Star Health Insurance

Star Health insurance plans are designed to suit your requirements best as per your budget. By providing a guidance to the path of wellness through protection of prevention and cover, Star Health insurance helps the insured to guard oneself from costly health care.

Key Highlights

  • Inpatient hospitalization/treatment
  • Pre-hospitalization and Post-hospitalization expenses
  • Pre-existing diseases are included subject to prior coverage by a domestic insurer; usually for the four years preceding policy inception
  • Floater basis and individual basis
  • Reinstatement of sum assured
  • Individual basis: The sum assured is per person insured
  • Reinstatement of sum assured: Normally allowed after a specified number of claim-free years
  • (Room, nursing, boarding, surgery, anaesthetist, medical practitioner, consultation, specialists, oxygen, OT charges, X-ray, dialysis, chemotherapy, diagnostic materials, blood, medicine, drugs etc. depending on the plan chosen. This is not a restrictive list)

Star health insurance sum insured
1 lac − 100 lacs options available

Star health insurance tenure options
1, 2, 3 years options available

List of network hospitals
9,900+ hospitals

Maximum family floater coverage
Self, Spouse + 3 dependent children

Star health insurance sum insured
1 lac − 100 lacs options available

Star health insurance tenure options
1, 2, 3 years options available

List of network hospitals
9,900+ hospitals

Maximum family floater coverage
Self, Spouse + 3 dependent children

* As per IRDAI report for 2018-19 | ** As per NL25 data published on the Insurance Company website

Star health insurance – Overview

Star Health and Allied Insurance Co Ltd commenced its operations in 2006 with the business interests in Health Insurance, Overseas Mediclaim Policy and Personal Accident and thereby had the distinction of being the First Stand Alone Health Insurance company in India. With no other insurance category to focus and divide their attention, they usedtheir resources to focus on service excellence, design products and use core competency of innovation to deliver the best to all category of customers.

Star Health Insuranceoffers a wide range of comprehensive health insurance products at affordable prices to make health insurance accessible to every human being in India. And as a company, single-mindedly dedicated to health insurance, they have the been able to penetrate the average Indian household with their unique products and superior service on claims to become the largest Retail Health insurer in the country in 2018-19. Their USP’s include:

  • India’s First Stand-Alone Health Insurance Company
  • Pan India Presence With More Than 450+ Branch Offices
  • Cashless Hospitalization And Reimbursement Facility In Our Large Network Base With More Than 8800+ Hospitals Across India
  • Hassle-free and customer-friendly direct claim settlement without intervention of TPA
  • Wide Range Of Health Insurance Products From Individual Plans to Family Floater Schemes To Senior Citizen Health Coverage
  • Life Time Renewal of all policies
  • Over 5.4 lac claims settled in the financial year 2017-2018
  • 93% of cashless claims settled in less than 2 hours

They have also been the recipient of many awards in the Health Insurance domain including:

  • World Health Organisation (WHO) Award Of Excellence 2017
  • Best Health Insurance Provider of the year – Business Today, Money Today Financial Awards 2018-2019
  • ‘Claims Service Company Of The Year, 2014’, Beating 28 General Insurance Companies At The Indian Insurance Award
  • Rated Best Claim Settlement Insurer – Hindustan MaRs Survey

Critical factors of the Star Health insurance

  • Room Rent : Up to Rs.5,000/- per day for a Private Single A/c Room
  • Co-pay : No co-pay if entry age < 60 yrs / 10% co-pay for ages > 60 years
  • Restoration : 100% of Base Sum Insured for unrelated illness/diseases

When you make a claim on your insurance coverage, Co-pay is the certain percentage of hospital bill that you pay from your pocket and the Insurer will pay the balance amount.

When you make a claim on your insurance coverage, Co-pay is the certain percentage of hospital bill that you pay from your pocket and the Insurer will pay the balance amount.

After a waiting period of 4 years any of your pre-existing condition will be covered.

