A health insurance policy is a product through which allows an individual to pay for his/her healthcare expenses. It is a kind of financial protection against the medical costs incurred by the insured. A part of the medical expenses borne by the policyholder is paid by the insurance company in exchange for premium payments over the life of the policy.
The need for a health insurance policy has been increasing over the years. The inflation in healthcare is greater than the inflation in other categories including food. For a person who does not have enough savings, arranging funds for healthcare emergencies might prove to be very difficult. This problem is solved by taking a health insurance policy. Various policies available in the market allow the individual to choose a plan that fits his/her requirements. The health insurance policy makes paying for health expenses easier by making payment for medical and surgical expenses promptly in case of need.
The Three Main Types of Health Insurance Available in India Are:
Hospitalisation Plans: These plans are also known as indemnity plan. This type of insurance policy covers the cost of hospitalisation subject to the limit of the sum insured. The policy can be taken for an individual or can be taken on a family floater basis.
Hospital Daily Cash Benefit Plans: These policies provide a daily amount of money for every day of hospitalisation. The amount paid is fixed and does not depend on the actual hospitalisation costs incurred.
Critical Illness Plans: The illnesses and other medical conditions are pre-defined for these type of policies. A lump sum amount is paid on diagnosis of these critical illnesses. These policies usually provide higher coverage and charge higher premium because the costs of treatment for these illnesses is higher.
About Star Health Insurance:
Star Health Insurance is a leading health insurance company in India. Star Health Insurance began its operations in India in the year 2006. The health insurance company has its main focus on health insurance and accident policies. The company has more 8500 hospitals in its network. The company has received various awards like World Health Organization Award of Excellence for the year 2017, Best Health Insurer at Outlook Money Awards in 2016, Best Health Insurance Provider of the year by Business Today for the year 2016-17 and other corporate excellence awards.
Star Health Insurance offers various products including individual and family floater policies, policies for senior citizens, critical illness policies and policies specially designed for certain groups of people. Some of the plans are mentioned below:
1. Family Health Optima Insurance Plan:
This star health insurance plan provides protection for the entire family in a single policy at an affordable premium. Family can include policyholder, spouse and dependent children. The policy offers lifetime renewals beyond the age of 65 years. The policyholder can claim tax benefits for amount paid by means other than cash. The benefits offered by the policy are:
Pre and Post Hospitalisation Expenses: The policy covers pre hospitalisation expenses of up to 60 days before admission and post hospitalisation expenses up to 90 days after discharge.
Health Check-Up Costs: The expenses incurred for health check-ups are covered up to the limits.
Assisted Reproductive Treatment: Expenses incurred towards treatment of sub fertility to the upper limit for Rs.1 Lakh for policy of Rs.5 Lakh and Rs.2 Lakh for a policy of Rs.10 Lakh and above for a period of every 36 months.
Road Traffic Accident: The sum assured would be enhanced by 25% limited to Rs.5 Lakhs in case the policyholder meets with a road accident requiring hospitalisation. This is applicable if the policyholder was wearing a helmet and was riding on a two wheeler.
Bonus: In case of a claim free year, a bonus of 25% of amount assured will be allowed in the second year and additional 10% would be allowed for subsequent years.
2. Star Comprehensive Insurance Policy:
This policy by star health insurance can be taken for an individual as well as on a family floater basis. The policy allows renewals without any upper limit on age. The policyholder can claim tax benefits for amount paid by means other than cash. The benefits of this policy are:
Expense Cover: It covers hospitalisation expenses for minimum period of 24 hours. The policy covers pre hospitalisation expenses of up to 30 days before admission and post hospitalisation expenses up to 60 days after discharge. Ambulance charges in case of hospitalisation in emergency also covered.
New Born Expenses: Pre-natal and Post-Natal expenses incurred are covered under the policy subject to the limits. Vaccination costs of up to Rs.1000 also covered.
Accidental Death and Permanent Total Disablement: The expenses for the same are covered up to the amount of the sum insured.
Health Check-up: Expenses incurred for health check-up once in every three claim free terms.
Hospital Cash Benefit: This is available for every completed day in the hospital.
Second Medical Opinion: The option of taking a second medical advice from the doctors mentioned in the insurance company’s network via electronic mode is also present.
Bonus: A bonus amount of 50% of amount insured is allowed after a claim free period.
3. Medi-Classic Insurance Policy (Individual):
The policy provides cover for hospitalisation expenses of the policyholder in case of illnesses and accidents and ensures a stress free recovery. The advantages of the plan are:
Policy Term: In case the policy is availed for 2 years, a 5% discount on the premium paid for 2 years is made available.
Hospitalisation Expenses: These include room, nursing charges, medicine costs, fees of consultants and specialists etc. Pre hospitalisation expenses available for up to 30 days before and post hospitalisation expenses made as a lump sum payment according to the specified limit.
Add-On Covers: Add on covers like patient care and hospital cash can be availed by paying additional premium.
Health Check-Up: Expenses for health check-up can be claimed once in every 4 claim free years.
HIV Persons Coverage: The plan can also be availed by HIV positive people subject to the provision of proof of CD 4 count above 350 at time of entry.
