| Family Health Optima from Star Health is a health insurance plan that gives protection for the entire family on the payment of a single premium under a single sum insured. The sum insured floats among the family members insured. It's just one more way to tighten the family bonds. |
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A Super Saver Policy |
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Single Sum Insured |
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Wider Coverage |
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Coverage for entire family |
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Single premium |
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Considerable saving in premium as the family is covered under one policy. |
| Who Can Take This Insurance? |
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Any persons aged between 5 months and 65years, residing in India, can take this insurance. |
| Family Includes |
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Proposer, spouse, dependent children upto 25 years (those who are economically dependent on their parents) |
| Pre- Medical screening |
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Persons above 45 years may be required to undergo pre-acceptance medical screening at the Company nominated centers.Cost of which is borne by the Company at present. |
| Pre-Existing Diseases / Illness |
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Are covered after 48 months of continuous Insurance with any Indian Insurance Copmany. |
| Policy Benefits |
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Hospitalisation Cover Protects the insured for in patient hospitalisation expenses for a minimum of 24 hrs.These expenses include room rent,nursing and boarding charges as per policy condition. |
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Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees. |
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Cost of Medicines and Drugs |
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Emergency ambulance charges up-to a sum of Rs. 750/- per hospitalization and overall limit of Rs. 1,500/- per policy period for transportation of the insured person. |
| Day Care Procedures |
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The 24 hrs Hospitalisation Limit is not applicable for 101 Day Care procedures listed in the policy conditions |
| Treatment of Cataract |
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Expenses incurred on treatment of cataract are limited to as per the following table |
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For Sum Insured Rs 100000/and 200000/ the limit will be Rs 12000/ for the entire policy period |
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For Sum Insured Rs 300000/,400000/and 500000/ the limit will be Rs 20000/in respect of one eye and Rs30000/for entire policy period |
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For Sum Insured Rs 1000000/ and 1500000/Lakhs the limit will be Rs 30000/in respect of one eye and Rs40000/for the entire policy period. |
| Pre and Post Hospitalisation |
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Pre-hospitalization medical expenses upto 30 days prior to the date of admission. |
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Post-hospitalizationn - a lumpsum calculated at 7% of the hospitalization expenses (excluding room charges) subject to a maximum of Rs.5,000/- is payable |
| How much to pay? |
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| Zone1 |
MUMBAI, DELHI & GUJARAT |
| SUM INSURED: Rs. 1,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
3890 |
3890 |
NA |
NA |
NA |
NA |
| 2A+1C |
NA |
NA |
NA |
NA |
NA |
NA |
| 2A+2C |
NA |
NA |
NA |
NA |
NA |
NA |
| 2A+3C |
NA |
