Star Health and Allied Insurance

Star Health Comprehensive Product Page

Star Health Comprehensive Product Page

Star Health Comprehensive Product Page

Let’s Know The Plan Better!

Star Health Comprehensive is a health insurance plan provided by Star Health and Allied Insurance Company. Designed to prioritise your convenience, this comprehensive plan aims to save you precious time, valuable money, and all the usual headaches associated with health insurance. With the Star Health Comprehensive Plan, you can finally put your mind at ease. The necessary medical care for you and your family will always be within reach, without the overwhelming burden of exorbitant costs. Say hello to a future where your health is protected without compromising on quality care.
 

Are you Eligible?

Minimum Entry Age

  • Adults: 18 years
  • Dependent Children: 91st day after birth

Maximum Entry Age

  • Adults: 65 years
  • Dependent Children: 25 years
     

Check Out The Plan’s Benefits & Limits

In addition to covering your inpatient hospitalisation expenses, such as the costs incurred when you are admitted to a hospital for more than 24 hours, including room and boarding charges, nursing fees, medical practitioner's fees, prescription medication costs, ICU charges, and other related expenses, the Star Health Comprehensive Plan covers other costs as well.

Let’s have a look at the benefits and limits of the plan -

  • Pre & Post hospitalisation expenses: You may incur some expenses pre- or post-hospitalisation like diagnostic tests, physiotherapy, etc. Star Health Comprehensive has your back every step of the way. It offers coverage up to 60 days before hospitalisation and up to 90 days after discharge. There is no limit, i.e., your expenses will be covered up to the sum insured.
    These expenses will be covered only if they’re related to the medical condition you’re hospitalised for and if your claim is approved under inpatient hospitalisation coverage.
     
  • Daycare treatment coverage: Now there’ll be no extended hospital stays as advanced medical technology allows you to undergo certain treatments within 24 hours. These are known as daycare treatments. The Star Health Comprehensive Plan covers these up to the sum insured.
     
  • Domiciliary treatment coverage: There may arise situations wherein immediate attention is needed for illnesses and injuries, but treatment is administered at home because the patient's condition is so severe that they cannot be safely transferred to a hospital or due to a lack of hospital beds in the locality. These are known as domiciliary treatments, which are covered up to the sum insured under the Star Health Comprehensive Plan.
     
  • Organ donor coverage: The plan also takes care of costs associated with organ donation. It covers inpatient hospitalisation costs for organ transplants, where the insured is the recipient, up to the sum insured.
     
  • Modern treatment coverage: The field of healthcare is going through a remarkable transformation, driven by continuous advancements in technology. With these innovations, modern treatments that were once deemed impossible are now becoming a reality. To keep up with this ever-changing landscape, the Star Health Comprehensive Plan provides coverage for the expenses associated with these modern treatments, up to the sum insured if you go for the Extra Protect Add-On.
     
  • Non-medical expenses: The Star Health Comprehensive Plan recognises the importance of non-medical expenses in the overall healthcare journey. It acknowledges that consumables are an essential part of any treatment and can often accumulate and lead to a hefty price tag. By opting for the add-on coverage, you can ensure that the cost of consumables, such as gloves, nebulization kits, oxygen masks, and other necessary items, is taken care of - up to the sum insured if you choose the add-on.
     
  • Room rent limit: Health insurance plans generally impose a limit on the type of room you can choose when you get hospitalised. If you select a room beyond your eligibility, you will have to undergo something known as a proportionate deduction. This means that you will have to pay a proportionate amount of not just the excess room charge, but also the medical bill you incur. The Star Health Comprehensive Plan comes with a room rent limit of Single Private AC Room.

    If you’re seeking greater flexibility, you can opt for their ‘Extra Protect Add-on’, which allows you to choose any room if you have a sum insured of above Rs 20 Lakhs. If you have a sum insured between Rs 10-20 lakhs, you can choose any room except for a suite room or above.
     
  • Cumulative Bonus: If you don’t make any claims during a policy year, you will be rewarded with a generous bonus. Under this exciting feature, for every claim-free year, your base sum insured will be increased by -​​​​
  1. 50% if your sum insured is Rs 5 Lakhs
  2. 100% if your sum insured is Rs 7 Lakhs or above

It's important to note that this bonus comes with a maximum sub-limit of up to 100% of the base sum insured. But that's not all. If you choose to opt for the Extra Protect Add-on, you can enjoy the added benefit of keeping your bonus intact even if you make a claim during a policy year.

  • Restoration of Sum Insured: The Restoration Benefit ensures that your sum insured is fully restored once depleted within a policy year. The plan restores 100% of your basic sum insured. The benefit kicks in when your basic sum insured and any applicable cumulative bonus have been completely utilised. It's exclusively available for subsequent claims in a policy year. And the best part? You can utilise the Restore Benefit once in every policy year for a lifetime, as long as you keep renewing your policy.

