
2Adults+3Children5mths-3582507000625052504250
36-4582506700575049003700
46-55NA47503250NANA
56-60NA40001150NANA
Annual Premium (in Rs)13350
Premium is exclusive of service tax and cess

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