NA |
NA |
NA |
NA |
NA |
| 1A+1C |
3250 |
3875 |
NA |
NA |
NA |
NA |
| 1A+2C |
4150 |
4700 |
NA |
NA |
NA |
NA |
| 1A+3C |
NA |
NA |
NA |
NA |
NA |
NA |
|
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| Service Tax Extra |
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| Zone2 |
REST OF INDIA |
| SUM INSURED: Rs. 1,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
3600 |
3600 |
NA |
NA |
NA |
NA |
| 2A+1C |
NA |
NA |
NA |
NA |
NA |
NA |
| 2A+2C |
NA |
NA |
NA |
NA |
NA |
NA |
| 2A+3C |
NA |
NA |
NA |
NA |
NA |
NA |
| 1A+1C |
3250 |
3700 |
NA |
NA |
NA |
NA |
| 1A+2C |
3850 |
4300 |
NA |
NA |
NA |
NA |
| 1A+3C |
NA |
NA |
NA |
NA |
NA |
NA |
|
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| Service Tax Extra |
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| Zone1 |
MUMBAI, DELHI & GUJARAT |
| SUM INSURED: Rs. 2,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
3950 |
4675 |
7870 |
8145 |
9400 |
NA |
| 2A+1C |
4620 |
5170 |
8580 |
8855 |
9635 |
NA |
| 2A+2C |
6110 |
6875 |
9425 |
9800 |
10840 |
NA |
| 2A+3C |
6510 |
7975 |
10625 |
11200 |
11840 |
NA |
| 1A+1C |
3500 |
3950 |
5800 |
6225 |
7225 |
NA |
| 1A+2C |
4310 |
4905 |
7400 |
7575 |
8200 |
NA |
| 1A+3C |
5200 |
5960 |
8975 |
9735 |
11000 |
NA |
|
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| Service Tax Extra |
|
| Zone2 |
REST OF INDIA |
| SUM INSURED: Rs. 2,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
3850 |
4465 |
7515 |
7775 |
8515 |
NA |
| 2A+1C |
4255 |
4935 |
8190 |
8455 |
9195 |
NA |
| 2A+2C |
5450 |
6565 |
8995 |
9260 |
9870 |
NA |
| 2A+3C |
6300 |
7415 |
9845 |
10110 |
10720 |
NA |
| 1A+1C |
3500 |
3875 |
5300 |
6000 |
7005 |
NA |
| 1A+2C |
4100 |
4830 |
7210 |
7300 |
8200 |
NA |
| 1A+3C |
5200 |
5410 |
8530 |
8790 |
9030 |
NA |
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| Service Tax Extra |
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| Zone1 |
MUMBAI, DELHI & GUJARAT |
| SUM INSURED: Rs.3,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
4300 |
5320 |
9515 |
9790 |
12675 |
20500 |
| 2A+1C |
5400 |
5900 |
11070 |
11350 |
13440 |
NA |
| 2A+2C |
6875 |
7245 |
11880 |
12155 |
14030 |
NA |
| 2A+3C |
7975 |
8195 |
12980 |
13255 |
15130 |
NA |
| 1A+1C |
3875 |
4275 |
7010 |
7335 |
8995 |
NA |
| 1A+2C |
4910 |
5365 |
7980 |
8910 |
9995 |
NA |
| 1A+3C |
5940 |
6005 |
9725 |
10100 |
11445 |
NA |
|
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| Service Tax Extra |
|
| Zone2 |
REST OF INDIA |
| SUM INSURED: Rs.3,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
4200 |
5170 |
9085 |
9345 |
12090 |
18750 |
| 2A+1C |
5300 |
5555 |
10565 |
10830 |
12830 |
NA |
| 2A+2C |
6565 |
6775 |
11340 |
11605 |
13390 |
NA |
| 2A+3C |
7465 |
7675 |
12240 |
12505 |
14290 |
NA |
| 1A+1C |
3875 |
4275 |
7010 |
7335 |
8645 |
NA |
| 1A+2C |
4910 |
5100 |
7810 |
8770 |
9510 |
NA |
| 1A+3C |
5670 |
5670 |
9555 |
9800 |
11225 |
NA |
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| Service Tax Extra |
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| Zone1 |
MUMBAI, DELHI & GUJARAT |
| SUM INSURED: Rs.4,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
5300 |
6510 |
12000 |
13200 |
16000 |
28500 |
| 2A+1C |
6825 |
7730 |
13900 |
14925 |
18075 |
NA |
| 2A+2C |
8300 |
8915 |
15270 |
16100 |
18835 |
NA |
| 2A+3C |
9500 |
9715 |
16570 |
16890 |
20035 |
NA |
| 1A+1C |
4640 |
5165 |
8570 |
9090 |
10135 |
NA |
| 1A+2C |
5865 |
6235 |
9565 |
11110 |
12665 |
NA |
| 1A+3C |
7385 |
7590 |
11960 |
12985 |
14420 |
NA |
|
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| Service Tax Extra |
|
| Zone2 |
REST OF INDIA |
| SUM INSURED: Rs.4,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
5300 |
6350 |
12000 |
13000 |
15500 |
23200 |
| 2A+1C |
6610 |
7375 |
13200 |
14250 |
17255 |
NA |
| 2A+2C |
7920 |
8525 |
14665 |
15185 |
17980 |
NA |
| 2A+3C |