  • There are different types of insurance policies by Star Health and Allied insurance to cover you in the event of medical emergencies and safeguard financial position. The insured can avail cost efficient medical treatment with the products designed by the company with the analysis of the economic fallouts of rising medical costs.
  • Each insurance policy has unique coverage to serve the insured in meeting varied medical costs. Some of the greatest benefits of buying insurance from the company are quick, easy and direct settling of claims (i.e. no third party involvement), cashless facilities and free telephonic medical advice at any time.

Claims Settlement Process for Star Health Insurance

Cashless Claim Procedure during hospitalization
Cashless Claim: a six step process
  • Step 1 – Approach the insurance desk at a network hospital. Intimation can be given either through contacting us at 1800 425 2255 / 1800 102 4477 or e-mail us at support@starhealth.in
  • Step 2 – Show your Star Health ID card for identification purpose at the hospital reception.
  • Step 3 – Submit to the hospital Pre admission investigations and Doctor’s consultation papers.
  • Step 4 – Network hospitals will verify your identity and submit duly filled pre – authorization form with Star Health.
  • Step 5 – Our doctors verifies all the submitted documents before processing the claim as per terms and conditions. An assigned field doctor may visit the patient at the hospital if required.
  • Step 6 – After discharge, the hospital will send the claim documents to the company and the authorized amount will be settled directly to the hospital.

(Note: Non-Payable items would be at the insured’s own cost)

a) In case of planned hospitalization:

  • Please contact the toll-free help line: 1800 425 2255 / 1800 102 4477
  • The hospital will send the duly filled pre-authorization from through hospital portal (or) at the below number (or) Email ID
    • Call : Toll-free FAX: 1800 425 5522 (or)
    • Call : Non Toll-free FAX: 044 -28302200
    • Email : cashless.network@starhealth.in
  • Please carry your ID card.

b) Procedures to be followed in case of emergency hospitalization: In case of Emergency like accident or sudden bout of illness may that requires immediate admission to the hospital

  • Upon receiving intimation from the insured/insured’s attender, they are contacted by the network hospital
  • Customer Care will verify the validity and coverage of the policy
  • A field visit doctor is deputed to visit the patient at the hospital if required.
  • Our medical team will process the cashless request for the insured person subject to policy terms and conditions.

c) Cashless claim authorization process

  • Upon receiving intimation from the insured/insured’s attender, they are contacted by the network hospital.
  • Customer Care will verify the validity and coverage of the policy
  • A field visit doctor is deputed to visit the patient at the hospital if required
  • Our medical team will process the cashless request for the insured person subject to policy terms and conditions.

d) Documents required for cashless claim submission by Hospital

  • Health card
  • Doctor’s consultation papers
  • Discharge summary
  • Investigation reports (e.g. X-ray, scans, blood report, etc.)
  • Pharmacy invoices supported by respective prescriptions
  • In cases of accidents, Medico Legal Certificate (MLC) and / or FIR
  • KYC documents of the insured if claimed amount exceed Rs.1, 00,000/-

(Note: Documents other than the Health Card should be submitted in original)
When the Insured gives prior intimation about the treatment and the insured pays the expenses himself with the hospital and then claims for a reimbursement of those expenses within 15 days from the date of discharge.

Reimbursement Claims Procedure following hospitalization

Procedure for Reimbursement of Claim

  • All claims need to be intimated within 24 hours of hospitalization. Reimbursement facility is available at network hospitals as well as at non-network hospitals
  • Avail treatment, settle all bills and file a claim for reimbursement.
  • Submit the claim documents to the company within 15 days from the date of discharge.
  • To receive the claim form, cite your policy number and intimate Star Health about hospitalization.

Reimbursement Claim Procedure

  • Upon discharge, pay all hospital bills and collect all original documents of treatment undergone and expenses incurred.
  • Claim form has to be filled in and along with, all the relevant original documents have to be submitted at the nearest Star Office
  • We settle the claim in subject to policy terms and conditions.
  • Non-Payable items would be at the insured’s own cost.

