Star Cancer Care Platinum Plan

Here’s All That You Need To Know About The Plan!

The Star Cancer Care Platinum Plan is a health insurance plan that is offered by Star Health and Allied Insurance Company Limited. This plan is designed to help people who have been diagnosed with cancer by providing financial assistance. It covers expenses for both cancer and non-cancer treatments. Cancer treatment costs can be high, but with this plan, you can feel secure knowing that you and your family can get the necessary medical care without the stress of unexpected bills.

Who Is Eligible?

If you have been diagnosed with cancer and you are between 5 months and 65 years old, you will be eligible for the policy.
 

Benefits and Limits of The Star Cancer Care Platinum Plan

In addition to covering hospitalisation costs incurred when you stay in the hospital for over 24 hours, including room fees, nursing care, doctor's fees, prescribed medications, ICU charges, and related expenses, here are some other expenses covered by the Star Cancer Care Platinum Plan -

• Pre & Post Hospitalisation Expenses
  If the doctor needs to do tests before or after your time in the hospital, the insurance company has got you covered. They will cover expenses up to the total sum insured for a period of 30 days before you are hospitalised. After you leave the hospital, expenses for the next 60 days are also covered, up to 2% of the sum insured for each hospitalisation. Just remember that the insurer will cover such expenses only if they are related to the disease or medical condition for which you were hospitalised, and the approval is part of the inpatient hospitalisation coverage.
   
• Daycare Treatment Coverage
  The Star Cancer Care Platinum Plan covers daycare treatments. These are medical procedures or surgeries that used to need a long hospital stay but can now be done in less than 24 hours because of medical progress. All daycare procedures are covered without any limit. This means that the insurance company will cover the expenses up to the sum insured.
   
• Modern Treatment Coverage
  Every day, healthcare is advancing, propelled by new technologies that enable treatments previously unimaginable. The Star Health Cancer Care (Platinum) Plan keeps up with these changes by covering the costs of modern treatments. However, you should remember that there are specific limits that apply to different treatments.
   
• Cumulative Bonus
  In the Star Health Cancer Care Platinum Plan, you can get a No Claim or Cumulative Bonus as a reward for not making any claims in a policy year. You’ll receive  5% of the sum insured as a No Claim Bonus, and the maximum bonus that you can earn is 50% of your sum insured. But, if you make a claim during the policy year, the bonus will decrease at the same rate it was earned.
   
• Room Rent Limit
  The maximum amount the insurance company will pay for your hospital room is called the room rent limit. If you choose a room within this limit, you will not need to pay anything extra. But, if you pick a room with higher rent, you will face a proportionate deduction. This means that you will be responsible for a proportionate share of the total bill, not just the extra room cost. In the Star Health Cancer Care Platinum Plan, the room rent limit extends to a single private AC room.
   

Additional Noteworthy Features of The Product

The Star Health Cancer Care Platinum Plan come with various other notable features that include -

• Lump Sum for Cancer
  The financial impact of cancer does not stop after the initial treatment. Sometimes, survivors deal with the worry of cancer coming back or secondary malignancy. This is where the lump sum cover for cancer steps in as a dependable support. It offers an extra lump sum payment if cancer recurs, spreads to another part of the body, or a new cancer develops unrelated to the first one. This benefit amount is 50% of the sum insured that you choose, and to receive this benefit, you will need to pay an extra premium. Remember, there are specific terms and conditions for this coverage.
   
• Hospice Care
  The hospice care feature is more than just financial support; it is a compassionate gesture. It acts as a protective shield for individuals facing the tough last stages of life-limiting cancer, ensuring they can live as comfortably as possible. This benefit covers hospice care expenses, offering up to 20% of the sum insured. This support is available once in a lifetime, aiming to enhance your quality of life. To access this benefit, you need to use services from the insurer's network providers after completing a waiting period.
   
• Rehabilitation And Pain Management
  Dealing with the various effects of cancer treatment, like surgery and chemotherapy, can be challenging for you. The rehabilitation and pain management coverage serves as a lifeline, aiming to help survivors recover physically and improve their overall quality of life. The maximum limit under this cover is either the applicable sub-limits on different treatments or 10% of the sum insured, whichever is lower, per policy year. However, you should keep in mind there might be specific terms and conditions to this coverage.
   

Understanding Waiting Periods

Upon buying a health insurance policy, there is a specific time frame during which certain health conditions or illnesses are not covered. This is called the waiting period. Once this time is over, you can claim for these conditions. There are different types of waiting periods, like –

• Initial Waiting Period: When you buy your health insurance policy, there is a 30-day initial waiting period for all medical conditions except accidents. This means you cannot claim any hospitalisation expenses in the first 30 days unless it is due to an accident.
• Waiting Period For Pre-existing Diseases: When talking about a pre-existing disease, it is any health condition you had in the 48 months before getting a health insurance policy. In the Star Cancer Care Platinum Plan, there is a waiting period of 30 months for pre-existing diseases, including cancer. During this time, the policy will not cover expenses related to your pre-existing conditions.
• Waiting Period For Specific Diseases: Insurance companies set a list of medical conditions that will have a waiting period, irrespective of whether you had those diseases before or not. This waiting time is decided by the insurer and is not based on your current health. The Star Cancer Care Platinum Plan has a waiting period of 24 months for such specific diseases.

