Family Health Optima
Additional information
| Health Policy | Covers hospitalization expenses incurred as a result of illness and/or accidental injuries. |
|---|---|
| Type of Cover | Individual and Floater |
| Entry Age | Individual: 18 days -75 years |
| Maximum Family Size | 2A+3C+4P; or 6A+3C |
| Midterm Inclusion | Newly wedded spouse |
| Zone based policy | Zone A: Delhi, Mumbai, Ahmedabad, Surat & Vadodara |
| Co-payment | 10% of every claim amount |
| Renewal | Lifelong |
| Policy Term | 1 yr, 2 yr, 3 yr |
| Long Term Discount | 2 yr: 10% discount on 2nd yr premium |
| Floater discount | Child upto 17 years. |
| Pre-medical screening | Pre-medical checkup: 100% cost borne by company |
| Sum insured options | (Rs. in lakhs) |
| Room Rent | Upto 1% of sum insured. |
| Coverage for non-medical items (Consumables) | Admissible claim, as per List 1 |
| Emergency Road Ambulance | Covered upto sum insured |
| Pre- and post-hospitalization | 60 days and 120 days. |
| Domiciliary Hospitalization | Covered upto sum insured, for periods exceeding 3 days. |
| Home Care Treatment | Covered upto 10% of sum insured. |
| Air ambulance | Covered upto 10% of sum insured. |
| Star Wellness program | Star Power app |
| Age of Entry - Adult | 18yrs to 65 yrs |
| Age of Entry - Child | 16days to 25yrs |
| Policy Type | Family Floater |
| Sum insured options | 10 lakhs, 15 lakhs, 20 lakhs, 25 lakhs, 3 lakhs, 4 lakhs, 5 lakhs |
| Family Size | 1A+1C, 2A+3C |
| Family Includes | Self, Spouse and 3 Dependent Children |
| Policy Period | 1yr |
| Renewal Guarantee | Life Long |
| In Patient Hospitalization | Covered |
| Room Rent | 5K/Day(3 & 4 Lac SI) & Single Standard A/Croom For 5Lac & Above SI |
| ICU Charges | Actual |
| Pre-hospitalization | 60 days |
| Post hospitalization | 90 days |
| Day Care Procedure | All Day Care Procedure ( Sub Limit On Cataract) |
| Road Ambulance Charges | Rs.750 Per Hospitalization & Rs. 1,500 PPP |
| Air ambulance | 10% of SI (5Lac & Above SI Only) |
| Emergency Domestic Medical Evacuation | Rs. 5K to 10K (Depend on SI |
| Auto Recharge | 25 % of SI ( 3Lac & 4 Lac SI )& 1.5 Lac (5Lac & Above SI) |
| Auto Restoration Benefit | 3 Times of Basic Sum Insured(100 % ) |
| Super Restoration | NA |
| No Claim Bonus | Up to 100 % of Sum insued (1st Yr 25 % & 2nd yr 10% onwords) |
| Health Checkup | Every Claim Free Year (Rs. 750 to 3,500) |
| Donor Expenses | 10 % of Sum Insured or Maximum Rs. 1 Lac |
| Domiciliary Treatment | Covered |
| E Opinion / Second Medical Opinion | Covered |
| Hospital Cash Benefit | NA |
| AYUSH Treatment | Rs. 10,000 to 20,000 ( Depend on Sum Insured) |
| Preferred Network Hospital | 1% of Sum Insured or Maximum 5K |
| Shared Accomodation | Rs. 800/Day for 3Lac to 15Lac SI & Rs. 1,000/Day for 20Lac & 25 Lac |
| Additional Road Traffic Accident Cover | 25 % of Sum Insured or Maximum 5 Lac |
| Assisted Reproduction Treatment Cover | Rs. 1Lac for 5Lac SI & Rs. 2Lac for 10Lac & Above SI |
| Bariatric Surgery | NA |
| Dental and Eye Treatment | NA |
| Out Patient Consultation | NA |
| PA Cover | NA |
| PED Waiting Period | After 48 Months |
| Buy Back PED | NA |
| Co-payment | 20% of Claim Amount ( Above 60 Year entry in New policy |
| Star Wellness program | NA |
| Maternity Expenses | NA |
| New Born Baby Cover | 10 % of Sum Insured or maximum 50 K |
| First Year Vaccinations | NA |
| Tax Benefits | 80 D |
| Repatriation of Mortal Remains | Rs. 5K |
| Compassionate Travel | Upto Rs 5,000/- per Hospitalization |
| Midterm Inclusion | NA |
| Psychiatric and Psychosomatic | NA |
| Premium Discount | NA |
| Modern Treatment | Covered |
| Moratorium Period | Available |
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