When you turn 60, you might think there is nothing left in life for you. At that stage of your life, you can have more health issues. But having financial cover for the same will ensure a successful treatment of ailments, should they occur, without any cost. Yes, there’s one Star Health Senior Citizens Red Carpet Health Insurance plan that ensures the same. The Star Senior Citizens Red Carpet Health Insurance Plan provides cover to anyone between the age of 60 and 75 years. Read this post and find its features and benefits.
Eligibility for Star Senior Citizens Red Carpet Health Insurance Plan
You can buy this policy if you meet the below-mentioned criteria:-
- Age is between 60 and 75 years
- Agree to guaranteed lifelong renewals
The policy term can be for 1, 2, or 3 years which you can renew before it expires. If you are issued a policy for more than 1 year, the Sum Insured for each year can be carried without any benefit. Star Senior Citizens Red Carpet Health Insurance Plan is available on the Individual Sum Insured and Floater Sum Insured basis. On a floater Sum Insured basis, the sum insured floats amongst the insured persons. And the policy will cover all daycare procedures.
Sum Insured Options for Star Senior Citizens Red Carpet Health Insurance Plan
Check out the table below and understand the sum insured option of this health insurance plan.
And to reach the sum insured, you need to pay the premium for Star Senior Citizens Red Carpet Health Insurance Plan regularly. With the installment facility, the policy premium can be paid Monthly, Quarterly, Half-yearly. And also Annually, Biennial (Once in 2 years) and Triennial (Once in 3 years).
Star Senior Citizens Red Carpet Health Insurance Plan Coverage
The insurer provides you the following coverage in this policy-
- Hospitalization cover that includes room, boarding and nursing expenses. The room rent limit is up to 1% of the sum insured or INR 6,000 to 10,000 depending on your sum insured amount.
- Coverage for Modern Treatments
- ICU charges are covered in this policy whose limit is up to 2% of the sum insured or the actual sum insured depending on your sum insured amount.
- Surgeon, Anesthetist, Medical Practitioner, Consultants and Specialist fees are also covered for which the company has set a limit up to 25% of the sum insured per hospitalization of the insured person.
- Anesthesia, Blood, Oxygen, Operation Theatre, Pacemaker fees, with a limit up to 50% of the sum insured per hospitalization.
- Emergency ambulance charges per hospitalization whose limit ranges from INR 600 to INR 1,500.
- Pre hospitalization medical expenses which are incurred 30 days before the date of hospitalization. This cover applies to disease, illness, or injury.
- Post hospitalization expenses if they are recommended by the treating medical practitioner, for which the insurer has set a limit up to 7% of the hospitalization expenses comprising Nursing, Surgeon, Consultant, Diagnostic, Medicines, and drugs expenses.
Star Senior Citizens Red Carpet Health Insurance Plan Exclusions
The company is not liable to make any payments under this policy for the below-mentioned expenses:-
Pre-Existing Diseases: Any expenses related to your pre-existing disease and its consequence are excluded from the policy until the expiry of 12 months waiting period. And the insured needs to inform the insurer of their pre-existing diseases/conditions at the time of application and the same needs to be accepted by the Insurer.
Specified Disease or Procedure: Expenses related to the treatment of the following listed conditions, surgeries, or treatments shall be excluded from the Star Senior Citizens Red Carpet Health Insurance Plan until 24 months of its continuous coverage. This exclusion is, however, not for the claims that arise due to an accident.
List of Specific diseases or Procedures:
- Cataract treatment
- Subcutaneous Benign Lumps
- Sebaceous cyst
- Dermoid cyst
- Mucous cyst lip or cheek
- Carpal Tunnel Syndrome
- Trigger Finger
- Ganglion and similar pathology
- Hernia of all types
- Desmoid Tumor
- Umbilical Granuloma
- Umbilical Sinus
- Umbilical Fistula
- Benign Tumours of Epididymis
- Fissure in Ano
- Pilonidal Sinus and Fistula
- Rectal Prolapse
- Stress Incontinence
- Varicose veins and Varicose ulcers
- Types of transplant and related surgeries
- Congenital Internal disease or defect
- Treatments and intervention for diseases related to Tendon, Ligament, Fascia, Bones, and Joint, including Arthroscopy and Arthroplasty or Joint Replacement [if not caused by an accident]
- Treatment for Degenerative disc, Vertebral diseases, Replacement of bones and joints, degenerative diseases of the Musculoskeletal system, Prolapse of the Intervertebral Disc (if not caused by an accident)
- Treatment related to Hepato-pancreato-biliary diseases, Gallbladder, and Pancreatic calculi, including all types of management for Kidney and Genitourinary tract calculi
- Diseases of the anterior and posterior chamber of the Eye, ENT, and the disease related to Thyroid, Benign diseases of the breast.
