Star Women Care

Let’s Delve Into The Specific Of The Star Women Care Plan!

The Star Women Care is a health insurance policy that is offered by Star Health and Allied Insurance Company Limited. Specifically designed for women, it provides tailored features and benefits to address their healthcare needs and those of their families. With this plan, women can rest assured that they and their loved ones will receive necessary medical care without the stress of unexpected expenses.
 

Who is Eligible To Buy The Star Women Care Plan?

• Minimum Age To Join The Policy: 18 years

• Maximum Age To Join The Policy: 75 years
   

What Are The Benefits And Limits of The Star Women Care Plan That You Should Be Aware of?

The Star Women Care Plan takes care of inpatient hospitalisation costs, such as expenses linked to staying in the hospital for over 24 hours, covering room and nursing charges, medical practitioner fees, prescribed medicines, drugs, ICU charges, and related expenses. Let's take a quick look at some of the other expenses covered by this plan –

• Pre & Post-Hospitalisation Expenses
  For all those diagnostic and other tests before or after your hospital stay, you do not have to stress, as your insurer has got you covered. You will be eligible for coverage up to the sum insured for an extended period of 60 days before being admitted to the hospital and 90 days after being discharged. You should remember that these expenses will be taken care of only if they are linked to the medical condition that led to your hospitalisation, and approval for these claims is part of the inpatient hospitalisation coverage.
   
• Daycare Treatment Coverage
  The Star Women Care Plan covers all daycare treatments. Daycare treatments are those medical procedures or surgeries that used to need a long hospital stay but can now be successfully completed within 24 hours, because of advancements in the medical field. The good news is that under this plan, there is no limit for daycare treatments, and they will be covered up to the sum insured.
   
• Organ Donor Coverage
  The Star Women Care Plan also covers expenses related to organ donation when you are the recipient. It takes care of inpatient costs of the organ donor for organ transplantation, up to the sum insured you choose for the policy. If your donor faces any complications requiring redo surgery or ICU admission, this plan will also cover those expenses. However, the coverage limit for these situations is separate from your regular coverage limit.
   
• Modern Treatment Coverage
  The world of healthcare is changing fast, with new technologies bringing about treatments that were once unimaginable. The Star Women Care Plan is here to support you through these advancements. It covers the costs of these modern treatments, giving you financial help when you need it most. Depending on the sum insured you pick, the plan covers up to either 50%, 40%, or 30% of the expenses associated with these treatments.

• Non-Medical Expenses
  Non-medical expenses include the cost of items like gloves, nebulization kits, oxygen masks, etc., that are essential for treatment. These items can get pricey and can quickly pile up. But the Star Women Care Plan covers these non-medical costs up to the sum insured. It is a helpful way to ease the financial load of these necessary items.
   
• Cumulative Bonus (No Claim Bonus)
  Cumulative Bonus, also referred to as the No Claim Bonus,  is a reward you’ll receive from your insurer if you go without making a claim and stay healthy in a policy year.  It is given by boosting your base sum insured by 20% starting from the 2nd year of the policy.  You can accumulate this bonus each year, up to a maximum limit of 100% of the base sum insured. And, even if you make a claim later on, the bonuses you earned before that remain untouched, i.e., they will not decrease.
   
• Restoration Benefit
  The restoration benefit offered by the Star Women Care Plan is a handy feature that automatically replenishes your sum insured amount if it runs out within a policy year. This benefit kicks in when you have used up all or part of your base sum insured, and it stays available for subsequent claims during a policy year. You can use the restoration benefit once per policy year, and it is available for both related and unrelated illnesses.
   
• Room Rent Limit
  It is the maximum amount your health insurance policy covers for the hospital room you choose. If you stick within this limit, you will not have to pay any additional amount. But, if you go for a room with a higher rent than allowed, you will face a proportionate deduction. This means that instead of just paying the extra room rent, you will be responsible for a proportionate share of the whole bill. In the Star Women Care Plan, the room rent limit depends on the sum insured you chose while purchasing the policy.

Additional Noteworthy Features Of The Star Women Care Plan

• Maternity Benefit
  Welcoming a new life into the world is a wonderful experience for any woman. However, it can also bring financial challenges. This is why the Star Women Care Plan offers maternity benefits to support you during this special time. The plan helps cover various expenses related to pregnancy up to a certain limit. These expenses include –

• • Infertility treatments, covering inpatient costs of the oocyte donor for any complications arising from it, as well as postpartum delivery complications for the surrogate mother.
  • Outpatient ante-natal care expenses once your pregnancy is confirmed.
  • Miscarriage due to accidental causes.
  • Delivery expenses, including care before and after childbirth (pre and postnatal care), etc.
     
• Newborn Baby Coverage
  The Star Women Care Plan understands the overwhelming joy and responsibility that comes along with welcoming a new member into your family. That is why it provides coverage for newborn babies, ensuring you can focus on caring for your little one without worrying about financial strain. You should, however, note that this coverage is subject to specific limits and conditions. And, it includes  –
• • Inpatient hospitalisation expenses for your newborn, starting from day one of birth, covering external birth defects or anomalies. This coverage extends up to 25% of the sum insured in the first year and 100% of the sum insured in subsequent years upon premium payment for your newborn.
  • Vaccination expenses until your baby reaches one year of age, up to a specified limit determined by your chosen sum insured.
  • Metabolic screening and paediatrician consultation costs until your child turns 12, up to certain limits.
     
