- About Coverfox
Family Health Optima from Star Health Insurance is a cover that provides protection for the entire family on the payment of a single premium under a floating sum insured. It offers valuable benefits like the cover for 405 Day-care Procedures, Domiciliary Hospitalization, Donor Expenses for Organ Transplantation, Coverage for Newborn Baby, and so on.
For children : 16 days old
Minimum : 18 yrs
Maximum : 65 yrs
Maximum Members : 05
Maximum Adults : 02
Maximum Children : 03
Above 50 years of age
The plan covers the expenses towards 405 day-care procedures that would otherwise require hospitalization of a minimum of 24 hours.
Depending on the sum insured you have opted, for every claim free year, you will be entitled to a bonus of up to 35% of your sum insured.
If you are the recipient, then the expenses for organ transplantation will be paid up to 10% of the sum insured or Rs.1 lakh (whichever is less) subject to the availability of the sum insured.
Compensates for the Pre-Hospitalisation expenses for consultations, investigations and medicines incurred up to 60 days before Hospitalisation
Compensates for the Post-Hospitalization expenses for consultations, investigations and drugs incurred up to 90 days after discharge from Hospitalization.
For sum insured of Rs.3 lakh and above, there is 100% automatic restoration of the sum insured in case the original is exhausted.
This plan has recharge benefit which would get activated even when the entire sum insured is not exhausted, and the claim is raised for the same illness. This benefit is applicable for sum insured in the range of Rs.3 lakh and Rs.5 lakh. The recharge amount is in the range of 15% to 30% of sum insured depending on the zone and sum insured opted. Note: Both the restore and recharge can be used up for the same hospitalization.
If you want to transfer the policy to another insurer, the plan allows you to do so without losing your accrued benefits after the waiting periods.
You can avail tax benefits for the premium amount paid towards this plan under Section 80D of the Income Tax Act,1961.
This plan offers health check-up benefit up to 1% of sum insured for a maximum of Rs.5,000 every three years for those with sum insured of Rs.3 lakh and above.
You can avail treatment at home up to the base sum insured exceeding three days. There are certain terms and conditions related to this privilege, and you can refer them in the policy wordings.
You can apply for the sum increase at the time of renewal. However, there should not be any claim made on the policy for considering the request.
Compensates you up to Rs.750 for each hospitalization towards the emergency ambulance services up to a maximum of Rs.1,500 per policy period.
This plan offers newborn coverage up to 10 % of sum insured for a maximum of Rs.50,000. This newborn coverage is appropriate for newborn above age 16 days at an additional premium.
For any reason, should you decide not to proceed with the policy, you can return the same and request for a refund within 15 days from the date of receipt of the policy document.
Depending on the geographical zone you reside in and on the sum insured you have opted, there’s a room rent limit that varies from 1% of the sum insured to a Single Standard AC Room up to a maximum of Rs.10,000 per day.
This plan has age based co-pay equal to 20% of claimable expenses for individuals with entry age above 60 years.
CATARACT: Depending on the sum insured you have paid for, expenses incurred on the treatment of cataract will be paid Rs.12,000 and Rs.40,000 for the entire policy period.
A 30 days cooling off period for all claims except any arising out of accidental injuries.
The policy covers some specific diseases/treatments only after 24 months. These include Cataract, Arthritis, Hernia, Kidney Stone, and so forth.
You can claim for any pre-existing conditions after 24 months from the policy start date.
The Plan will not cover any liabilities towards the treatments of following conditions-
This is Star's flagship standard family health insurance product in the market. To keep the premiums affordable, the plan comes with Room Rent capping of 1-2% of sum insured depending on the customer's location. In case of Sum Insured opted of Rs. 5,00,000 in Mumbai/Thane, Delhi/NCR and Gujarat, one will be eligible for Single AC Room.
The product recharges your cover up-to 15% in case it exhausts for related or unrelated claims. Further, it also has the restore option that restores your coverage amount when the sum insured is completely exhausted.**Reviews and ratings are based only on Benefits and Conditions. Things like Claim Settlement Ratio, Hospital Network have not been covered under product ratings. These are covered under Company ratings.**