- Treatment related to Cervix, Uterus, Fallopian tubes, Ovaries, Uterine Bleeding, and Pelvic Inflammatory Diseases
- Diseases of Prostate, Stricture Urethra, all Obstructive Uropathies
If any of the above-mentioned diseases or procedures fall under the waiting period which is specified for pre-existing diseases, two waiting periods will apply to it. The waiting period for the listed conditions shall apply even if it is contracted after the policy declaration and acceptance without a specific exclusion.
30-Day Waiting Period: Expenses related to the treatment of any illness within 30 days from the policy commencement date will be excluded if it is not due to an accident. This exclusion may not apply if you have continuous coverage for more than 12 months with the insurer. This referred waiting period is made applicable also in the enhanced sum insured if the insurer grants you a higher sum insured subsequently.
Investigation and Evaluation: If any of your diagnostic expenses are not related or not incidental to the current diagnosis and treatment, the company will not pay for it.
Rest Cure, Rehabilitation, and Respite Care: If your admission is primarily for enforced bed rest and not for any treatment, you won’t get the cover then. This also includes under custodial care at home or a nursing facility where personal care activities are performed such as bathing, dressing, moving around either by a nurse, assistant, or non-skilled person. Any service to the insured who is terminally ill to address physical, social, emotional, and spiritual needs.
Obesity or Weight Control: The insurer will not pay for the expenses related to the surgical treatment of obesity in case you do not fulfill the below conditions:
- Surgery is conducted upon the advice of the doctor
- The conducted surgery or procedure is supported by clinical protocols
- Body Mass Index (BMI) should be greater than or equal to 40 or greater than or equal to 35 in conjunction with any of the severe comorbidities.
Following are the Failure of Less Invasive Methods of Weight Loss:-
- Obesity-related cardiomyopathy
- Coronary heart disease
- Severe Sleep Apnea
- Uncontrolled Type 2 Diabetes
Gender Change Treatments: Expenses related to any treatment, including surgical management, which changes the characteristics of the body to those of the opposite sex, will not be covered.
Cosmetic or Plastic Surgery: Any cosmetic or plastic treatment that changes appearance will be excluded unless it is required for reconstruction due to the following: Accident, Burn(s), Cancer, or if it is part of the necessary treatment to remove health risk. For a medical necessity, this must be certified by the attending Medical Practitioner. Then only, the insurer will pay for it.
Hazardous or Adventure Sports: If you take part in professional hazardous or adventure sports, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing, scuba diving, hand gliding, skydiving, or deep-sea diving, you won’t get cover if you get injured in any of these activities
Breach of Law: If a treatment arises because of committing or attempting to commit a breach of law with criminal intent, the company will not pay for the same.
Excluded Providers: Treatment in any hospital or by any Medical Practitioner or provider that is specifically excluded and it is disclosed on the website or notified to you. However, in case of a life-threatening situation or an accident, expenses up to stages of stabilization will be payable except for the complete claim.
Treatments & Diseases Excluded from the Star Senior Citizens Red Carpet Health Insurance Plan
Check out below the treatments and diseases which are excused from the Star Senior Citizens Red Carpet Health Insurance Plan:
- Alcoholism, drug or substance abuse
- Any addictive condition and consequences of it
- Treatments in health hydros, nature cure clinics, spas, or similar type of establishments
- Private beds in a registered nursing home attached to an establishment or where admission is arranged wholly or partly for domestic reasons only
- Dietary supplements and any substances purchased without a prescription, including but not limited to vitamins, minerals, and organic substances unless the substance is prescribed by a medical practitioner, or if it is a part of hospitalization claim or daycare procedure.