8820 |
9425 |
15565 |
15885 |
18880 |
NA |
| 1A+1C |
4640 |
5005 |
8375 |
8685 |
9865 |
NA |
| 1A+2C |
5640 |
6000 |
9345 |
10875 |
12440 |
NA |
| 1A+3C |
7050 |
7245 |
11730 |
12650 |
14100 |
NA |
|
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| Service Tax Extra |
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| Zone1 |
MUMBAI, DELHI & GUJARAT |
| SUM INSURED: Rs.5,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
6885 |
8000 |
14970 |
15300 |
20050 |
30315 |
| 2A+1C |
8080 |
9125 |
16080 |
16400 |
21180 |
NA |
| 2A+2C |
9655 |
10090 |
16510 |
16840 |
22075 |
NA |
| 2A+3C |
10955 |
11390 |
17810 |
18140 |
23375 |
NA |
| 1A+1C |
6510 |
7225 |
9995 |
12100 |
14885 |
NA |
| 1A+2C |
7785 |
8010 |
14240 |
14700 |
16900 |
NA |
| 1A+3C |
8800 |
9000 |
15610 |
15930 |
20590 |
NA |
|
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| Service Tax Extra |
|
| Zone2 |
REST OF INDIA |
| SUM INSURED: Rs.5,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
6885 |
7640 |
14290 |
14600 |
19145 |
25750 |
| 2A+1C |
7710 |
8710 |
15350 |
15665 |
20225 |
NA |
| 2A+2C |
9210 |
9635 |
15760 |
16075 |
21070 |
NA |
| 2A+3C |
10210 |
10635 |
16760 |
17075 |
22070 |
NA |
| 1A+1C |
6510 |
7225 |
9565 |
11850 |
14500 |
NA |
| 1A+2C |
7435 |
7650 |
14000 |
14450 |
16335 |
NA |
| 1A+3C |
8560 |
8630 |
14895 |
15215 |
19650 |
NA |
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| Service Tax Extra |
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| Zone1 |
MUMBAI, DELHI & GUJARAT |
| SUM INSURED: Rs.10,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
9110 |
11350 |
20500 |
22100 |
30300 |
40500 |
| 2A+1C |
11665 |
13450 |
21800 |
24800 |
32340 |
NA |
| 2A+2C |
13445 |
16200 |
23555 |
27900 |
36210 |
NA |
| 2A+3C |
16405 |
19505 |
26780 |
32665 |
39500 |
NA |
| 1A+1C |
8700 |
9900 |
16330 |
17680 |
24000 |
NA |
| 1A+2C |
10775 |
11995 |
17750 |
22875 |
26970 |
NA |
| 1A+3C |
13575 |
15010 |
22100 |
26860 |
30010 |
NA |
|
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| Service Tax Extra |
|
| Zone2 |
REST OF INDIA |
| SUM INSURED: Rs.10,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
8900 |
11000 |
18750 |
21000 |
28800 |
38500 |
| 2A+1C |
11000 |
12875 |
20990 |
22700 |
30325 |
NA |
| 2A+2C |
12800 |
15380 |
22800 |
26440 |
35080 |
NA |
| 2A+3C |
15900 |
18100 |
25710 |
28850 |
37500 |
NA |
| 1A+1C |
8500 |
9700 |
15000 |
16810 |
23000 |
NA |
| 1A+2C |
10100 |
11000 |
16900 |
21000 |
26090 |
NA |
| 1A+3C |
12575 |
13895 |
20100 |
25660 |
27775 |
NA |
|
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| Service Tax Extra |
|
| Zone1 |
MUMBAI, DELHI & GUJARAT |
| SUM INSURED: Rs.15,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
10885 |
13865 |
25650 |
31125 |
39500 |
50500 |
| 2A+1C |
13990 |
15800 |
29910 |
37750 |
43660 |
NA |
| 2A+2C |
17780 |
19700 |
32100 |
41780 |
49205 |
NA |
| 2A+3C |
20780 |
22700 |
35100 |
44780 |
52205 |
NA |
| 1A+1C |
10540 |
11995 |
19875 |
24000 |
30890 |
NA |
| 1A+2C |
13450 |
14400 |
21880 |
29020 |
32910 |
NA |
| 1A+3C |
16770 |
18000 |
27030 |
33770 |
37990 |
NA |
|
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| Service Tax Extra |
|
| Zone2 |
REST OF INDIA |
| SUM INSURED: Rs.15,00,000/- |
Family Size |
5 months to 35 yrs |
36 yrs to 45 yrs |
46 yrs to 50 yrs |
51 yrs to 55 yrs |
56 yrs to 60 yrs |
61 yrs to 65 yrs |
| 2A |
10100 |
12500 |
24400 |
29895 |
36500 |
41135 |
| 2A+1C |
12770 |
14500 |
27500 |
35000 |
41200 |
NA |
| 2A+2C |
16660 |
18300 |
31650 |
40700 |
47810 |
NA |
| 2A+3C |
19310 |
20950 |
34300 |
43350 |
50460 |
NA |
| 1A+1C |
10000 |
11240 |
19030 |
22875 |
28880 |
NA |
| 1A+2C |
12450 |
13750 |
21000 |
28050 |
32000 |
NA |
| 1A+3C |
15875 |
16550 |
25010 |
30080 |
34700 |
NA |
|
| Service Tax Extra |
|
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| Relief under Income Tax Act |
