Star Health Special Care

Star Health Special Care is a health cover for children aged between 3 and 25 years. This is a specially designed product for children who are suffering from Autism Spectrum Disorder (ASD). Usually, ASD is diagnosed in childhood from the age of 2-3 years, but sometimes ASD develops even during toddlerhood days. But a Star Health Special Care can cover your child against health risks financially with a sum insured of INR 3 lakh. Also, Star Health doesn’t require any pre-acceptance medical check-up. However, along with your signed proposal form, submit a copy of the prior treatment records of your child. Let’s read this page below and know about Star Health Special Care coverage and exclusions.

Coverage Under Star Health Special Care

Star Health will pay the following expenses if you purchase the Star Health Special Care policy.

1. Room Rent, Boarding and Nursing Expense from hospital/nursing home up to INR 5,000
2. For Shared Accommodation, Hospitalization Expenses to be covered are as follows INR 500 per day, INR 2,000 for each hospitalization and INR 10,000 per policy period.
3. Surgeon, Anesthetist, Medical Practitioner, Consultants and Specialist fees
4. Cost of anesthesia, blood, oxygen, surgical appliances, medicines and drugs used during your hospitalization.
5. Operation theatre charges
6. ICU charges 
7. Emergency Ambulance charges up to INR 750 per hospitalization and INR 1,500/ per policy period.
8. Post-hospitalization expenses equal to 7% of the hospitalization expenses or the actuals incurred up to 60 days after discharge from the hospital.
9. All daycare treatments
10. Modern Treatments

Sub-limits for Ailments/Treatments Under Star Health Special Care

Star Health put a cap for covering the following diseases under this health insurance plan.

1. Adeno Tonsillectomy has a sub-limit of INR 25,000 per policy period
2. Treatment of Seizures is capped at INR 30,000 per policy period
3. Treatment of fractures is capped up to 20% of the sum insured per policy period
4. Botox injection capped at INR 5,000 per sitting and covered up to INR 20,000 per policy period, only when it is administered during in-patient hospitalization.
5. Behavioral Therapy, Physiotherapy, Occupational Therapy and Speech Therapy capped up to INR 15,000 per policy period.

Waiting Period on Star Health Special Care

Star Health is not liable to pay certain medical expenses related to Pre-Existing Diseases for a certain period, which is also called a waiting period in a health insurance policy. So let’s check out the waiting period for treatment/diseases under Star Health Special Care.

Exclusions from Star Health Special Care

Star Health is not liable to pay for the following expenses under this health insurance plan.

1. Investigation & Evaluation
2. Rest Cure, rehabilitation and respite care
3. Obesity/ Weight Control Programmes
4. Change-of-Gender treatments
5. Cosmetic or Plastic Surgery
6. Injury from participation in Hazardous or Adventure sports
7. Breach of law with a criminal intent
8. Treatment at excluded providers
9. Alcoholism and Drug Abuse treatments
10. Treatments at health hydros, nature cure clinics, spas or similar establishments
11. Non-prescribed dietary supplements and medicines
12. Refractive error
13. Unproven treatments
14. Sterility and infertility treatments
15. Maternity expenses
16. Congenital Internal disease, defect or anomalies excluded till the waiting period completes
17. Convalescence, General Debility, Run-down condition and Nutritional Deficiency states
18. Venereal disease
19. Sexually transmitted diseases(Other than HIV)
20. Injury/Illness due to war, invasion, an act of foreign enemy and warlike operations
21. Injury/Illness due to nuclear weapons/materials
22. Cerebral palsy
23. Mental retardation
24. Chromosomal
25. Genetic abnormalities
26. Unconventional, untested, experimental therapies
27. Chondrocyte Implantation
28. Bone marrow transplantation
29. Naturopathy Treatment
30. Erectile dysfunctions treatments
31. Inoculation or Vaccination (not for post-bite treatment and medical treatment for therapeutic reasons)
32.  Dental treatment or surgery
33. Expenses of diseases, illness or accidental injuries treatment from the system of medicines other than Allopathy
34. Hospital registration charges, admission charges, record charges, telephone charges and similar other charges
35. Expenses of spectacles, contact lens, hearing aids, walkers, crutches, wheelchairs, muscle relaxing pump, CPAP, BIPAP, etc.
36. Continuous Ambulatory Peritoneal Dialysis, infusion pump and similar aids
37. Cochlear implants and procedure-related expenses
38. Hospitalizations that are not medically necessary
39. OPD expenses, except for Behavioral Therapy, Physiotherapy, Occupational Therapy and Speech Therapy

Free Look Period on Star Health Special Care

A free look of 15 days will be provided to you under Star Health Special Care during which you can read the terms and conditions of the policy and return the same if not satisfied with it. If you haven’t made any claim at Star Health Special Care during the free look period, you will be entitled to receive your paid premiums minus the medical examination expenses and stamp duty charges.

Claim Procedure for Star Health Special Care

To claim the sum insured from Star Health Special Care, you need to follow the below instructions:-

1. Contact the 24X7 help-line number – 1800 425 2255 or 1800 102 4477
2. Tell your Policy Number to the service provider
3. If this is a planned hospitalization, inform Star Health 24 hours before hospitalization
4. Whereas in case of emergency hospitalization, inform Star Health within 24 hours of hospitalization.

Note- For cashless facilities get treatment at network hospitals. Because if you get treatment in non-network hospitals, you need to pay upfront and get the expenses reimbursed by Star Health later by submitting the necessary documents.