 

 Some Noteworthy Features You Should Be Aware Of

  • Wellness Cover: The Star Wellness Program is specifically designed to motivate and encourage you in maintaining a healthy lifestyle through a range of wellness activities. By actively participating in activities such as walking, marathons, and more, you have the opportunity to earn valuable wellness reward points. These points can then be utilised to receive a discount on your renewal premium. Have a look at the discount premium vis-a-vis wellness points earned -

Wellness Points Earned

Discount in Premium

200-350

2%

351- 600

5%

601-750

7%

751-1000

10%

 

  • Bariatric Surgery: The Star Comprehensive Plan is designed to provide financial support for bariatric surgical procedures and any complications that may arise during your weight loss journey. Normally, expenses related to these procedures are not covered by most top plans. However, the Star Health Comprehensive Plan covers these expenses subject to the terms and conditions outlined in the policy.
     
  • No financial limits on treatments/diseases: If your insurer has not explicitly stated that they will not cover a specific illness, you have the ability to claim the full amount up to the sum insured, regardless of the disease you are facing. Under the Star Health Comprehensive Plan, you are not subjected to any limitations or sub-limits based on the type of treatment or disease.

 

Understanding Waiting Periods

After you buy a health insurance policy, you may have to wait for a certain period of time before coverage is provided for certain illnesses and diseases. This is known as the waiting period, which varies depending on the type of condition. Once this waiting period is over, you will be eligible to make claims for these conditions.

It is important to note that there are different types of waiting periods that you should be aware of -

  • Initial waiting period: You will have to wait for 30 days before you can make a claim for any medical condition, except accidents. This means that during the first 30 days after buying a policy, you won't be able to claim hospitalisation unless it's due to an accident.
     
  • Waiting period for pre-existing diseases: A pre-existing disease refers to any medical condition or illness that you have experienced in the 48 months prior to the issuance of your health insurance policy. When you choose the Star Health Comprehensive Plan, you will need to keep in mind that there is a waiting period of 36 months for pre-existing diseases. This means that during this time, any expenses related to your pre-existing conditions will not be covered by the policy.
     
  • Waiting period for specific diseases: You will find that insurers maintain a designated list of medical conditions or illnesses, apart from the pre-existing conditions, that will require a waiting period irrespective of whether you have had those ailments in the past or not. This waiting period is determined by the insurer and is completely unattached to your current health status. In the case of the Star Health Comprehensive Plan, there is a waiting period of 24 months for specific diseases.

What the Plan Does Not Include?

Exclusions are certain circumstances that your health insurance policy does not cover. These typically include -

  • Standard permanent exclusions: You should be aware that the IRDAI has implemented a set of 'standard permanent exclusions' that all insurance companies are obligated to adhere to. These exclusions encompass the following:
  1. Investigation and evaluation:  Hospital admissions for observation or monitoring purposes are not covered under your policy.
     
  2. Rest cure, rehabilitation, and respite care: Seeking admission to a facility for bed rest, where no active treatment is provided, are not covered.
     
  3. Obesity/weight control: You won't get coverage for treatments or surgeries related to weight control or obesity.
     
  4. Change of gender treatment: Treatment that aims to change your body's characteristics to match those of the opposite sex is not covered.
     
  5. Plastic/cosmetic surgery: Treatment or surgery that aims to alter your body characteristics or appearance is not included in the coverage.
     
  6. Profession in hazardous or adventure sports: When you engage in adventure activities such as river rafting, mountaineering, scuba diving, horse racing, and more as a professional, these are not covered.
     
  7. Breach of law: You are not entitled to coverage for expenses related to the treatment if you have committed or attempted to commit a breach of law with criminal intent.
     
  8. Excluded providers:  The company excludes coverage for treatment from a medical practitioner or hospital excluded by them.
     
  9. Narcotics: Individuals struggling with addictive conditions such as alcohol addiction or drug usage, the treatment expenses are not covered.
     
  10. Treatments in establishments arranged for domestic purposes: You will not be eligible for coverage for the costs of treatment received at health spas, nursing homes, or similar establishments that were arranged solely or partially for domestic reasons.
     
  11. Dietary supplements, substances purchased without prescription: If you are considering taking vitamins, minerals, or other supplements that have not been prescribed by a medical practitioner, it is important to know that the expenses are not covered.
     
  12. Refractive error: You are not eligible for coverage of expenses related to correcting refractive errors of up to 7.5 diopters in order to improve your eyesight.
     
  13. Unproven treatments: Surgeries, medical procedures, or treatments that have not been proven to be effective are not covered.
     
  14. Expenses related to birth control, sterility, infertility: Certain of these treatments like contraception methods, sterilisation procedures, artificial insemination techniques, as well as advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, and gestational surrogacy are not covered.
     
