Star Health Gain Insurance
Objective
This policy aims to provide for both, inpatient and outpatient treatment.
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.
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.
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.
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.
Eligibility
Entry Age (years)
Minimum
5 months
Maximum
60
Coverage Type
Individual/ Family floater
Sum Insured (Rs)
Maximum
5 lakh
Minimum
1 lakh
Policy Term (years)
1
Tax Benefit
Premium paid is eligible for tax benefit under section 80D of the Income Tax Act
Customer Service
Address
Star 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 to
1800 425 2255/ / 044 2826 3300
SMS
STAR to 56677
Additions to the Plan
| Scope Of Cover | |
| Cashless facility | Available at empanelled network hospitals in India |
| Re-imbursement | Available |
| Pre hospitalisation | covers medical expenses upto 30 days prior to the hospitalisation |
| Post Hospitalisation | lumpsum calculated at 7% of the hospitalization expenses (excluding room charges) subject to a maximum of Rs.5,000 per occurrence |
| In-patient hospitalisation | Covered |
| Room rent, boarding | 2% 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 medicines | covered |
| Emergency Ambulance | Rs 750 per hospitalisation upto maximum of Rs 1500 per policy period |
| Out-patient Treatment | Covered |
| Pre-existing diseases | Covered |
| dental expenses | Covered |
| prenatal and postnatal care | Covered |
| Exclusions and Waiting Period | |
| for in patient cover | |
| Pre existing diseases | Covered after 48 months |
| No claim period | Any disease contracted during the first 30 days of commencement of the policy |
| Waiting Period | Certain 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 Cover | no exclusions |
Cost Details
| Annual Premium Option for Individual | |||||
| Age (in years) | Sum Insured for Inpatient Treatment (in Rs) | ||||
| 1 lakh | 2 lakh | 3 lakh | 4 lakh | 5 lakh | |
| Sum Insured for Outpatient Treatment (in Rs) | |||||
| 5mths-45 | 8700 | 7750 | 7000 | 6250 | 5750 |
| 46-55 | 7900 | 6350 | 5200 | 3000 | NA |
| 56-60 | 7500 | 5800 | 3700 | NA | NA |
| 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 Size | Age (in years) | 1 lakh | 2 lakh | 3 lakh | 4 lakh | 5 lakh |
| Sum Insured for Outpatient Treatment (in Rs) | ||||||
| 2Adults | 5mths-35 | 8400 | 7400 | 6750 | 5900 | 5250 |
| 36-45 | 8400 | 7400 | 6500 | 5500 | 4900 | |
| 46-55 | NA | 5650 | 4000 | 2000 | NA | |
| 56-60 | NA | 5000 | 2250 | NA | NA | |
| 1Adult+1Child | 5mths-35 | 8500 | 7700 | 6950 | 5750 | 5500 |
| 36-45 | 8500 | 7500 | 6750 | 5750 | 5250 | |
| 46-55 | NA | 5850 | 4500 | 2400 | NA | |
| 56-60 | NA | 5200 | 2250 | NA | NA | |
| 1Adult+2Children | 5mths-35 | 8450 | 7500 | 6900 | 6000 | 5500 |
| 36-45 | 8450 | 7250 | 6650 | 5750 | 5000 | |
| 46-55 | NA | 5750 | 4450 | 2250 | NA | |
| 56-60 | NA | 5150 | 2250 | NA | NA | |
| 1Adult+3Children | 5mths-35 | 8350 | 7400 | 6650 | 5750 | 5250 |
| 36-45 | 8350 | 7200 | 6450 | 5500 | 4750 | |
| 46-55 | NA | 5500 | 4000 | NA | NA | |
| 56-60 | 4750 | 2250 | NA | NA | NA | |
| 2Adults+1Child | 5mths-35 | 8250 | 7250 | 6600 | 5750 | 5000 |
| 36-45 | 8250 | 7000 | 6150 | 5450 | 4500 | |
| 46-55 | NA | 5250 | 3750 | NA | NA | |
| 56-60 | NA | 4500 | 1500 | NA | NA | |
| 2Adults+2Children | 5mths-35 | 8250 | 7000 | 6500 | 5500 | 4650 |
| 36-45 | 8250 | 7000 | 5950 | 5000 | 3750 | |
| 46-55 | NA | 5000 | 3500 | NA | NA | |
| 56-60 | NA | 4250 | 1500 | NA | NA | |
| 2Adults+3Children | 5mths-35 | 8250 | 7000 | 6250 | 5250 | 4250 |
| 36-45 | 8250 | 6700 | 5750 | 4900 | 3700 | |
| 46-55 | NA | 4750 | 3250 | NA | NA | |
| 56-60 | NA | 4000 | 1150 | NA | NA | |
| Annual Premium (in Rs) | 13350 | |||||
| Premium is exclusive of service tax and cess | ||||||
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