• Bariatric Surgery
  The Star Women Care Plan goes the extra mile by providing coverage for expenses related to bariatric surgical procedures and any complications arising from weight loss efforts, all on a cashless basis. The coverage limit can be either up to Rs. 2,50,000/- or Rs. 5,00,000/-, depending on the sum insured you choose. This limit includes both pre-hospitalisation and post-hospitalisation expenses. This coverage is available for individuals aged 18 years and above who have completed the applicable waiting period. You should also keep in mind that there are additional conditions related to this coverage.
   

Waiting Period

When you invest in health insurance, there is a waiting period before coverage kicks in for certain illnesses or diseases. This means you cannot make a claim for such conditions right away. And once this waiting period is over, you can start claiming for those conditions. There are various types of waiting periods, each with its own conditions –

• Initial Waiting Period
  First, there is a 30-day initial waiting period for all medical conditions/illnesses except accidents. During this time, you cannot claim for hospitalisation unless it is due to an accident.
   
• Waiting Period For Pre-Existing Diseases
  The waiting period for a pre-existing disease applies to any health issue you have had in the 48 months before getting your insurance. With the Star Women Care Plan, there is a 24-month waiting period for these conditions. During this time, the policy will not cover expenses related to your pre-existing diseases.
   
• Waiting Period For Specific Diseases
  Some diseases have their own waiting period, decided by the insurer, separate from your pre-existing conditions. This period applies regardless of whether you have had these diseases before or not. For the Star Women Care Plan, there is a 24-month waiting period for specific diseases.
   

Exclusions

Exclusions refer to situations not covered by your health insurance policy. These include –

• Standard Permanent Exclusions: The IRDAI (Insurance Regulatory and Development Authority of India) mandates certain 'standard permanent exclusions' that all insurance companies must adhere to. Let's delve into these exclusions set by the IRDAI -
  • Hospital Admission For Observation: Hospital admissions solely for observation or monitoring.
  • Rehabilitation, Rest Cure, And Respite Care: Getting admitted to a facility for bed rest when no active treatment is provided.
  • Obesity/Weight Control: Any treatment or surgery for weight control or obesity that is not covered under the insurance policy.
  • Change Of Gender Treatment: Treatment that is aimed at changing the body's characteristics to that of the opposite sex.
  • Cosmetic/Plastic Surgery: Surgery or treatment that is intended to modify body characteristics or appearance.
  • Profession In Adventure Or Hazardous Sports: Treatment expenses incurred while participating as a professional in adventure activities like mountaineering, scuba diving, river rafting, horse racing, etc.
  • Breach Of Law: Costs that are related to the treatment of anyone who has carried out or attempted to carry out a breach of law with criminal intent.
  • Excluded Providers: Treatment from a hospital or medical practitioner excluded by the insurance company.
  • Narcotics: Getting treatment for addictive conditions like alcohol addiction, drug usage, etc.
  • Treatments In Establishments For Domestic Purposes: Expenses of treatment undergone in health spas, nursing homes, or similar establishments arranged entirely or partially for domestic reasons.
  • Dietary Supplements, Substances Without Prescription: Costs related to minerals, vitamins, etc., not prescribed by a medical practitioner.
  • Refractive Error: Costs associated with improved eyesight by correcting any refractive errors of up to 7.5 diopters.
  • Unproven Treatments: Treatments, medical procedures, or surgeries that are not proven to be effective.
  • Birth Control, Sterility Infertility Expenses: Expenses related to contraception, sterilisation, artificial insemination, advanced reproductive technologies such as ZIFT, GIFT, IVF, ICSI, gestational surrogacy, etc.
  • Maternity Expenses: Childbirth-related hospitalisation expenses, pre/post-natal costs, etc.
• Additional Permanent Exclusions: Apart from the usual permanent exclusions mentioned earlier, insurance providers might add extra exclusions for specific cases or health issues. If you have certain serious illnesses or medical conditions that insurers think are risky to cover, they might permanently leave them out of your policy. But remember, insurers can only exclude illnesses listed by the IRDAI.
• Non-standard exclusions (Specific exclusions): Special exclusions, also known as non-standard exclusions, are exceptions beyond the usual permanent exclusions set by the IRDAI. Such exclusions can differ among insurance companies and may depend on the specifics of your policy. Here are some of the key exclusions you need to know under the Star Women Care Plan –
  • Circumcision (unless necessary for treating a disease or due to an accident), preputioplasty, frenuloplasty, preputial dilatation, and removal of SMEGMA.
  • Convalescence, a run-down condition, general debility, and nutritional deficiency states.
  • Intentional self-harm.
  • Injuries or diseases caused by war, invasion, foreign enemies, warlike operations (declared or not), nuclear weapons/materials, etc.
  • Unconventional, untested, or experimental therapies
  • Autologous-derived stromal vascular fraction, chondrocyte implantation, procedures using platelet-rich plasma, and intra-articular injection therapy.
  • Biologicals unless administered as an in-patient, clinically indicated, and requiring hospitalisation.
  • Inoculation or vaccination (except for newborns, post-bite treatment, and therapeutic medical reasons).
  • Cost of spectacles, walkers, hearing aids, cochlear implants, contact lenses, wheelchairs, infusion pumps, CPAP, BIPAP, crutches, continuous ambulatory peritoneal dialysis, and similar aids.
     

Summary

How Can You Know More About The Policy Specifics?

• Brochure: https://d28c6jni2fmamz.cloudfront.net/Brochure_Star_Women_Care_Insurance_Policy_V_5_Web_10_1f319a50ba.pdf

• Policy Wording: https://d28c6jni2fmamz.cloudfront.net/Policy_Star_Women_Care_Insurance_Policy_V_8_Web_2_824e6a4919.pdf

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