Health Insurance 3239 views February 14, 2020

Star Outpatient Care policy

A leading private sector insurance provider ‘Star Health’ has recently launched a specific health insurance plan to cover outpatient care procedures. This launch is in regard to honour the long-standing demand of insured to cover outpatient care expenses under the health insurance policies. Traditionally, the health insurance policies are designed to cover the expenses incurred in the event of hospitalization for more than 24 hours for treatment related to disease or injury. The health insurance policy also covers for the pre-hospitalization and post-hospitalization expenses incurred for the check-up and diagnostic tests related to the same.

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However, a healthy individual tends to visit a physician for treatment which is not of a serious nature therefore under such situations a health insurance policy covering outpatient care expenses is much appealing. Considering these appealing considerations by most of the policyholders IRDA, the insurance regulatory body in India, also favours providing outpatient Care cover under the traditional health insurance policy. However, most of the health insurance providers fear to provide the OP cover due to the higher probability of fraud. But, to meet the expectation of the existing and future customers, Start Health launches star outpatient care policy, a standalone plan instead of a traditional health insurance cover.

All the expenses related to outpatient care is not usually covered under the normal health insurance policy. However, the recently launched start outpatient care policy offers expense cover for all the incurred for the treatment under the outpatient department. The outpatient consultation involves treatment of the ailment, injury or disease which requires medical attention from a doctor without getting admitted to the hospital. A normal expense incurred under outpatient consultation includes doctor fees, diagnostic test expenses, pharmacy bills, charges of physiotherapy, non-allopathic treatments, dental treatments, and other therapeutic procedures.

Benefits of Star Outpatient Care Policy

The benefit of availing the policy are as under:

  1. Immediate outpatient consultation at any network hospital across India
  2. Covers for the expenses of Non-Allopathic Treatments like Ayurvedic treatment, Yoga and Naturopathy treatments, Unani, Siddha, Homeopathic Treatments availed from a government recognized institute and accredited by the Quality Council of India/National Accreditation Board on Health
  3. Covers the expenses related to diagnostic tests, pharmacy bills, and physiotherapy treatments
  4. Covers dental treatment expenses carried out at any network hospital
  5. Covers eye treatment / ophthalmic treatment arising out of an accidental injury. The treatment is to be carried out at any Network Hospital in India under the Outpatient Department.
  6. The insured is eligible to receive a 25% discount on the premium amount at the time of renewal. This renewal discount is received after every 2 continuous claim-free years.
  7. Waiting Period: The plan mentions a certain waiting period under which the Star Health Company is not liable to cover expenses directly or indirectly. The waiting period under the plan is as under:
    • First, 30 days starting from the date of issuance of a policy
    • Under the Silver Plan, 48 months for pre-existing disease
    • Under the Gold Plan, 24 months for pre-existing disease
    • Under the Platinum Plan, 12 months for pre-existing disease
  8. The policyholder is eligible to receive income tax benefit under section 80D of the Income Tax Act, 1961.
  9. The plan offers a free look period of 15 days to the customers in case they wish to review their decision to purchase a policy
  10. A grace period of 30 days is offered for renewal starting from the date of expiry of the policy

Star Outpatient Care Policy Premiums

The benefits of the Star Outpatient Care Policy are impressive, but how much will you need to pay to get the same? The premium outgo will depend on the sum insured, the plan variant and the number of insured members. Sum insured options are INR 25,000, INR 50,000, INR 75,000 and INR 1,00,000 across Silver, Gold and Platinum Plan variants. The premium amount starts from INR 10,821 annually. Let’s check out the table below to know the premium applicable to different variants of this health insurance plan.

Silver Plan

Number of Insured Members2500050000750001,00,000

Gold Plan

Number of Insured Members2500050000750001,00,000

Platinum Plan

Number of Insured Members2500050000750001,00,000

Important Notes

  • The premium shown above is inclusive of tax
  • In the case of floater policies, the premium for members (2 to 6) will apply.
  • If it is an individual policy and the number of members is more than 1, the premium will be an individual premium x number of members.

Eligibility Criteria

The company states certain pre-determined eligibility criteria for the purchase of the policy. This plan offers coverage to customers in the age group of 18 years to 50 years. Dependent children from the age of 31 days are also covered under the plan. The coverage for dependent children can be extended up to 25 years under the floater policy. Under this plan, dependent children are defined as those who do not have their independent source of Income.

The insured has an option to choose the sum insured as per their convenience. The plan offers 4 sum insured options – Rs 25000, Rs 50000, Rs 75000, and Rs 100000.

Advantage of buying Star Outpatient Care Policy

A Star Outpatient Care Policy is designed to cover the OPD expenses which does not require hospitalization. The advantage of buying this policy is as under:

  1. the insurance provider offers direct in-house claim settlement thereby reducing the turn-around-time for claim settlement. Also, it cuts down the involvement of third-party administrator
  2. ensures faster and hassle-free claim settlement
  3. Star Health has a network of 9800+ hospitals across India

Final Words

Doctor consultation, pharmacy bills, cost of diagnostic tests, etc have increased exponentially in the past years. So availing a Star Outpatient Care Policy offers financial relief to many individuals who are spending a substantial amount on healthcare expenses.

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