Family Health Optima Insurance Plan
A cover for You and Your Loved Ones too
Highlights
Plan Essentials
PED Buy-Back
On payment of additional premium, the waiting period for Pre-Existing Diseases can be reduced from 3 years to 1 year this is an optional cover.
Bariatric Surgery
Expenses incurred on hospitalisation for Bariatric surgical procedures are covered up to the limits mentioned in the policy clause.
Delivery Benefit
Both Normal and C-section delivery (including pre and post-natal) expenses are covered up to the limits mentioned in the policy clause.
Outpatient Cover
Outpatient consultation and outpatient treatment (Dental & Ophthalmic) expenses are covered up to the limits mentioned in the policy clause.
Cumulative Bonus
For Sum Insured of Rs. 5 lakhs, Cumulative Bonus is calculated at 50% of the basic Sum Insured after every claim free year up to a maximum of 100%. For Sum Insured Rs. 7,50,000/- or above, Cumulative Bonus is calculated at 100% of the basic Sum Insured.
Automatic Restoration of Sum Insured
On exhaustion of the basic Sum Insured during the policy period, 100% of the Sum Insured will be restored once in the policy year that can be utilised for illness or disease for which claims were already made.
Personal Accident Cover
Worldwide personal accident cover is provided in case of accidental death or permanent total disablement of the insured person during the policy period at no additional premium.
Hospital Cash
A cash benefit for each completed day in the hospital is provided up to the limits mentioned in the policy clause for a maximum of 7 days per hospitalisation and 120 days per policy period.
Detailed List
Understand what’s included
Policy TypeThis policy can be availed either on an Individual or Floater basis.
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Entry AgeAny person aged between 18 and 65 years can avail this policy. Dependent children are covered from the 91st day onwards up to 25 years.
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In-Patient HospitalisationHospitalisation expenses incurred for a period of more than 24 hours on account of illness, injury or accidents are covered.
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Pre-HospitalisationPre-hospitalisation medical expenses incurred up to 60 days before the date of admission to the hospital are covered.
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Post-HospitalisationPost-hospitalisation medical expenses up to 90 days from the date of discharge from the hospital are covered.
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Room RentThere is no capping on room rent (Private Single A/C room), Boarding and Nursing expenses under this policy.
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Road AmbulanceThe policy covers ambulance charges for admission to the hospital, shifting from one hospital to another hospital for better facilities and from hospital to the residence.
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Air AmbulanceAir ambulance expenses are also covered up to Rs. 2,50,000/- per hospitalisation, to the maximum of Rs. 5,00,000/- per policy period.
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Mid-Term InclusionThe newly married spouse and newborn baby can be included in the policy by paying an additional premium. The waiting periods will be applicable from the date of inclusion of new joiners.
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Day Care ProceduresMedical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered.
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Modern TreatmentModern treatment expenses are payable to the extent of the limits mentioned in the policy clause.
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Hospital CashA cash benefit for each completed day in the hospital is provided up to the limits mentioned in the policy clause for a maximum of 7 days per hospitalisation and 120 days per policy period.
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Domiciliary HospitalisationExpenses incurred for domiciliary hospitalisation, including AYUSH, which is taken for a period of more than three days on the advice of a Medical Practitioner are covered.
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Delivery ExpensesDelivery expenses including the Caesarean section (both pre-natal and post-natal) are covered up to the specified limits subject to the maximum of two deliveries.
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New Born CoverThe hospitalisation expenses for the new born baby are covered up to the specified limits based on the opted Sum Insured.
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Vaccination ExpensesVaccination expenses for the new born baby are covered up to the specified limits based on the opted Sum Insured.
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Automatic Restoration of Sum InsuredUpon exhaustion of the basic Sum Insured during the policy period, 100% of the Sum Insured will be restored once in the policy period.
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Co-paymentThis policy is subjected to co-payment of 10% of each and every claim amount for fresh as well as renewal policies for insured persons whose age at the time of entry is 61 years and above.
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Bariatric SurgeryHospitalisation expenses incurred for Bariatric surgical procedures are covered up to the limits of Rs. 2,50,000/- and Rs. 5,00,000/- which are inclusive of pre and post-hospitalisation expenses.
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AYUSH TreatmentExpenses incurred for the treatment under Ayurveda, Unani, Sidha and Homeopathy systems of medicines in AYUSH Hospitals are covered up to the specified limits.
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Outpatient ConsultationOutpatient expenses other than Dental and Ophthalmic treatments incurred in any Networked Facility are covered up to the limits mentioned in this policy.
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Outpatient Consultation – Dental & OphthalmicOutpatient expenses incurred for Dental and Ophthalmic treatments are covered up to the limits mentioned in the policy clause. The insured person is eligible to avail this benefit after every block of three years.
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Organ Donor ExpensesIn-Patient hospitalisation expenses incurred for organ transplantation from the donor to the recipient insured person are payable provided the claim for transplantation is payable.
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Health Check-UpHealth check-up expenses incurred at Network Hospitals are covered up to the specified limits for every claim-free year.
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Second Medical OpinionThe Insured person can avail a Second Medical Opinion from a Doctor in the Company’s network of medical practitioners. Medical records can be sent to the mail id e_medicalopinion@starhealth.in.
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Star Wellness ProgramWellness program designed to motivate and encourage the healthy lifestyle of the insured person through various wellness activities. In addition, the earned wellness bonus points can be utilised for availing renewal discounts.
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Instalment OptionsThe policy premium can be paid on a quarterly or half-yearly basis. It can also be paid on an annual, biennial (once in 2 years) and triennial (once in 3 years) basis.
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