Health Insurance 1959 views November 5, 2020

Star Health Family Optima Insurance Plan

The first and foremost priority for any individual should be his or her health. In the times we are living in, a Health Insurance Plan can take care of our medical expenses in case any medical emergency happens. But it is equally important to take care of your family’s health too. So, will you take an individual insurance plan for everyone? Well, the answer will be ‘No’ because you can take care of your family health by choosing Star Family Health Optima Insurance Plan. This plan from Star Health Insurance Company is one of the most popular plans that help individuals to cover all the members of the family under a Single Health Insurance Plan.

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So, you don’t need to pay premiums for individual plans for each member of the family. With Star Family Health Optima Insurance Plan, you only need to pay a single premium for all members. So, you can save a substantial amount. One of the main reasons behind this Health Insurance Plan’s popularity is the trust of individuals in Star Health Insurance Company, which has the largest network of 9,900 Hospitals.

In this article, we will discuss the features and benefits of the Star Family Optima Health Insurance Plan. Apart from this, we will also tell the exclusions, eligibility, and a few other things. Keep reading!

Star Family Health Optima Insurance Plan Highlights

If you are someone who wants to take care of yourself and your family, choosing the Star Family Health Optima Insurance Plan can be the right choice for you! Still, don’t believe it? Well, here are the highlights of this amazing Health Insurance Plan that will make you believe it. Please look!

  1. This plan from Star Health Insurance Company is a Family Floater Policy which means you only pay a single premium for your policy and the entire family will get covered under it
  2. With the help of the Auto Recharge facility, this plan offers Extra Sum insured without paying any extra premium
  3. Every year when you don’t get any claim for your policy, you can enjoy a Health Checkup Benefit upto INR750 every year without paying any extra cost
  4. Each time you exhaust your Health Insurance Plan completely, you will get 3 times Automatic Restoration of the Sum Insured by a total of 100%
  5. With your Star Family Optima Health Insurance Plan, you will also get cover for Assisted Reproductive Treatment
  6. Your New-born baby will start to get coverage under this Family Health Insurance from the 16th Day after the delivery
  7. In case of an Organ Transplantation, your plan will also cover all the expenses related to the Donor
  8. You will get coverage for all Daycare treatments – Treatments for which you get discharged from the hospital on the same day
  9. You will also get a grace period of 120 days from the date of expiry of your policy within which you can renew your policy without paying any penalty charges

Benefits of Star Family Health Optima Insurance Plan

What are the various benefits of the Star Family Health Optima Insurance Plan that you can enjoy? Well, we are showing below all the benefits such as Pre-hospitalization, Organ Donor Expenses, Health Checkup costs, etc. Do check!

  1. Pre-hospitalization expenses up to 60 days before the admission to the Hospital
  2. Post-hospitalization expenses up to 90 days after you get discharged from the hospital
  3. Expenses related to Room, Boarding and Nursery according to the limits of Plan
  4. Ambulance Charges in case you need emergency transportation to the hospital
  5. Air-ambulance charges upto 10% of the Basic Sum Insured during the Total Policy period
  6. Surgeon, Consultants, Medical Practitioner, Specialist Fees, Oxygen, Operation Theatre, Imaging Modalities, and Medicines & Drugs, Diagnostic and Cost of Pacemaker
  7. Shared Accommodation up to limits
  8. AYUSH Treatment
  9. Second Medical Opinion from the Doctor in the Insurance Company’s network of Medical Practitioners
  10. Additional Sum Insured for Road Traffic Accident (RTA) up to INR 5,00,000. The person must be wearing a helmet and traveling in a two-wheeler.

Domiciliary Hospitalization

If you require the treatments at your home for certain diseases and stages, you will get coverage for such Domiciliary Hospitalization with your Star Family Health Optima Health Insurance Plan. However, the plan will cover only those treatments exceeding 3 days.

Organ Donor Expenses 

With this benefit from Family Health Optima Insurance Plan, the insured person will get cover up to 10% of the Sum Insured or INR 1 Lakh, whichever is less.

Cost of Health Checkup

With your Star Health Insurance Policy, you will also get cover for your health checkups within the limit decided in your Policy.

