• Star Criticare Plus Insurance Policy

    Health Insurance
    • Enjoy options to cover yourself, your spouse, kids and even your parents
    • Enjoy access to 10,000+ hospitals for cashless treatment
    • Reduce your taxable income by up to Rs. 50,000 deduction under section 80D**

    Star Criticare Plus Insurance Policy is an insurance policy that offers both health insurance cover and critical illness cover for policyholders. With this cover, policyholders can get the benefit of both health insurance and critical illness cover. For major critical illnesses, a lumpsum payment is provided to the insured following the diagnosis. This is an individual cover, and it must be taken separately for all members in a family. A unique feature of this policy is that it provides cover for non allopathic treatment up to a certain limit.

    Eligibility For Star Criticare Plus Insurance Policy

    The eligibility criteria for Star Criticare Plus Insurance Policy can be given as follows:

    • Anyone between the age of 18 years and 65 years can take this cover.
    • Only renewal benefit is available for people above 65 years of age.
    • There is no exit age for this policy.

    Sum Insured & Premium Charges

    The minimum sum insured for this policy is Rs.2 lakh whereas the maximum sum insured is Rs.10 lakh. Based on the chosen sum insured and the age of the policyholder, the premium charges for this policy vary. The fixed premium charges (excluding taxes) for this policy can be given as follows.

    Sum insured Age 18 to 35 years Age 36 to 45 years Age 46 to 55 years Age 55 to 65 years Above 65 years
    Rs.2 lakh Rs.3,750 Rs.4,200 Rs.6,400 Rs.7,550 Rs.11,150
    Rs.3 lakh Rs.5,400 Rs.6,000 Rs.8,900 Rs.11,600 Rs.16,200
    Rs.4 lakh Rs.7,000 Rs.7,680 Rs.12,300 Rs.15,900 Rs.21,050
    Rs.5 lakh Rs.8,400 Rs.9,400 Rs.15,200 Rs.19,500 Rs.25,900
    Rs.10 lakh Rs.14,600 Rs.16,100 Rs.22,600 Rs.28,200 Rs.35,350

    For people entering the policy between 60 and 65 years of age, the maximum sum insured is restricted to Rs.2 lakh. A 5% discount on premium charges is available when two members in a family opt for this cover. A 10% discount on premium charges is available when more than two members in a family opt for this cover.

    Major Illnesses Covered Under Star Criticare Plus Insurance Policy

    • First diagnosis of brain tumour, cancer, chronic kidney disease
    • Major organ transplant for the first time
    • Cerebro-vascular stroke causing hemiplegia (first time)
    • Acute myocardial infarction (first time)
    • Established irreversible quadriplegia
    • Established irreversible coma
    • Established irreversible paraplegia

    Features Of Star Criticare Plus Insurance Policy

    Some of the key features of Star Criticare Plus Insurance Policy can be given as follows.

    • Pre-hospitalisation medical expenses are covered for a period up to 30 days before the date of hospitalisation.
    • Post-hospitalisation benefit is offered for up to 7% of the total medical expenses, and it is paid as a lumpsum. This benefit is subject to a maximum of Rs.5,000.
    • Pre-existing illnesses are covered after 48 months of continuous policy coverage.
    • There is no survival period for major illnesses covered under this policy.
    • The premium amount paid towards this policy is eligible for tax relief under Section 80D of the Income Tax Act.
    • A grace period of 30 days is available for renewal after the expiry date of the policy.
    • The sum insured amount can be enhanced during the time of renewal.
    • A free look period of 15 days is available with the policy to ensure that the insured person is satisfied with the policy terms.
    • Copayment of 30% of each and every claim is mandatory for people with entry age above 60 years.
    • Portability option is available with the policy, and it can be transferred to any other insurance service provider. However, the company must be notified at least 45 days prior to the date of renewal.

    Benefits Of Star Criticare Plus Insurance Policy

    Star’s Criticare Plus Insurance Policy comes with the following benefits for policyholders.

    Room, boarding, and nursing expenses Up to 2% of the sum insured subject to a maximum of Rs.4,000 per day
    Medical expenses covered Surgeon’s fee, consultant’s fee, specialist’s fee, anaesthetist’s fee, cost of drugs & medicines, etc.
    Emergency ambulance charges Up to Rs.750 per hospitalisation subject to a maximum of Rs.1,500 per policy period
    Non allopathic treatment Up to 25% of the sum insured subject to a maximum of Rs.25,000 per policy period
    Cover for major illnesses A lumpsum payment equal to the sum insured amount is paid to the insured person. This is a one time payment paid on first diagnosis of the illness. Upon payment of the amount, the policy will cease.

    Exclusions From Star Criticare Plus Insurance Policy

    Some of the exclusions under Star Criticare Plus Insurance Policy are as follows.

    • Any diseases or illnesses contracted within the first 30 days of the commencement of the policy.
    • Conditions such as benign prostatic hypertrophy, hydrocele, sinusitis, treatment of gallstones, etc. during the first one year of policy
    • Conditions such as cataract, hysterectomy, knee or joint treatment (other than due to accidents), varicose veins, etc. during the first two years of continuous policy coverage
    • Dental treatment of any kind unless necessitated by an accident
    • Expenses related to diagnosis, X-ray, or laboratory examinations that are not consistent with the primary reason for hospitalisation
    • Cost of medical aids such as walkers, wheelchairs, crutches, contact lens, hearing aids, spectacles, etc.
    • Circumcision, vaccination, or inoculation
    • Cosmetic and aesthetic treatments of all kinds
    • Expenses related to obesity treatments and weight management treatments
    • Treatment related to pregnancy, childbirth, abortion, miscarriage, etc.
    • Convalescence, general debility, and run-down condition rest cure
    • Injuries caused while under the influence of alcohol or drugs
    • Intentional self injuries
    • HIV, venereal diseases, and sexually transmitted diseases

    Claim Procedure

    The claim procedure for Star Criticare Plus Insurance Policy begins with notification to the insurer. The insurer can be contacted through the company’s customer helpline. In addition to getting details about the claim procedure, any other information related to a policy can also be obtained from this helpline. In case of planned hospitalisation, the company must be informed at least 24 hours before hospitalisation. For emergency hospitalisation, the company can be notified 24 hours after admission in a hospital.

    To avail cashless treatment facility in a company network hospital, the insured must provide the policy information and identity proof. For treatment in non-network hospitals, the payment must be made upfront and reimbursement can be claimed from the company. While making the reimbursement claim, the insured must submit all the documents related to the medical expenses incurred. Upon verification of the documents, the company will provide the reimbursement amount to the insured.

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