Star Health Gain Policy - Individual
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 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 |
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 our
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