What Are The Exclusions Of The Policy?

These are situations not covered by your health insurance policy, and they include –

• Standard Permanent Exclusions: The IRDAI (Insurance Regulatory and Development Authority of India) has set certain 'standard permanent exclusions' that every insurance company must follow. Some  of these exclusions include –
  • Observation And Monitoring: You are admitted to a hospital just to be observed or monitored.
  • Rest Cure, Rehabilitation, And Respite Care: You are admitted for bed rest without active treatment at a facility.
  • Obesity/Weight Control: Any treatment or surgery aimed at managing weight or addressing obesity.
  • Change Of Gender Treatment: Any treatment that aims to change the body's characteristics to those of the opposite sex.
  • Plastic/Cosmetic Surgery: Any treatment or surgery that aims to alter body characteristics or appearance.
  • Hazardous Or Adventure Sports: You are a professional participating in adventure activities like river rafting, mountaineering, scuba diving, horse racing, etc., and incur treatment expenses.
  • Breach Of Law: Treatment expenses for someone who has committed or attempted a breach of law with criminal intent.
  • Excluded Providers: Treatment received from a hospital or medical practitioner excluded by the insurance company.
  • Narcotics: Treatment for addictive conditions such as alcohol addiction, drug usage, etc.
  • Treatments In Domestic Establishments: Expenses for treatment in health spas, nursing homes, or similar establishments arranged partially or entirely for domestic reasons.
  • Dietary Supplements, Non-Prescription Substances: Expenses related to vitamins, minerals, etc., not prescribed by a medical practitioner.
  • Refractive Error: Costs associated with correcting refractive errors up to 7.5 diopters for improved eyesight.
  • Unproven Treatments: Medical procedures, surgeries, or treatments that haven't been proven to be effective.
  • Birth Control, Sterility, Infertility: Expenses related to contraception, artificial insemination, sterilisation, and advanced reproductive technologies such as ZIFT, IVF, gestational surrogacy, GIFT, ICSI, etc.
  • Maternity Expenses: These are costs related to pre/post-natal care, childbirth-related hospitalisation, etc.
     
• Additional Permanent Exclusions: Besides the list of standard permanent exclusions mentioned earlier, the insurer might add many other exclusions for specific situations or conditions. If you have certain diseases or severe medical conditions that the insurance company sees as risky to cover, they might permanently exclude them from your policy. However, it is important to note that insurers can only apply permanent exclusions for illnesses listed by the IRDAI.
   
• Special Exclusions (Non-Standard Exclusions): These are specific exclusions besides the list of standard permanent exclusions set by the IRDAI. Different insurance companies may have their own set of exclusions, depending on the policy terms. Here are some of the key exclusions under the Star Cancer Care Platinum Plan –
  • Congenital external conditions, defects, or anomalies from birth.
  • Expenses related to convalescence , general debility, run-down condition, nutritional deficiency states.
  • Deliberate self-harm.
  • Venereal diseases and sexually transmitted diseases, except for HIV.
  • Costs related to injury or illness caused by nuclear weapons or materials directly or indirectly.
  • Experimental or untested treatments.
  • Biological treatments unless given as in-patient and deemed medically necessary.
  • Treatment for priapism (a persistent erection) or erectile dysfunction.
  • Vaccines except for certain situations like post-bite treatment and treatments for therapeutic reasons.
  • Treatment from non-allopathic medical systems.
     

Summary

Links To Important Documents!

• Brochure: You can find detailed information about the Star Cancer Care Platinum plan from - https://web.starhealth.in/sites/default/files/brochure/Star-cancer-care-brochure-platinum.pdf

• Policy Wording: For all the specifics and details of the policy, refer to the policy wording document – https://web.starhealth.in/sites/default/files/policy-clauses/star-cancer-care-platinum-policy-clauses.pdf
   

FAQs

1. Does the Star Cancer Care Platinum Plan cover domiciliary treatments?
   No, the plan does not cover expenses for domiciliary treatments (treatments taken at home).
    
2. Does the Star Cancer Care Platinum Plan provide coverage for non-cancer ailments?
   Yes, the Star Cancer Care Platinum Plan covers expenses for both cancer-related and non-cancer ailments.
    
3. Are modern treatments covered under the Star Cancer Care Platinum Plan?
   Yes, the Star Cancer Care Platinum Plan covers modern treatments. There, however, are sub-limits applicable for coverage of modern treatments.
    
4. Does Star Cancer Care Platinum have room rent restrictions?
   Yes, there is a limit on room rent, which is up to a single private AC room.
    
5. Under the Star Cancer Care Platinum Plan, what is the maximum cover one can opt for?
   The Star Cancer Care Platinum Plan offers health coverage of up to Rs. 10 lakhs.