Star Gain Insurance for Family

Star Health Gain Policy - Family

With the perfect balance between insurance and tax benefit – Star Health Gain Insurance is the policy just for you. Despite a reassuringly low premium, it offers both outpatient and inpatient hospitalization expenses cover with maximum tax benefits. Sure enough, the best of both worlds is now yours.

Major Product Features

• Flat amount of Rs 14,725 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 policy.
• Any unutilized amount under outpatient benefit can be carried forward to the next one year.

Policy Benefits

• Expenses in a hospital for inpatient hospitalization (minimum 24-hour stay).
• 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 1000 per day in subject to a maximum of Rs 1000 per day in other locations. # b) 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 1500.
• 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).

Eligibility

• Any person aged between 5 months and 60 years can be covered under this insurance.

Policy Premium

• Low premium of just Rs 14,725 inclusive of Service Tax.

Tax Benefit

· Premium paid by any mode other than cash, Cheque [Payable A/c pay at STAR HEATLH AND ALLIED INSURANCE COMPANY LIMITED] relief under Section 80-D of the IT Act

Outpatient treatment cover

• Covers cost of treatment incurred as an outpatient in any hospital or nursing home.
• Treatment costs covered even for pre-existing conditions/diseases, dental expenses, prenatal and post-natal care.

Exclusions (for inpatient cover only)

• Expenses on the treatment of pre-existing diseases/conditions.
• Expenses during the first 30-day period from the date of commencement of the policy (other than accident cases).
• In the first year of insurance expenses on the treatment of Benign Prostate Hypertrophy, Hernia, Hydrocele, Fistula in Anus, Piles, Sinusitis and related disorders, Gallstones and renal stones removal.
• In the first two years of continuous operation of insurance expenses on the treatment of Cataract, Hysterectomy, Menorrhagia or Fibromyoma, Knee Joint Replacement Surgery (other than caused by an accident), Joint Replacement Surgery (other than caused by an accident), Prolapse of Intervertebral Disc (other than caused by an accident), Varicose Veins and Varicose Ulcers.
• Naturopathy treatment/Cosmetic treatment.
• Expenses that is purely diagnostic.
• Non-allopathic treatments.
• Treatment of congenital defects/anomalies.

Limit of Outpatient Benefits for Various Family Sizes

Family Size	Limit of Outpatient Benefits
	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	5000	2250	NA	NA
1A+2C	5mths-35yr	8450	7500	6900	6000	5500
	36y-45y	NA	5750	4450	2250	NA
	46-55y	NA	5850	4500	2400	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	NA	4750	2250	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	4500	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

Claim Procedure

• Call 24 hour help-line for assistance
• Inform ID number for easy reference
• For planned hospitalisation, please inform 24 hours prior to admission to the hospital
• For emergency hospitalisation, information to be given within 24 hours after hospitalisation
• Cashless facility can be availed in all network hospitals
• For treatment in non-network hospitals, payment must be made up-front and then reimbursement will be effected on submission of documents

Renewal Features

• Renewal of policy under mutual consent

How to buy this insurance?

• Please Contact Us through our Mobile 099946 12916, 93628 54443 / SMS / Marketing & Sales Manager