  15. Maternity expenses: Pre/post-natal costs, expenses related to childbirth hospitalisation, and so on are excluded.
     
  • Additional permanent exclusions:  It is important to note that insurers are bound by a list of illnesses provided by the Insurance Regulatory and Development Authority of India (IRDAI) when applying for additional permanent exclusions. In addition to the standard permanent exclusions mentioned above, insurance companies may also add specific exclusions for certain situations or medical conditions when it comes to your policy. If you have particular diseases or severe medical conditions that insurers deem as risky to cover, they may choose to permanently exclude them from your policy.
     
  • Non-standard exclusions (Specific exclusions): You should be aware that the Star Health Comprehensive Plan includes certain exclusions that are not covered under the standard permanent exclusions set by the IRDAI. It's important to note that these exclusions can differ among insurance companies and may be subject to the specific terms and conditions of your policy.

Here are some of the key specific exclusions to consider under the Star Health Comprehensive Plan:

  1. You are not covered for procedures such as Circumcision (unless it is necessary for treating a disease not excluded under this policy or required due to an accident), Preputioplasty, Frenuloplasty, Preputial Dilatation, and removal of SMEGMA.
     
  2. You are not covered for injuries or diseases that are caused by war, invasion, and similar situations.
     
  3. Convalescence, general debility, run-down condition, and nutritional deficiency are not covered.
     
  4. Intentional self-injury is excluded from coverage.
     
  5. Venereal Disease and Sexually Transmitted Diseases, with the exception of HIV, are not covered.
     
  6. Injury or disease that is directly or indirectly caused by or contributed to by nuclear weapons/materials is excluded.
     
  7. Unconventional, untested, and experimental therapies are not covered.
     
  8. Biologicals are not covered by the policy unless they are administered to a patient as an inpatient, when there is a clinical indication and hospitalisation is deemed necessary.
     
  9. Treatments for Priapism and erectile dysfunctions are not covered under the policy.
     
  10. Particular scenarios, such as inoculation or vaccination (excluding post-bite treatment and medical treatment for therapeutic reasons), are not included in the policy coverage.
     
  11. The policy does not provide coverage for medical and/or surgical treatment of sleep apnea or treatment for endocrine disorders.

 

A Quick Recap Of The Benefits & Limits

 

Product Benefits

Coverage Limits

Pre-Hospitalisation Expenses

60 days up to the sum insured

Post-Hospitalisation Expenses

90 days up to the sum insured

Daycare Treatment Coverage

Up to the sum insured

Domiciliary Treatment Coverage

Up to the sum insured

Organ Donor Coverage

Inpatient expenses up to the sum insured

Non-Medical Expenses

Covered up to the sum insured, if you opt for an add-on

Modern Treatment Coverage

Up to the sum insured, if you opt for the Extra Protect add-on

Room Rent Limit

Single Private AC Room.

If you want to expand your eligibility, you can opt for their Extra Protect add-on.

Cumulative Benefit

  • 50% increase every claim-free year if the sum insured is Rs 5 lakhs
  • 100% increase every claim-free year if the sum insured is Rs above 7 lakhs

This is subject to a max of 100% of the base sum insured.

Restoration Benefit

Up to 100% of the sum insured.

Pre-Existing Disease

Covered after a 36-month waiting period

Specified Treatment

Covered after a 24-month waiting period

 

Here’s The OG Reading Material

 

FAQs

  1. What is the maximum coverage you can choose under the Star Health Comprehensive Plan?
    Star Health's Comprehensive Plan is designed to provide individuals with a robust health cover of up to Rs 1 Crore.

     
  2. Does the Star Health Comprehensive Plan come with room rent limits?
    Under the Star Health Comprehensive plan, customers are subject to a room rent limit of Single Private AC Room. However, if you opt for the 'Extra Protect Add-on', you can enjoy the flexibility of choosing a room of your choice if your sum insured is above Rs 20 lakhs. If your sum insured falls between Rs 10-20 lakhs, you can choose any room except suite rooms and those above the category of suite room.

     
  3. Do OPD expenses fall under the scope of coverage of the Star Health Comprehensive Plan?
    Yes, the Star Health Comprehensive Plan does cover OPD (Outpatient Department) expenses for Dental and Ophthalmic Treatments as per the policy terms.

     
  4. Does Star Health Comprehensive take care of AYUSH treatments?
    Star Health Comprehensive is a comprehensive health insurance plan that understands the importance of holistic healthcare. It goes beyond conventional treatments and covers AYUSH treatments such as Ayurveda, Unani, Siddha, homoeopathy, etc.

     
  5. Does the Star Health Comprehensive Plan allow the inclusion of family members in the middle of the policy term?
    In order to provide comprehensive coverage for the entire family, the Star Health Comprehensive Plan offers the option to include the newly married spouse and newborn baby by paying an additional premium. Waiting periods will be applicable from the date of their inclusion.