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Star Health Gain

 

Combine the financial prudence of a significant Tax saving with the necessary health cover for your family. Avail of the maximum tax benefit with Star Health Gain Insurance paying a very affordable premium. What's more, it extends both outpatient and inpatient hospitalization expenses. Two facets of gain indeed.
 
Major Product Features
Flat amount of Rs 15,000 only irrespective of the sum insured or age of the persons or number of persons covered.
Coverage for both inpatient and outpatient treatments under one health insurance policy
Any unutilized amount under outpatient benefit can be carried forward to the next one year.
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Who can take this health insurance plan?
Any person aged between 5 months and 60 years can be covered under this insurance.
 
Pre-Existing Diseases / Illness
Are covered after 48 months of continuous insurance with us
 
Policy Benefits -  Outpatient coverage
You are covered for outpatient limits also.
 
Limit of Outpatient Benefits for Individuals
Individual Limit of Outpatient Benefits for Individuals Sum
Sum insured for IP (Rs) 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000
5mths-45yr 8,700 7,750 7,000 6,250 5,750
46-55yr 7,900 6,350 5,200 3,000 NA
56-60yr 7,500 5,800 3,700 NA NA

Maximum Outpatient Treatment Benefit for Various Family Sizes
Family Size Limit of Outpatient Benefits for Individuals Sum
  Sum insured
for IP (Rs)
1,00,000 2,00,000 3,00,000 4,00,000 5,00,000
2A 5mths-35yr 8400 7400 6750 5900 5250
  36y-45y 8400 7400 6500 5500 4900
  46-55y NA 5650 4000 2000 NA
  56-60y NA 5000 2250 NA NA
1A+1C 5mths-35yr 8500 7700 6950 5750 5500
  36y-45y 8500 7500 6750 5750 5250
  46-55y NA 5850 4500 2400 NA
  56-60y NA 5200 2250 NA NA
1A+2C 5mths-35yr 8450 7500 6900 6000 5500
  36y-45y 8450 7250 6650 5750 5000
  46-55y NA 5750 4450 2250 NA
  56-60y NA 5150 2250 NA NA
1A+3C 5mths-35yr 8350 7400 6650 5750 5250
  36y-45y 8350 7200 6450 5500 4750
  46-55y NA 5500 4000 NA NA
  56-60y 4750 2250 NA NA NA
2A+1C 5mths-35yr 8250 7250 6600 5750 5000
  36y-45y 8250 7000 6150 5450 4500
  46-55y NA 5250 3750 NA NA
  56-60y NA 4500 1500 NA NA
2A+2C 5mths-35yr 8250 7000 6500 5500 4650
  36y-45y 8250 7000 5950 5000 3750
  46-55y NA 5000 3500 NA NA
  56-60y NA 4250 1500 NA NA
2A+3C 5mths-35yr 8250 7000 6250 5250 4250
  36y-45y 8250 6700 5750 4900 3700
  46-55y NA 4750 3250 NA NA
  56-60y NA 4000 1150 NA NA
A -  Adult C -  Child IP -  Inpatient NA -  Plan Not Available
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Other pre - and post - hospitalisation benefits
Expenses in a hospital for inpatient hospitalization (minimum 24-hour stay).
Hospitalisation expenses under the following heads are payable:
 
Room rent or boarding upto 2% of the sum insured, subject to a maximum of Rs 4000 per day in Class A cities; 1% of the sum insured, subject to a maximum of Rs 3000 per day in Class B cities; 1% of the sum insured, subject to a maximum of Rs 1,000 per day in subject to a maximum of Rs 1000 per day in other locations.
Nursing charges.
Surgeons, consultants and anaesthetists fees.
Blood, oxygen, diagnostic expenses, cost of pacemakers and similar expenses.
Drugs and medicines.
Emergency ambulance charges for transporting the patient to the hospital upto a sum of Rs 750 per hospitalization and overall policy limit of Rs 1,500.
Pre-hospitalization expenses upto 30 days prior to the date of admission in hospital/nursing home.
Post-hospitalization expenses calculated @7% of the hospitalization expenses (excluding room rent), subject to a maximum of Rs 5000 (benefit-based).
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Policy Premium
Low premium of just Rs 15,000 inclusive of Service Tax.
 
Tax Benefit
Premium paid for this insurance is eligible for relief under Section 80D of the IT Act.
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What cannot be claimed?
Treatment of illness/disease/sickness contracted by the insured person during the first 30 days from the commencement date of the policy
First Two Years Exclusions: Cataract, Hysterectomy for Menorrhagia or Fibromyoma, Replacement surgery for knee and/or joint (other than caused by an accident), Prolapse of intervertebral disc(other than caused by accident),varicose veins and varicose ulcers
First Year Exclusions: Benign Prostate Hypertrophy, Hernia, Hydrocele, Fistula in anus, Piles, Sinusitis and related disorders, congenital internal disease/defects, removal of gallstones and renal stone
Naturopathy treatment
Expenses which are purely diagnostic in nature with no positive existence of any disease
Expenses incurred for non-allopathic treatment
Treatment of external Congenital disease/defects/anomalies
Expenses which are mainly cosmetic in nature
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Claims Procedure
Call the 24-hour helpline 1800 425 2255 for assistance
Inform the ID number/policy number for easy reference
In case of a planned hospitalisation, please inform 24 hours prior to admission into the hospital.
In case of emergency hospitalisation, information to be given within 24 hours after hospitalisation
At non-network hospitals, payments must be made upfront and then reimbursement will be effected on the submission of documents
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Star Advantages
No Third Party Administrator; direct in-house claims settlement.
Faster & hassle-free claim settlement.
Cashless hospitalization.
Network of more than 4900 hospitals across India
24x7 Toll- free Helpline
Free General Physician Consultation over phone. Doctors on duty 24x7. By quoting the policy number, any person can contact our Doctor on the toll free number 1800 425 2255 for medical advices.
Free Health magazines are issued to policy holders at regular intervals
 
NOTE: benefits and exclusions mentioned herein are only an outline of the policy. For complete details, please contact your nearest Star Health office.
 

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customercare@saubhagyaenterprises.in
      
      Contact us at: 011-22571217