Bonus: A bonus of 5% is provided for every claim free period subject to a maximum of 25%. This benefit is not available for family floater plan.
4. Senior Citizens Red Carpet Health Insurance Policy:
This policy is for people aged between 60 and 75 years. This policy offered by Star Health insurance does not also require any pre-acceptance medical screening. The benefits offered are:
High Sum Insured: The policy offers coverage up to Rs.10 Lakh.
Discount: In case the policy is bought online, a 5% discount on the premium can be availed.
Hospitalisation Coverage: Coverage is provided for expenses incurred for minimum admission of 24 hours. Ambulance charges are also included.
Medical Consultations: Expenses for medical consultation in the network of hospitals covered up to the specified limits. Day-Care procedures specified in the policy also covered.
5. Star Health Gain Insurance Policy:
This policy allows the individual to choose the sum insured and the premium to be paid thus providing flexibility. The advantages of this plan are:
Expenses Covered: The policy covers pre hospitalisation expenses of up to 30 days before admission and post hospitalisation expenses up to 60 days after discharge. Ambulances charges subject to a maximum of Rs.750 per hospitalisation and Rs.1500 for every policy period allowed. All day care procedures included.
Co-Payment: 20% co-payment for every claim of new and renewed policies for policyholder whose age at entry time is more than 60 years.
Out Patient Benefits: Medical costs in network of hospitals to be reimbursed without any waiting period.
Carry forward: Benefit not availed in one policy period can be carried forward to immediate next policy renewal period.
6. Super Surplus Insurance Policy:
It is available on both individual as well as floater basis. There are two plans on offer- Silver plan and Golden plan. Advantages are:
Expenses: Expenses of hospitalisation including Nursing, Room and Boarding covered up to Rs.4000 per day. Pre hospitalisation expenses of up to 30 days before admission and post hospitalisation expenses up to 60 days after discharge.
Option of Migration: The policyholder can choose to change to any other indemnity based policy once this policy has been continuously renewed for 5 years.
Co-pay: 10% when the age at time of entry is more than 60 years.
7. Diabetes Safe Insurance Policy:
This policy is available for people aged between 18 and 65 years suffering from Diabetes Mellitus. The advantages are:
Expenses: Hospitalisation expenses due to diabetes complications covered with nursing, boarding, room, medicines all expenses covered. Complications other than diabetes are also covered.
Personal Accident: Compensation provided for death by accident for insured at 100% of sum insured.
Out Patient Expenses: Expenses of diagnostic tests and medical consultation covered.
8. Star Cardiac Care Insurance Policy:
This policy offers two plan options- Gold Plan and Silver Plan. This policy can be availed for any person who is between the age of 10 and 65 years and has undergone any of the following procedures- PTCA or CABG, Correction of VSD/ASD, PDA treatment and RF Ablation. The advantages of the plan are:
Hospitalisation Expenses: Hospitalisation costs for minimum of 24 hours covered under the policy. Pre-hospitalisation expenses up to 30 days before admission and post-hospitalisation expenses of up to of 7% of costs of hospitalisation or Rs.5000 per admission whichever is lower covered.
Cardiac Section: The policy provides cover for treatment of cardiac illnesses after waiting period of 90 days.
Out Patient Expenses: Expenses of up to Rs.500 for every event and Rs.1500 for every policy period are covered under the plan.
Personal Accident: In case the insured meets with an accident and dies within 12 months from the date of accident, the sum insured will be paid by the company in this case.
9. Star Cancer Care Gold:
This product is the first of its kind health insurance policy for Cancer patients. The plan is a limited period offer. Anyone from 5 months to 65 Years of age can avail this policy. The benefits offered are:
Expenses: Pre-hospitalisation expenses 30 days before and post-hospitalisation expenses 60 days after covered. Medical costs of all day care expenses covered. Room rent, boarding, nursing expenses covered. Ambulance charges up to Rs.1500 per event and Rs.2000 for the policy period covered.
Co-pay: 10% if the insured is above 60 years of age at time of entry.
Indemnity Cover: Coverage provided for expenses for accidents and other diseases other than cancer also.
10. Star Net Plus:
This policy by Star Health Insurance is the first policy in the country that provides health cover to HIV positive people. NGO’s, societies and agencies involved in serving individuals with HIV can provide proposals for their members to avail insurance for them.
11. Star Special Care:
This health insurance plan is a policy which has been specially designed for autistic children. Any child between the ages of 3 and 25 years can be covered under this plan. The benefits offered are:
Sum Insured: Provides a sum insured of Rs.300000.
Expenses: The plan covers hospitalisation expenses of up to Rs.5000 per day. Expenses for some procedures will be paid as per the conditions mentioned in the policy document.
Co-pay: 20% co-payment for every claim.
A health insurance policy has become a necessity today with the sky rocketing health expenditures and increased prevalence of lifestyle and other diseases. It is important to secure oneself financially and provide security to the family for unforeseen circumstances. The individual should be careful while choosing a health insurance policy and take into consideration all the necessary factors. Star health insurance provides plans suited for every need and requirement and individuals can make the best use of a health insurance policy through these plans.