Star Health Gain is an insurance policy that offers comprehensive health insurance coverage for both individuals and families. This policy can be used to cover both inpatient and outpatient medical expenses. One of the unique features of this health insurance cover is that it has a flat premium charge irrespective of the age of the insured, sum insured opted, or the number of members covered in a family. The range of benefits offered by this cover aims to address the health insurance requirements of individuals as well as families.
The following eligibility criteria applies to Star Health Gain Insurance Policy.
Star Health Gain Insurance Policy is available in five different sum insured options - Rs.1 lakh, Rs.2 lakh, Rs.3 lakh, Rs.4 lakh, and Rs.5 lakh. Irrespective of the sum insured opted, age of the insured person, or the number of members in a family (under family floater), the premium amount for this policy remains the same.
|Options||Premium Amount||Sum Insured|
|Option 1||Rs.15,000||Rs.1 lakh||Rs.2 lakh||Rs.3 lakh||Rs.4 lakh||Rs.5 lakh|
Some of the key features of Star Health Gain Insurance Policy can be listed as follows:
The maximum extent of hospitalisation coverage and outpatient treatment benefits under Star Health Gain Insurance Policy can be given as follows.
|Room rent and boarding expenses||Class A cities - 2% of the sum insured subject to a maximum of Rs.4,000 per day Class B cities - 1% of the sum insured subject to a maximum of Rs.3,000 per day Other locations - 1% of the sum insured subject to a maximum of Rs.1,000 per day|
|Medical expenses covered||Surgeon’s fee, consultant’s fee, anaesthetist’s fee, medical practitioner’s fee, blood, oxygen, drugs & medicines, cost of pacemaker, diagnostic expenses, and other similar expenses|
|Emergency ambulance charges||Up to Rs.750 per hospitalisation subject to a maximum of Rs.1,500 per policy period|
|Outpatient treatment cover||Expenses are covered up to certain limits specified in the policy document. Treatment costs are covered even for pre-existing diseases, dental conditions, prenatal and postnatal care, etc. Unutilised amount can be carried forward subject to a maximum of one year.|
|No claim bonus||A 10% discount on premium charges is available following a claim-free year. However, this discount is not cumulative.|
There are certain exclusions under Star Health Gain Insurance Policy for which the company is not liable for any payment. These exclusions apply only for inpatient medical treatment.
Claim procedure for Star Health Gain Insurance Policy is similar to the company’s other insurance products. Policyholders can contact the company’s helpline anytime and request information related to their policies. The insurer must be notified 24 hours before admission in case of planned hospitalisation. During emergency hospitalisation, the insurer must be notified within 24 hours after admission in a hospital.
Cashless treatment can be availed in the company’s network hospitals. The insured must provide the policy details and identity proof to the hospital in order to avail cashless treatment. Since there are no third-party administrators involved, the claim settlement process is direct and hassle-free. For normal hospitalisation claims, the insured must provide all the documents related to the medical expenses incurred. Once these documents are validated by the company, the settlement amount will be provided to the insured.
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