STAR FAMILY HEALTH OPTIMA

Family Health Optima from Star Health is a health insurance plan that gives protection for the entire family on the payment of a single premium under a single sum insured.The sum insured floats among the family members insured.It's just one more way to tighten the family bonds.

Policy Benefits

Hospitalisation Cover:Protects the insured person for in-patient hospitalisation expenses for a minimum of 24 hours.These expenses include room and boarding charges as per policy conditions

Nursing expenses

Surgeon's fees,Consultant's fees, Anaesthetist's and Specialist's fees

Cost of medicines and drugs

Emergency ambulance charges for transporting the insured patient to the hospital upto a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period

A Super Saver Policy

• Single Sum Insured
• Coverage for entire family
• Single Premium
• Considerable saving in premium as the family is covered under one policy

Pre and Post Hospitalisation Cover

• Pre-hospitalisation medical expenses upto 30 days prior to the date of admission
• Post-hospitalisation calculated at 7% of the hospitalisation expenses(excluding room charges),subject to a maximum of Rs.5000 is payable.

Family Includes

• Proposer,spouse,dependent children upto 25 years those who are economically dependent on their parents.

Eligibility

• Any person aged between 5 months and 60 years residing in India can take this insurance.

How much to pay?

A: Adult C: Children upto 25 yrs. NA: Not Available

Age of the oldest family member covered should be taken for premium calculation
Service tax extra

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.

Exclusions

• Expenses for the treatment of any illness/ disease/condition which is pre-existing
  Treatment of illness/disease/sickness contracted by the insured person during the first 30 days from the commencement date of the policy
• First Two Years Exclusions:Cataract,Hysterectomy for Menorrhagia or Fibromyoma,Replacement surgery for knee and/or joint (other than caused by an accident),Prolapse of intervertebral disc(other than caused by accident),varicose veins and varicose ulcers
• First Year Exclusions:Benign Prostate Hypertrophy,Hernia,Hydrocele,Fistula in anus,Piles,Sinusitis and related disorders,congenital internal disease/defects, removal of gallstones and renal stone
• Naturopathy treatment
• Expenses which are purely diagnostic in nature with no positive existence of any disease
• Expenses incurred for non-allopathic treatment
• Treatment of external Congential disease/defects/anomalies
• Expenses which are mainly cosmetic in nature
  
  NOTE:For a detailed list of exclusions, refer policy document.

Claims Procedure

• Inform the ID number for easy reference
• In case of a planned hospitalisation, please inform 24 hours prior to admission into the hospital
• In case of emergency hospitalisation, information to be given within 24 hours after hospitalisation
• At non-network hospitals,payments must be made upfront and then reimbursement will be effected on the submission of documents
  
  NOTE:The benefits and exclusions mentioned herein are only an outline of the policy.For complete details, please contact your nearest Star Health office