Star Health Assure Plan
An Angioplasty procedure costs ₹2.5 Lakh in a hich class hospital in Kerala. Including the room rent and other expenses, the total hospital bill may amount to ₹5 Lakh. When we take the present inflation rate into consideration, this expense is likely to increase to ₹15 Lakh by the year 2030. Even a person who has an Insurance policy with coverage of ₹5 Lakh will find it extremely difficult to bridge the gap between the insurance coverage and actual expense.
Angioplasy is a procedure that costs very less in comparison with other deceases. There are many other deceases like Kidney related problems. In the event when a Kidney Transplantation is required minimum ₹40 Lakh will have to be raised to meet the hospital expense. Just imagine what would be the requirement in 2030.
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Certainly, a Health Insurance Policy of ₹5 Lakh or even ₹10 Lakh may not be helpful in cases studied above in the next decade.
Case Study
A friend of mine (name withheld intentionally) has been a Kidney patient for the last two years. He has been undergoing three Dialysis a week since December 2021. Now his Doctors said only a Kidney transplant would save him. In fact he has come to the priority list of the Mrithasanjeevani scheme of Kerala Government. That apart, he needs to find the Lakhs of Rupees needed for the Hospital expense. He has a Health Insurance Policy from Star Health for ₹5 Lakh. But, the Insured Sum is almost over for the treatment he has undergone till now this year. For the Transplant, the expense is many times higher. In this pathetic situation, despite the higher financial status he was believed to be possessing in the past, he had put forward many appeals in the social media for help from the public.
As a solution to this grave problem of the public, Star Health Insurance Company has come up with a new Plan called Assure. In Star Health Assure, one can include up to 9 family members (6 Adults and 3 Children) for a coverage up to ₹2 Cr. When I say Adults, the proposer can include his/her parents who are below 75 years old. Notably, a parent who is included in this plan at the age of 74 would enjoy the protection till the end of his/her life.
Because there is a provision to avail a maximum of ₹15,000 every year for Health Checkup, a major portion of the yearly premium amount is coming back to the proposer.
Those who have coverage under MEDISEP (Medical Insurance for State Employees and Pensioners) or any other Health Plans of any agency, may opt for Optional Deduction so that he/she may claim only for amounts above ₹50,000 or ₹1 Lakh through Assure policy. In such cases premium will be discounted up to 50%.
That means, a coverage of ₹2 Cr can be ensured for a comparatively low premium. Because all modern treatments are covered and even Air Ambulance charges up to 10% of Sum Insured (₹20 Lakh for ₹2 Cr policy) are covered, policyholders can spend their lives tension free.
Call me for More Information on Star Health Policies: +918891052375
Salient Features of Assure Plan
Age Limit
Adults: 18 to 75 Years
Children: 16 Days to 17 Years
From 18 years of age children will get 40% discount in premium till marriage.
Parents of the proposer will get a 10% discount in premium.
Sum Insured
5 Lakh, 10 Lakh, 15 Lakh, 20 Lakh, 25 Lakh, 50 Lakh, 75 Lakh, 1 Crore and 2 Crore
Inclusions During Policy Term
Life partner joined through marriage during policy term
Children born during policy term
Children adopted during policy term
Automatic Restoration of Sum Insured
Maximum amount that can be claimed at a time is the Sum Insured + Bonus. However, the Sum Insured will be restored fully in the same policy year when the balance becomes zero. That means, consequent claims before next renewal also will be accepted and approved.
Room Rent
For policies with Sum Insured up to ₹50 Lakh, either 1% of the Sum Insured or ₹20,000, whichever is less, shall be the upper limit for room rent.
For Policies with Sum Insured ₹75 Lakh, ₹1 Cr and ₹2 Cr, there shall not be any limit for room rent. That means, those policy holders can go for the best available rooms.
Pre and Post Hospitalisation Expense
Hospital expenses prior to 60 days of the date of admission and 180 days after the date of discharge shall be covered under the policy.
Day Care
Treatments like Dialysis, Cataract Surgery etc that may not need hospitalisation will be covered under the policy.
Emergency Ambulance Service
In cases of claims that are admissible, actual expense incurred during emergency admission to hospital and expense for conveyance to home in the same city/town the hospital is situated can be reimbursed on actuals.
Air Ambulance Service
Up to 10% of the Sum Insured can be claimed for Air Ambulance in cases advised by Doctors. That means, a policy holder of ₹2 Crore Sum Insured can avail up to ₹20 Lakh for Air Ambulance service.
Domiciliary Hospitalisation
When beds are not available in hospitals and in cases of old age patients, hospitals may recommend domiciliary hospitalisation for treatments. All hospital expenses incurred during such treatments can be reimbursed.
Expenses of Ayush Treatment
All treatments undernAyurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems can be claimed provided that the treatment is done in approved Ayush centres.
Treatment of Organ Donor
During organ transplant treatments, the remaining amount of Sum Insured can be used for the Donor in case the Donor needs treatment for any complications as an after effect of the donation. If the complication is developed after the settlement of the claim, full Sum Insured can be utilised for the Donor.
Health Checkup
Health checkup expenses can be claimed every year as given below.
Infertility Treatment
Infertility treatment commencing after two years of joining the policy and expenses incurred for delivery following infertility treatment are covered under the policy. The limit for various Sum Insured is given in the table below. Infertility treatment should be done in approved hospitals.
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Delivery Expense
10% of the Sum Insured is the upper limit for Delivery Expenses. Claims will be accepted only when both Husband and Wife complete two years after joining the policy.
In Utero Foetal Treatment
Treatment of an unborn baby (foetus) in the uterus (in utero) is covered under the policy if both Husband and Wife complete two years after joining the policy.
Modern Treatments
Modern treatments like Robotic Treatments are covered fully under this policy.
Discounts for Star Wellness Programme Participants
Those who participate in Star Wellness Programme can avail 4% to 20% discount in premium. For example, a policyholder who takes yearly membership in an approved Gymnasium shall claim for 20% discount in subsequent premium. Those who walk regularly for 5 Km and those who engage in physical fitness activities will also get a certain percentage of discount in premium.
Optional Deductions
Those who have coverage under MEDISEP (Medical Insurance for State Employees and Pensioners) or any other Health Plans of any agency, may opt for Optional Deduction so that he/she may claim only for amounts above ₹50,000 or ₹1 Lakh through Assure policy. In such cases premium will be discounted as given in the table below.
Waiting Periods
Pre Existing Diseases (PED)
Any typical diseases a person has at the time of joining the policy and declared and recorded in policy related documents are called Pre Existing Diseases. There is a waiting period of 3 years to claim expenses of treatment for these Pre Existing Diseases.
In cases of long term Policy Term of 3 years (where initial premium is paid for 3 years), the waithing period for PED is reduced to 2 years and 6 months.
Specified Diseases (Cataract etc.)
Treatment expenses of diseases like Cataract can be claimed only after 2 years.
Delivery Expenses
Delivery expenses can be claimed only after 2 years of completion by both husband and wife after joining the policy.
In Utero Foetal Treatment
Treatment of an unborn baby (foetus) in the uterus (in utero) is covered under the policy if both Husband and Wife complete 2 years after joining the policy.
Infertility Treatment
Claims for Infertility treatment will be accepted only for treatments commencing after 2 years of joining the policy.
New Born Baby
Children born after 1 Year only will be added to policy coverage.
Mathews Jacob
+917907228608
23-Nov-2022
