Family Health Optima

Description

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
Dependent Children: 91 days -18 years
Floater: 18 days – 75 years
Dependent Children: 16 days – 18 years
Children can continue under floater policy until they get married.

Maximum Family Size

2A+3C+4P; or 6A+3C
IF parents want cover separately , 2A policy is available.

Midterm Inclusion

Newly wedded spouse
New born baby
Legally adopted child
Intimation within 45 days.

Zone based policy

Zone A: Delhi, Mumbai, Ahmedabad, Surat & Vadodara
Zone B: Pune+Nasik,Trivandrum, Ernakulam, Chennai, Bengalure, Hyderabad, Secunderabad, Rest of Gujarat
Zone C: Rest of India

Co-payment

10% of every claim amount
For entry age, above 61 years

Renewal

Lifelong

Policy Term

1 yr, 2 yr, 3 yr

Long Term Discount

2 yr: 10% discount on 2nd yr premium
3 yr: 10% discount on 2nd & 3rd yr premium

Floater discount

Child upto 17 years.
After 17 years,discount upto 40%
Parents: 10% for each parent.

Pre-medical screening

Pre-medical checkup: 100% cost borne by company
For children, age less than 12 years, paedeatrician letters and vaccination report required.

Sum insured options

(Rs. in lakhs)
5, 10, 15, 20, 25, 50, 75, 100, 200
75-200 lakhs – only upto 65 years.

Room Rent

Upto 1% of sum insured.
or
Upto Rs. 20,000/- per day.,
whichever is less.

Coverage for non-medical items (Consumables)

Admissible claim, as per List 1

Emergency Road Ambulance

Covered upto sum insured
Transportation:
1. To hospital
2.From hospital to hospital
3.From hospital to home

Pre- and post-hospitalization

60 days and 120 days.
Covered upto sum insured.

Domiciliary Hospitalization

Covered upto sum insured, for periods exceeding 3 days.

Home Care Treatment

Covered upto 10% of sum insured.
Upto maximum of Rs. 5 lakhs.

Air ambulance

Covered upto 10% of sum insured.

Star Wellness program

Star Power app
Consumer portal
Upto 20% discount for enrolling in wellness program.

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

Reviews

There are no reviews yet.

Be the first to review “Family Health Optima”

Your email address will not be published. Required fields are marked *

Verified by MonsterInsights