Star Family Health Optima Insurance Plan | Full Information

Star Family Health Optima Insurance Plan is a super saver plan, which provides coverage at a reasonable cost to the entire family members, including spouses and dependent children in the age group of 16 days to 25 years. People from 18 years to 65 years living in India can buy this policy. After 65 years of age, the plan can be renewed for life. Under this policy, the gift of health check-ups is given for every claim-free year. The plan brings in automatic restitution of up to 100% of the Sum Assured for every complete exhaustion.

Star Family Health Optima Insurance Plan | Full Information

Star Family Health Optima Insurance Plan covers hundreds of day-care procedures, pre-hospitalization, and post-hospitalization, home hospitalization, donor expenses for an organ transplant, coverage for newborn baby from day 16, and provides similar comprehensive coverage. , Policyholders can get an additional sum insured by spending a little more. Due to the sedentary lifestyle, people have now become more vulnerable to health issues and the cost of medical treatment is also exorbitant. This comprehensive and affordable plan helps pay the hospital bills of the entire family.

Star Family Health Optima Insurance Plan | Inclusion

The coverage provided in Star Family Health Optima Insurance Plan is as follows:-

  • Health Checkup Cost: It provides health checkup benefits for each claim-free year.
  • Home hospitalization: It provides coverage for treatment done at home for a period not exceeding 3 days on the recommendation of a doctor.
  • Inpatient hospitalization expenses: This covers hospitalization costs for at least 24 hours, including room charges, boarding expenses, nursing expenses, medical practitioners, surgeons, anesthetists, specialists, and consultants. Fees etc. are included.
  • Emergency Road Ambulance: It provides coverage for emergency ambulance services taken to reach the nearest hospital as per the specified limit.
  • Air Ambulance: It provides coverage for air ambulance services up to 10% of SI.
  • Pre-hospitalization expenses: This includes expenses up to 60 days before hospitalization.
  • Post Hospitalization Expenses: This includes hospitalization expenses up to 90 days after discharge from the hospital.
  • Newborn Coverage: It provides newborn baby cover subject to a limit of 10% of SI or Rs 50,000, whichever is lower.
  • Coverage for modern treatment: It covers the expenses incurred on modern treatment.
  • Emergency Home Medical Evacuation: The insurer covers the expenses incurred for transportation of the policyholder from one hospital to another up to the specified limit. Coverage is limited within India.
  • Repatriation of mortal remains: The insurer will reimburse up to Rs.5,000 towards the cost of repatriation of the mortal remains of the insured to the city of residence.
  • Compassionate Travel: If the insured is hospitalized in another city, the insurer will reimburse up to Rs.5000 towards air transport expenses for one family member.
  • Treatment in Network Hospital: In case of emergency hospitalization, the insurer may suggest a suitable hospital from the list of network hospitals for treatment and will provide a lump sum payment of up to 1% of SI subject to a maximum of Rs.5000 per policy.
  • Shared Accommodation: It pays for the shared accommodation expenses during the hospitalization of the patient up to the specified limit.
  • Second Medical Opinion: This pays for the cost of obtaining a second medical opinion from any of the impaneled doctors.
  • Additional Sum Assured for Road Traffic Accident: In case of accidental hospitalization, the Basic Sum Assured will be increased by 25%, subject to a maximum limit of Rs.5 lakh. But to avail of this benefit, the insured rider/previous rider must wear a helmet while traveling in a two-wheeler.
  • Assisted Fertility Treatment: Compensation is provided for the expenses incurred on Assisted Fertility Treatment for the subfertility. It can be covered only after the completion of the waiting period of 36 months from the date of commencement of the policy. For a sum insured of Rs 5 lakh, the compensation limit is Rs 1 lakh and for a sum insured of Rs 10 lakh or more, the limit is Rs 2 lakh.

Star Family Health Optima Plan | Eligibility Criteria

Have a look at the eligibility criteria of the Star Family Health Optima plan given below:-

  • Any person between 18 years to 65 years living in India can buy this plan.
  • Lifelong renewal is possible for all applicants.
  • Children ages 16 days to 25 years can be covered.
  • Family members who may be covered include self, spouse, dependent children, dependent parents, and dependent parents.

Star Family Health Optima Plan | Claim Process

To file a claim under the Star Family Health Optima plan, just follow the simple procedure given below:-

  • Report a medical emergency/claim to the insurance company’s 24-hour support number.
  • Provide policy number and ID proof.
  • For planned hospitalization, inform the insurer 24 hours before the hospitalization.
  • Cashless hospitalization cover can be availed in-network hospitals.
  • For treatment in non-network hospitals, the insured needs to pay and then file for reimbursement.
  • Claim approval is based on the submission of required documents.
  • In the case of a cashless claim, the claim amount will be settled directly with the hospital.
  • In a reimbursement claim, the claim amount will be paid to the policyholder after verification of the documents submitted.

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Star Family Health Optima Insurance | Benefits

The key features and benefits of the Star Family Health Optima plan are as follows:

  • Floater Coverage: This plan provides coverage to the policyholder and family members on a floater basis.
  • Sum Insured: It comes with a sum insured ranging from Rs 1 lakh to Rs 25 lakh.
  • Automatic Reinstatement of Sum Assured: 100% of Sum Assured will be restored on the expiry of a maximum of 3 times during the policy term.
  • Lifelong policy renewal: Lifelong policy renewal is possible for all policyholders.
  • Co-payment: If applicants are above 60 years of age, 20% of the co-payment is applicable on each claim and their subsequent renewal.
  • Pre-approval Medical Examination: People above the age of 50 years will have to undergo a pre-approval medical examination at a registered diagnostic center. The cost of the medical examination is also borne by the insurer.
  • Recharge Benefit: Additional coverage amount up to the specified limit will be provided once in a policy year in case the sum insured expires.
  • Cumulative Bonus: Increase in Sum Assured by 25% in the second year and an additional 10% for each claim-free year in subsequent years (Subject to policy terms and conditions).
  • Direct Claim Settlement: Direct claim settlement without the involvement of any third-party administrator.
  • Cashless Treatment: Cashless hospitalization can be availed at over 11,000 network hospitals across India.

READ MORE: Star Health Corona Rakshak Policy

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