Documents required for reimbursement claim submission

    • Copy of Health card
    • Duly filled claim form
    • Pre admission investigations and Doctor’s consultation papers
    • Discharge summary from hospital in Original.
    • Investigation reports (e.g. X-ray, scans, blood report, etc.)
    • Pharmacy invoices supported by respective prescriptions
    • Case receipts from hospital, chemist
    • In cases of accidents, Medico Legal Certificate (MLC) and / or FIR
    • Copy of the KYC documents – NEFT details, Contact number and E-mail ID

Exclusions under the Star Health Policy

Some of the major exclusions under the policy are listed below, kindly go through the entire list of exclusion in the policy kit which accompanies the insurance policy:

  • Congenital External Condition / Defects / Anomalies (except to the extent provided under Section specific to a New Born infant).
  • Intentional self injury.
  • Use of intoxicating substances, substance abuse, drugs / alcohol, smoking and tobacco chewing.
  • Venereal Disease and Sexually Transmitted Diseases,
  • Injury/disease directly or indirectly caused by or arising from or attributable to war, invasion, act of foreign enemy, warlike operations (whether war be declared or not)
  • Injury or disease directly or indirectly caused by or contributed to by nuclear weapons/materials
  • Expenses incurred on weight control services including surgical procedures such as Bariatric Surgery and /or medical treatment of obesity (except to the extent provided as per “Coverage” of the opted policy variant)
  • Expenses incurred on High Intensity Focused Ultra Sound, Uterine Fibroid Embolisation, Balloon Sinoplasty, Enhanced External Counter Pulsation Therapy and related therapies, Chelation therapy, Deep Brain Stimulation, Hyperbaric Oxygen Therapy, Rotational Field Quantum Magnetic Resonance Therapy, VAX-D, Low level laser therapy, Photodynamic therapy and such other therapies similar to those mentioned under this exclusion
  • Charges incurred on diagnostics that are not consistent with the treatment for which the insured is admitted in the hospital / nursing home. Admission primarily for diagnostic purpose with no positive existence of sickness / disease / ailment / injury and no further treatment is indicated
  • Unconventional, Untested, Unproven, Experimental therapies
  • Stem cell Therapy, Autologous derived Stromal vascular fraction, Chondrocyte Implantation, Procedures using Platelet Rich plasma and Intra articular injection therapy
  • All types of Cosmetic, Aesthetic treatment of any description, all treatment for Priapism and erectile dysfunctions, Change of Sex
  • Plastic surgery (other than as necessitated due to an accident or as a part of any illness)
  • Inoculation or Vaccination (except for post–bite treatment and for medical treatment for therapeutic reasons)
  • Dental treatment or surgery (in excess of what is specifically provided) unless necessitated due to accidental injuries and requiring hospitalization
  • Treatment arising from or traceable to pregnancy, childbirth, family planning, miscarriage, abortion and complications of any of these (other than ectopic pregnancy and to the extent covered under polic variant)
  • Medical and / or surgical treatment of Sleep apnea, treatment for genetic and endocrine disorders. Expenses incurred on Lasik Laser or other procedures Refractive Error Correction and its complications, all treatment for disorders of eye requiring intra-vitreal injections
  • Cochlear implants and procedure related hospitalization expenses
  • Cost of spectacles and contact lens (in excess of what is specifically provided), hearing aids, Cochlear implants and procedures, walkers and crutches, wheel chairs, CPAP, BIPAP, Continuous Ambulatory Peritoneal Dialysis, infusion pump and such other similar aids.

