Star Family Health Optima Health Insurance
Cashless Approval TAT | Within 2 hours |
Claim Settlement Ratio | 99.10% |
Network Hospitals | 14,000+ |
Pre-existing Disease Waiting Period | 1 year |
Special Benefits | No Extra Premium for Disease Coverage |
Starting Premium for Rs. 5 lakhs SI | Rs. 410/month |
About Star Family Health Optima Health Insurance
The Family Health Optima Insurance Plan is a comprehensive health insurance plan. The plan provides financial protection for you and your loved ones during medical emergencies. With this Star Health Insurance Plan, you can cover yourself and your family members under a single policy. The policyholders of this family floater health insurance plan can monitor their health by using the free health check feature. Additionally, you can restore 100% of the sum assured up to three times in a year if the sum assured limit of your plan expires. Besides these standard benefits, Family Health Optima Plan policyholders can also avail of special discounts and rewards under the wellness program. Read on to find out more about the Family Health Optima Plan.
Star Family Health Optima Health Insurance At a Glance
Coverage |
Family |
Riders |
Personal Accident Rider, Critical Illness Rider, etc |
Variants |
N/A |
Key features |
Provides extensive coverage, Family health insurance plan, etc |
Inclusion |
AYUSH treatment, Organ donor, Modern treatment, etc |
Exclusion |
OPD treatment, Lasik Eye treatment, etc |
Key Features of Star Family Health Optima Plan
The key features of the Star Family Health Optima Plan are as follows:
- Family Plan: You can cover yourself and your family under a single health insurance policy with the Star Family Health Optima Plan.
- Policy Tenure: The policy tenure for the Star Family Health Optima Plan can be 1 or 2 years. However, you can renew the plan for a lifetime at affordable premiums.
- Maternity Coverage: The medical expenses incurred due to reproductive treatments as mentioned in the policy document are covered. Newborn baby coverage up to 10% or rupees fifty thousand, whichever is less provided from the 16th day of the birth.
- Wellness Program: The Star Family Health Optima also offers discounts under the Star Wellness Program. This means that if the policyholder is leading a healthy lifestyle, then they will be eligible for saving premium paid towards the Star Family Health Optima plan.
- Add-ons: You can include a number of add-ons to the Star Family Health Optima plan to further enhance the plan benefits. However, when you include these add-ons, the premium will become higher.
- Waiting Period: This plan comes with a specific waiting period for certain illnesses. The waiting period for pre-existing medical conditions is 4 years and the standard waiting period is of 30 days.
Eligibility Criteria For Star Family Health Optima Plan
The Star Family Health Optima Insurance Plan should meet the following eligibility criteria:
Parametres |
Eligibility Criteria |
Minimum entry age for child |
16 days |
Maximum entry age for child |
25 years |
Minimum entry age for adult |
18 years |
Maximum entry age for adult |
65 years |
Policy tenure |
1 or 2 year |
Benefits of Star Family Health Optima Plan
The benefits of the Star Family Health Optima Plan are highlighted below:
- Lifetime Policy Renewals: The policyholders of the Family Health Optima Plan can financially protect themselves during a medical emergency for a lifetime. In simple terms, the policy tenure is 2 years but you can renew this health insurance policy for a lifetime.
- In-House Claim Settlement: Star Health Insurance has an in-house claim settlement team to provide a seamless experience to customers. You can directly reach customer claim support for Family Health Optima Insurance Plan claim settlement.
- Tax Benefits: A premium paid against Star Family Health Optima policy is tax-free under Section 80D of the Income Tax Act, 1961.
- Affordable Health Coverage: When you purchase an individual health insurance policy, you pay separate premiums for each family member. However, with this family floater health plan, you can cover every family member under a single policy. Therefore, individuals can financially protect themselves and their dear ones against unforeseen medical emergencies at an affordable premium.
- Wide Network Hospitals: Star Health Insurance Company is associated with over 14000 network hospitals. The policyholders can visit these network hospitals to get high-quality medical care without paying hefty medical bills from their own pocket.
Riders Available with Star Family Health Optima Plan
To enhance the plan benefits even more, you can include a number of add-ons to your Star Family Health Optima plan. Some of the riders available with the Star Family Health Optima plan are as follows:
- Personal Accident Cover: With this rider, you will get coverage if you suffer any kind of injury and require hospitalisation due to any accident.