| Proposer is eligible for relief under Section 80-D of the Income Tax Act in respect of the amount paid any mode other than cash for Health premium. |
|
| No Claim Bonus |
| The insured would be entitled to benefit of bonus over and above the basic sum Insured in terms of table here under, in respect of a claim free year, of Insurance. |
|
| Basic Sum Insured (Rs) |
First Renewal |
Second Renewal |
Maximum Bonus Allowable |
| 100000/- |
10% |
5% |
15% |
| 200000/- |
10% |
5% |
15% |
| 300000/- |
25% |
10% |
35% |
| 400000/- |
25% |
10% |
35% |
| 500000/- |
25% |
10% |
35% |
| 1000000/- |
25% |
10% |
35% |
| 1500000/- |
25% |
10% |
35% |
|
|
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Such bonus shall be computed on the basic sum Insured, The Bonus so granted will be reduced by 50% in the event of a claim. If there is a claim in the successive year also the bonus will become zero. The basic sum insured shall however not be reduced.
|
| Automatic Restoration of Sum Insured |
| There shall be automatic restoration of the Basic Sum Insured immediately upon exhaustion of the limit of coverage during the policy period subject to the following terms and extent thereof |
|
| Basic Sum Insured (Rs) |
% of Restoration on the Basic Sum Insured |
| Upto 200000/- |
Nil |
| 300000/- and above |
100% |
|
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Such restored Sum Insured can be utilized for illness/disease unrelated to the illness/diseases for which claim's was/were made.
|
| Exclusion |
 |
Any disease contracted by the insured person during the first 30 days from the commencement date of the policy. |
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First two Years Exclusions - Cataract, Hysterectomy for Menorrhagia or Fibromyoma, treatment for Knee and/or Joint (other than caused by an accident )Prolapse of intervertibral disc(other than caused by accident), Varicose veins and Varicose ulcers. |
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First year Exclusion - Benign Prostate Hypertrophy, Hernia, Hydrocele, Congenital Internal disease/defect, Fistula / Fissure in anus, Piles, Sinusitis and related disorders, treatment for gallstones and renal stone . |
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Expenses incurred for treatment of diseases/illness/accidental injuries by systems of medicines other than Allopathic |
 |
Naturopathy |
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Expenses purely diagnostic in nature.with no positive existence of any disease. |
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Treatment of Congenital external disease or defects or anomalies |
 |
Treatment which are cosmetic in nature |
| How to make a claim under the policy? |
 |
Call the 24 hour help-line for assistance - 1800 425 2255 |
 |
Inform the ID number for easy reference |
 |
In case of planned hospitalization inform 24 hours prior to admission in the hospital |
 |
In case of emergency hospitalization information to be given within 24 hours after hospitalization |
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Cashless facility wherever possible |
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In non-network hospitals payment must be made up-front and then reimbursement will be effected on submission of documents |
| Portability: |
| This policy is portable. For details please contact Portability Cell. |
| Star Advantages |
 |
No Third Party Administrator direct in-house claims settlement. |
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Faster & hassle-free claim settlement. |
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Cashless hospitalization. Whereever possible |
 |
Network of more than 4900 hospitals across India |
 |
Free expert medical consultation over phone |
 |
24 x 7 Toll Free Helpline |
|