Star Health Insurance Products

Star Health Comprehensive plan insurance plan

Key Features:

  • Maximum coverage: Rs. 5,00,000 to Rs. 25,00,000.
  • Eligibility: 3 months to 65 years are eligible to buy this policy.
  • Renewal: Offers life long renewal.
  • Room Rent: No Room Rent Capping for Private Single Standard A/c Room.
  • Co – pay: No co-pay if entry age < 60 yrs / 10% co-pay for ages > 60 yrs.
  • Restoration Benefit: 100% of Base Sum Insured for unrelated illness/diseases.
Star Health Family Delite insurance plan

Key Features:

  • Maximum coverage: Rs. 2,00,000 to Rs. 3,00,000.
  • Eligibility: Policy is available for age between 5 months and 62 years of age.
  • Renewal: Offers life long renewal.
  • Room Rent: Upto 1% of Sum Insured per day.
  • Co – pay: NIL Co pay applicable.
  • Restoration Benefit: NIL Restoration Benefit.
Star Health Senior Citizens Red Carpet plan

Key Features:

  • Maximum coverage : Rs. 1,00,000 to Rs. 25,00,000.
  • Eligibility: Policy is available for age between 60 years and 75 years of age
  • Renewal: Renewal beyond 75 years of age.
  • Room Rent: 1% of SI per day till SI of 5 lacs / Rest between₹6,000 and ₹10,000.
  • Co – pay: Between 30% and 50% for Non Pre Existing (PED) and PED claims.
  • Restoration Benefit: NIL Restoration Benefit.
Star Health Medi Classic Insurance insurance plan

Key Features:

  • Maximum coverage : Rs. 1,50,000 to Rs. 15,00,000.
  • Eligibility: Policy is available for age between 5 months and 60 years
  • Renewal: Policy can be renewed life long.
  • Room Rent: Rs.5,000/- per day or Private Single A/c Room depending on SI.
  • Co – pay: No co-pay if entry age < 60 yrs / 10% co-pay for ages > 60 yrs.
  • Restoration Benefit: 200% of Base Sum Insured for unrelated illness/diseases.
Star Health Family Health Optima insurance plan

Key Features:

  • Maximum coverage : Rs. 3,00,000 to Rs. 25,00,000.
  • Eligibility: Policy is available for age between 18 years and 65 years of age
  • Renewal: Policy can be renewed up to 65 years of age
  • Room Rent: Capped at ₹2,000 / ₹5,000 / Single Standard A/c based on Plan SI.
  • Co – pay: No co-pay if entry age < 60 yrs / 20% co-pay for ages > 60 yrs.
  • Restoration Benefit: Thrice upto 100% of Base SI for plans with SI > 3 lacs.
Star Health Diabetes Safe insurance plan

Key Features:

  • Maximum coverage : Rs. 3,00,000 to Rs. 10,00,000.
  • Eligibility: Policy is available for age between 18 years and 65 years of age
  • Renewal: Guaranteed Lifetime Renewals beyond 65 years are offered under this policy.
  • Room Rent: Eligible for Single A/c Standard Room .
  • Co – pay: NIL Co Pay.
  • Restoration Benefit: NIL Restoration Benefit.
Star Health Criticare Plus insurance plan

Key Features:

  • Maximum coverage : Rs. 2,00,000 to Rs. 10,00,000.
  • Eligibility: Policy is available for age between 18 years and 65 years of age
  • Room Rent: 2% of Sum Insured subject to a maximum of ₹4,000 per day.
  • Co – pay: NIL for insureds < 60 yrs/ 30% co-pay for ages > 60 yrs.
  • Restoration Benefit: NIL Restoration Benefit.
Star Health Healthgain insurance plan

Key Features:

  • Maximum coverage : Rs. 1,00,000 to Rs. 5,00,000.
  • Eligibility: Policy is available for age between 91 days to 65 years of age
  • Family Size for Floater option : Family means Self, Spouse, Dependent children up to 25 years of age
  • Room Rent: Upto 1% of Sum Insured per day.
  • Co – pay: No co-pay if entry age < 60 yrs / 20% co-pay for ages > 60 yrs.
  • Restoration Benefit: NIL restoration benefit.
Star Health Super Surplus insurance plan

Key Features:

  • Eligibility:Policy is available for age between 18 years to 65 years of age
  • Children can be covered from 91 days to 25 yrs. Children can be covered only along with parents.
  • Available in individual and family floater basis.
  • Room Rent: At ₹4,000 per day for Silver / Single A/c Standard Room for Gold.
  • Co – pay: NIL for Silver & Gold < 60 yrs/ 10% co-pay for ages > 60 yrs in Gold plan.
  • Restoration Benefit: NIL Restoration Benefit.
Star Health Cardiac Care insurance plan