- Critical Illness Rider: This provides coverage in case the policyholder is diagnosed with any kind of critical illness.
- Reduction in PED Waiting Period: With this add-on, you can get the waiting period for pre-existing disease reduced.
Inclusions And Exclusions For Star Family Health Optima Plan
There are certain medical expenses that are not covered under the Star Family Health Optima Plan. A health insurance company will not pay for expenses that are not covered under a health plan. Therefore, when purchasing a health insurance plan, ensure that you read the policy document carefully to check what is covered and not covered under the plan.
Let’s find out the inclusions and exclusions for the Family Health Optima Insurance Plan:
Inclusions For Star Family Health Optima Plan
- Health checkup expenses
- Domiciliary hospitalization
- Daycare treatment
- In-patient hospitalization expenses
- Pre- and post-hospitalization
- Emergency road and air ambulance
- Orgon donor coverage
- Newborn baby coverage
- AYUSH treatment
- Assisted reproductive treatment
- Second medical opinion
Exclusions For Star Family Health Optima Plan
- Maternity coverage
- Cosmetic surgery or treatment procedures
- OPD treatment
- Hospital daily cash allowance
- Lasik eye treatment
- Injuries incurred during the war
- Medical emergency arising due to driving under the influence of alcohol or any other drugs.
Process To Buy Star Family Health Optima Plan
You can easily buy the Star Family Health Optima Plan online from the comfort of your home. All you need to do is visit the official website of InsuranceDekho and follow some simple steps. Read on to find out a detailed guide on how to buy the Star Health Insurance Plan online.
Documents Required To Buy Family Health Optima Plan
- Income proof
- Identity proof
- Bank details
- Nominee information
- Recent medical reports
- Policy form
- Address proof
Steps You Should Follow To Buy Family Health Optima Plan
- Go to the website of InsuranceDekho.
- Click on the “Star Health Insurance” tab available under the “Health Insurance Companies” section.
- Enter your full name and select the gender in the displayed form.
- Now select your age and enter your phone number.
- Click on the “Submit” button.
- On a new page that opens, select “Star Health Insurance Plans.”
- Choose the Star Family Health Optima Plan from the list.
- Submit all the necessary documents and complete the KYC process.
- Make a premium payment online to complete the process.
- Once the above process is complete, the policy document will be shared with your registered email ID.
Process To Claim Star Family Health Optima Plan
Star Health Insurance is one of the best insurance companies in India in terms of providing customer support. The company provides a 24-hour claim settlement service for its Family Health Optima Plan policyholders. Read on to find out the Star Health claim settlement process in detail!
Documents Required To Claim Family Health Optima Plan
- Original chemist bills
- Duly filled Star Health claim form
- Medical bills and other receipts
- Death certificate of the policyholder
- Details of surgeon
- FIR copy in case of accidental death
- Nominee bank details
Steps You Should Follow To Claim Family Health Optima Plan
Star Family Health Optima Plan policyholders can either make cashless or reimbursement claims. In cashless claims, you can visit any network hospital of your choice and avail of medical treatment without paying any expense from your own pocket. However, in reimbursement claim procedures, the policyholder can go to any hospital or medical center of their choice to get medical treatment. In this case, the policyholder pays the treatment cost out of their own pocket and reimburses it later.
Read on to find out the steps that you need to follow in each claim settlement process:
For Cashless Claims
- Locate and get admitted to any network hospital.
- Inform your insurance company about the hospitalisation.
- Submit your policy details and show your Star Health mediclaim card to the hospital authorities.
- The network hospital will verify your policy details. Once verification is completed, the network hospital will send the pre-authorization request form to a health insurance provider.
- The health insurance company will assess the claim details. Further, the company will confirm the claim status via fax or email.
- You will get discharged once an insurance company directly settles the claim with a network hospital.
For Reimbursement Claims
- Visit any hospital of your choice.
- Inform your insurance company about the hospitalisation within 7 hours.
- Get the treatment and pay the expenses incurred from your own pocket.
- Download the claim application form from the official website of Star Health Insurance.
- Duly fill out the form and attach all the necessary documents.
- Submit the form to a health insurance company.
- Star Health will assess your request for claim settlement and verify all the documents that you submitted.
- Once the above process is completed, an insurance company will either settle or reject your claim.