- Expenses for the treatment of eyesight correction due to refractive error less than 7. 5 dioptres. (It is not applicable for Outpatient Consultation)
- Unproven treatment, services, and supplies expenses are excluded from the policy, or if these treatments, services, and supplies lack significant medical documentation.
- Sterility and infertility expenses like any type of contraception, sterilization, assisted reproduction services for example artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI Gestational Surrogacy, and reversal of sterilization. (It is not applicable for Outpatient Consultation)
- If the treatment expenses are traceable to childbirth including the complicated deliveries and cesarean sections, except for the ectopic pregnancy. The expenses towards miscarriage (if not caused by an accident) and lawful medical termination of pregnancy during the policy term. (It is not applicable for Outpatient Consultation)
- Circumcision if it is not necessary for the treatment of a disease which is covered under this policy or caused due to an accident.
- Preputial Dilatation and Removal of SMEGMA
- Congenital External Condition, Defects, and Anomalies
- General debility
- Run-down condition
- Nutritional deficiency states
- Intentional self-injury
- Venereal Disease
- Sexually Transmitted Diseases (Other than HIV)
- Injury or disease if caused directly or indirectly by/from war, invasion, the act of a foreign enemy, warlike operations (whether a war is declared or not)
- Injury or disease if caused directly or indirectly by/from nuclear weapons and materials
- Expenses for Enhanced External Counterpulsation Therapy
- Chelation Therapy
- Hyperbaric Oxygen Therapy
- Rotational Field Quantum Magnetic Resonance Therapy
- VAX-D, Low-level laser Therapy
- Photodynamic Therapy and any such similar therapies
- Unconventional, Untested and Experimental therapies
- Autologous derived Stromal Vascular Fraction
- Chondrocyte Implantation
- Procedures of Platelet-rich plasma and Intraarticular injection therapy
- Biologicals, except for in-patient, when it is clinically indicated and hospitalization warranted
- Treatment for priapism and erectile dysfunctions
- Inoculation or Vaccination except for post-bite treatment and medical treatment for therapeutic reasons. (It is not applicable for Outpatient Consultation)
- Dental treatment or surgery unless it is an accidental injury and requires hospitalization (Dental implants are not payable in this policy) (It is not applicable for Outpatient Consultation)
- Sleep apnea and Endocrine disorders (It is not applicable for Outpatient Consultation)
- Hospital registration, admission, record, telephone charges, and any such other charges
- Cochlear implants and procedure along with its related hospitalization expenses (It is not applicable for Outpatient Consultation)
- Any hospitalizations if it is not necessary
- An existing disease disclosed by the insured and mentioned in the policy schedule
- Expenses if incurred for treatment of diseases, illness, or accidental injuries by systems of medicine other than allopathy (It is not applicable for Outpatient Consultation)
Other excluded expenses are explained in detail on the Star Health official website.
Note: In case you enhance the policy sum insured, the exclusion shall apply afresh to the extent of the increased sum insured. If you are continuously covered without any break under the applicable norms on portability as stipulated by the IRDAI, the waiting period for the same would be reduced to the extent of prior coverage.
Claims Procedure for the Star Senior Citizens Red Carpet Health Insurance Plan
If you want to claim the policy sum insured, you can follow the below steps:-
- Call the 24-hour helpline number 1800 425 2255 or 1800 102 4477
For a planned hospitalization, you need to inform the insurer 24 hours before admission. In case of emergency, you need to intimate the insurer within 24 hours of hospitalization. To get the cashless facility, you need to take admission to a network hospital. In case you take admission to a non-network hospital, you need to make the payment first and get that reimbursed from the insurance company later by submitting the required documents post the discharge.
Key Benefits of Star Senior Citizens Red Carpet Health Insurance Plan
- No Third Party Administrator
- Direct in-house claims settlement
- Faster and hassle-free claim settlement
- Cashless hospitalization service
- Tax benefits under Section 80D of the Income Tax Act 1961