Key Features:

  • Maximum coverage : Rs. 3,00,000 to Rs. 4,00,000.
  • Eligibility: Policy is available for age between 10 years to 65 years of age
  • Policy tenure :The policy will be issued for a 1 year
  • Covers regular medi-claim and also specific cover to cardiac related complications
  • Room Rent: Capped at ₹5,000 per day.
  • Co – pay: NIL for insureds < 60 yrs/ 10% co-pay for ages > 60 yrs.
  • Restoration Benefit: NIL Restoration Benefit.
Star Health Cancer Care Gold insurance plan

Key Features:

  • Maximum coverage : Rs. 3,00,000 and Rs. 5,00,000.
  • Eligibility: Policy is available 5 months to 65 years
  • Room Rent: Eligible for Single A/c Standard Room.
  • Co – pay: NIL for insureds < 60 yrs/ 10% co-pay for ages > 60 yrs.
  • Restoration Benefit: NIL Restoration Benefit.
Star Health Star Net plus insurance plan

Key Features:

  • A special policy from Star Health in India to cover HIV positive individuals.
Star Health Star Care Micro insurance plan

Key Features:

  • Policy is accessible in Tier I and Tier II locations on an individual and floater basis.
  • Pre-hospitalization cover and post-hospitalization cover.
  • Hospital Cash benefits if treatment is taken at the hospital of the government.
  • Room Rent: Upto 0.75% of SI per day for Private Room /Shared Accommodation.
  • Co – pay: NIL Co Pay.
  • Restoration Benefit: NIL Restoration Benefit.
Star Health Star Special Care insurance plan

Key Features:

  • This policy was intended specifically to provide health insurance cover for kids diagnosed with autism disorder
  • Any child diagnosed with Autism Spectrum Disorder between 3 years and 25 years of age can be covered.
  • Room Rent: Capped at ₹5,000 per day.
  • Co – pay: 20% co-pay on all claims for all insureds.
  • Restoration Benefit: NIL Restoration Benefit.
Star Health Hospital Cash insurance plan

Key Features:

  • Health insurance policy that provides lumpsum benefit for the period of hospitalization.
  • Eligibility: Age at entry 18 years and 65 years
  • Room Rent: NIL Cap, per day limit of Hospital Cash as per plan opted.
  • Co – pay: NIL Copay.
  • Restoration Benefit: NIL Restoration Benefit.
Star Micro Rural and Farmers Care insurance plan

Key Features:

  • Hospitalisation cover for rural population.
  • Eligibility: Age at entry 18 years and 65 years
  • Room Rent: 1% of Sum Insured per day.
  • Co – pay: NIL for insureds < 60 yrs/ 20% co-pay for ages > 60 yrs.
  • Restoration Benefit: NIL Restoration Benefit.
Young Star Insurance

Key Features:

  • Persons between 18 years and 40 years of age at the time of entry can take this Insurance. Dependent children can be covered from 91 days and up to 25 years of age.
Arogya Sanjeevani Policy

Key Features:

  • Persons between 18 years and 65 years of age at the time of entry can take this Insurance. Dependent children can be covered from 3 months and up to 25years of age.
Outpatient Care

Key Features:

  • For Adults – from 18 years to 50 years
  • For Dependent Children – from 31st day (Children can continue up to 25 years under Floater policy)
Novel Coronavirus

Key Features:

  • For Adults – from 18 years to 50 years
  • For Dependent Children – from 31st day (Children can continue up to 25 years under Floater policy)
Corona Rakshak

Key Features:

  • Minimum entry age shall be 18 years and maximum age at entry shall not be less than 65 years
Star Health Comprehensive plan insurance plan

Key Features:

  • Minimum entry age shall be 18 years and maximum age at entry shall not be less than 65 years
  • Dependent Children: 1 day to 25 years