Health Insurance Calculator
Whom do you want the insurance for ?
Select the age of all members
- You
Where do you live ?
Choose required Coverage for yourself?
Key Inclusions and Exclusions of the Plan
What's Included
- In-patient hospitalisation like room charges, nursing expenses, ICU, surgeon’s fee, etc.
- Domiciliary hospitalisation (treatment at home) for a period exceeding three days
- All sorts of day care procedures are covered that take less than 24 hours
- Air ambulance charges up to 10% of the basic sum insured during the policy period
- Pre and post hospitalisation expenses 60 days and 90 days respectively
What's Not Included
- Injury or ailment caused due to warlike situations, invasion of enemy etc.
- Expenses arising due to self-inflicted injury or suicide attempt etc.
- Venereal disease and sexually transmitted diseases
- Dental treatments, unless required due to accidental injuries
- Vaccinations except for post-bite and other medical treatment
Family Health Optima Plan Details
Features/Plan | Star Family Health Optima (3,4 lakh) | Star Family Health Optima (5, 10, 15, 20, 25 lakh) |
---|---|---|
Restoration Benefit | Up to 300% of SI | Up to 300% of SI |
No Claim Bonus | Up to 100% of SI | Up to 100% of SI |
Room Rent | Up to Rs. 5000 | Single standard A/C room |
9625 Star Cashless Network Hospitals in India
Choose Star Health Insurance Critical Illness Plan
Choose Star Health Insurance Plan for
Star Family Health Optima Expert Review
-
-
Major Attractions
The plan comes with a lot of attractive coverage features. A few to note are- AYUSH treatment, second medical opinion, the additional sum insured for Road Traffic Accident, ambulance charges for emergency hospitalisation and so on. Other areas where this policy keeps you covered are-
- All the daycare procedures
- Expenses of a newborn baby from the 16th day
- Donor expenses for organ transplantation
- Cover for the cost of health check-up for every claim free year
- Cover for pre-existing diseases after the waiting period of 48 months
- Domiciliary treatment expenses if the treatment exceeds 3 days
- 60 days pre-hospitalisation expenses and 90 days post-hospitalisation expenses
- 3 times automatic restoration of the sum insured by about 100%, every time on complete exhaustion of sum insured
- In-patient hospitalisation expenses that include room, boarding and nursing charges, cost of medicines, etc.
- Cover for an air ambulance for up to 10% of the basic sum insured for every policy period (for sum insured options above Rs. 5 Lakh)
-
What’s More?
The list of benefits provided under this plan has not ended yet. With the policy, you also get the following-
- Lifetime renewability
- Tax benefits under Section 80D of the Income Tax Act
- Free look period for 15 days
- Health-related information through a free health magazine
- Cashless hospitalisation at the network hospitals
-
Conclusion
The policy certainly provides a comprehensive cover for your family. You can go for it if you have a nuclear family and are looking for an economical health insurance plan to get them covered.
Now the question is-From where should you buy this plan to get the best deal? The answer is direct-ONLINE! You can get online to any leading health insurance broker like InsuranceDekho and tell them your requirements. The customer care executives there will suggest the best suitable variant under this plan after Need Analysis.
Claim Process at Star Health Insurance
FAQs on Family Health Optima Health Insurance Plan
-
-
How much coverage one can avail out of air ambulance cover? Is this feature available for every policyholder having this plan?
The insured individuals can get only up to 10% of the basic sum insured per policy period. The air ambulance feature is available for people having a sum insured of Rs. 5 Lakh and above only.
-
Who needs to go through pre-acceptance medical screening?
Individuals above 50 years of age or those who present adverse reports about their medical history in the proposal form are required to undergo pre-acceptance medical screening at the centers empanelled under the company. The expense of such screening will be borne by the firms. The age for screening and the cost sharing are subject to change.
-
What is the coverage of newborn baby under Star Health Optima Plan?
The coverage for New Born Baby starts only after the 16th day of its birth till plan gets expired. This coverage is subject to an expense of 10% of the sum insured or Rs. 50,000, whichever is less, on the basis of the sum insured. It is applicable only if the mother of the baby is insured under the plan for a continuous period of 1 year without
break . -
How much co-payment is there under this policy?
The plan is subject to co-payment of 20% of each and every claim amount for fresh as well as renewal policies for insured persons whose age at the time of entry is above 60 years.