New Born Baby Cover

After 15 days of the Delivery, your New Born Baby will also get coverage upto 10% of the Sum Insured or INR 50,000 (whichever is less between these two)

Emergency Domestic Medical Evaluation

If the insured person needs to be transported from one treating hospital to another, this plan will also cover the transportation expenses up to the limits specified in the Policy.

Compassionate Travel

With the Star Family Health Optima Insurance Plan, you can also get claims for the transportation expenses by Air up to INR 5,000 for any of your Immediate Family members (other than the travel companion) for travel towards the hospital.

Repatriation of Mortal Remains

The plan will reimburse upto INR 5,000 towards the cost of the Repatriation of Mortal Remains of the Insured Person to the residential address of the Policyholder.

Lump-Sum Amount for Treatment in Preferred Hospitals

If you face any medical emergency and want advice from the Insurance Company, it may suggest a preferred Network hospital where you can get the treatment upto 1% of the sum insured (maximum of INR 5,000) as a lump sum amount.

Assisted Reproductive Treatment

You can also get coverage for the expenses on the Assisted Reproductive Treatment for the sub-fertility waiting period of 36 months from the date of the policy inception. An insured person can get up to INR 1 lakh for the sum insured of INR 5 lakh and INR 2 lakh for a sum insured of INR 10 lakh.

Bonus on not Claiming in a Year

For the year when you will don’t make any claim for your Star Family Health Optima Insurance Plan, you will get a bonus of 25% of the expiring basic sum insured in the next year. After the second year, you will get an additional 10% for subsequent years. Every year, you get a claim, the company will reverse the bonus, in the same manner, it was given.

Star Family Health Optima Insurance Plan Eligibility Criteria

There are a few conditions that individuals should keep in their mind before choosing this Health Insurance Plan. We are showing them below. Please have a look!

  1. The age of an individual should be between 18 years and 65 years to take this Insurance Plan
  2. Individuals beyond 65 years of age can only opt for Policy Renewals
  3. A child from his/her 16th day of age will get coverage under the Plan as a part of the Family

What are the Exclusions under the Star Family Health Optima Insurance Plan?

There are a few things that this policy does not cover, and it is important to know them before going to choose a Family Health Optima Plan. We are showing them below. Please check!

  1. Any Hospitalization Expenses mainly for Diagnostic Purposes
  2. Pregnancy or Infertility
  3. Intentional Self-injury
  4. Substance Abuse
  5. Domiciliary treatment outside India
  6. Circumcision, Sex Change Surgery, Cosmetic Surgery, and Plastic Surgery
  7. Hospitalization due to Hazardous Sports, War, Terrorism, Civil War
  8. Dental Surgery, Mental Disorders, Non-allopathic, experimental therapies
  9. Treatments related to HIV/AIDS

How to Get Claims for Your Star Family Health Optima Insurance Plan?

The best thing about the Star Family Health Optima Insurance Plan is its hassle-free direct in-house claim settlement process without any interference of third parties. With this Insurance plan, you get two Health Insurance Plans –  Cashless and Reimbursement methods. We are showing you the details of both. Check them out!

Cashless Claim Method

  1. For the cashless claim method, the first thing you need to do is intimate by dialing 1800 425 2255 or 1800 012 4477. You can also intimate Star Health Insurance about your hospitalization via email.
  2. You will need to show your Health ID Card at the Hospital’s reception for identification.
  3. After this, you will need to submit the Pre-admission investigations and Consultation papers to the Hospital. Network hospitals will verify your identity, and they will submit the pre-authorization form to Star Health.
  4. Before processing the Claim, the team will verify all the documents. An assigned doctor may visit the hospital if required.
  5. After discharge, the hospital will send all the claim documents to the company, and the amount will be settled directly to the hospital.

Reimbursement Claim Method

  1. An insured person can get reimbursement of expenses within 15 days from the date of discharge at both Network and Non-network hospitals. However, a person should intimate about claims within 24 hours of Hospitalization.
  2. For this method, you should avail of the treatment, settle your bills, and send your reimbursement claims regarding the Star Family Health Optima Insurance Plan.
  3. You will need to submit the claim documents to the company within 15 days after getting discharged.

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