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Get Lowest Rates for Health Insurance

Mediclaim Plans starting @ Rs 250* / month

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50+ Lakhs
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Save Upto ₹75k Under 80D
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80D*
4.4/5 stars Customer Rating
4.4/5⭐
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Star Health Gain Policy

Star Health Gain Insurance is an excellent health insurance policy for the entire family covering medical expenses due to any sickness or injury. There is a flat premium amount irrespective of the sum insured or age of the persons or the total number persons covered in the policy. Hence, the more you include the members in the plan, the more advantageous the plan would be.

Highlights of Star Health Gain Policy

  • Covers both Individual and Family
  • Cover for both in-patient and out-patient treatments
  • The unutilized Outpatient benefit can be carried forward to next year against renewal
  • No claim discount up to 10% applicable at renewal
  • Flat premium across all Sum Insured ranges and age groups
  • Tax Benefit as per the prevailing Income Tax Laws

Scope of cover

Indivdual Plan

Entry Age

For children : 05 months

Adults :

Minimum : 18 years

Maximum : 65 years

Number of Members Covered

Maximum Members : NA

Maximum Adults : NA

Maximum Children : NA

Sum Insured

1/2/3/4/5 lakhs


discount

NA

Policy Periods Available

Annual


Pre-Policy Medical Check-up

Above 50 years of age

Family Floater Plan

Entry Age

For children : 05 months

Adults :

Minimum : 18 years

Maximum : 65 years

Number of Members Covered

Maximum Members : 05

Maximum Adults : 02

Maximum Children : 03

Sum Insured

1/2/3/4/5 lakhs


discount

NA

Policy Periods Available

Annual


Pre-Policy Medical Check-up

Above 50 years of age

Important Features

Day Care Treatments
Definition
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Day Care Treatments

Includes surgical processes conducted using local or general anaesthesia which requires less than 24 hours of hospitalization because of technological advancement in healthcare. Each company has a specific list of processes which are covered under this category.

Covers certain day care procedures like Dialysis, Chemotherapy, Radiotherapy, Cataract Surgery, etc.

No-Claim Benefits
Definition
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No-Claim Benefits

If no claim is made during the policy period, you insurance company can offer you a cumulative bonus. While some companies provide increase in the sum assured annually upto certain limits. Some insurers provide discount on the renewal of premium.

For every claim free year, you will be entitled to a bonus of up to 10% of your sum insured.

Pre Hospitalization
Definition
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Pre Hospitalization

Medical expenses incurred immediately before the insured individual is hospitalized are covered under this benefit. Usually, expenses up to 30 to 90 days before hospitalization are covered under the policy only after the in-patient hospitalization claim is accepted by the insurance company.

Compensates for the Pre-Hospitalisation expenses for consultations, investigations and medicines incurred up to 30 days before Hospitalisation

Post Hospitalization
Definition
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Post Hospitalization

Medical expenses incurred immediately after the hospitalization are covered under this benefit.The coverage under this benefit would be available only for approved in-patient hospitalization claim is accepted by the insurance company. Usually, expenses up to 30 to 180 days post discharge are covered under the policy.

Compensates for a lump sum amount equal to 7% of hospitalization expense (excluding room charges) up to a maximum of Rs.5,000 per occurrence of post-hospitalization expense. Note: In the case of packaged treatments, the post-hospitalization expense is covered within the specified limit after calculating the room rent and boarding charges.

Good to Have Benefits

OPD Expense Cover
Definition
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OPD Expense Cover

Includes coverage for expenses on treatments which do not require 24 hours of hospitalization.

This plan covers outpatient benefits up to specified limit depending on the sum insured opted and age of the members covered. Please refer the brochure for the details of these limits. The outpatient treatment also includes the cost for pre-existing conditions, dental expenses, pre and post natal care.

PORTABILITY
Definition
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PORTABILITY

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.

TAX BENEFITS
Definition
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TAX BENEFITS

You can avail tax benefits for the premium amount paid towards this plan under Section 80D of the Income Tax Act,1961.

SUM ASSURED ENHANCEMENT
Definition
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SUM ASSURED ENHANCEMENT

Sum assured or coverage is the minimum amount payable to the insured by the insurance company.

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.

Emergency Ambulance
Definition
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Emergency Ambulance

Includes coverage for expenses on ambulance for hospitalization of the insured.

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.

Value Adds

NEW BORN BABY COVER
Definition
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NEW BORN BABY COVER

The plan offers to take care of the delivery cost and subsequent expenses related to your little bundle of joy.

Not applicable unless added to the policy post the completion of the eligible age.

FREE LOOK PERIOD
Definition
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FREE LOOK PERIOD

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.

Terms & Conditions

Room Rent / Room Category
Definition
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Room Rent / Room Category

Hospitals have a fixed tariff or rate chart for all rooms. Mediclaim depends on the amount of room rent limit specified in the policy document. The amount varies depending on the type of room category chosen.

This plan has a room-rent limit in case of normal hospitalization up to 2% of sum insured up to a maximum of Rs.4,000 per day for Class A cities. Similarly, 1% of sum insured up to a maximum of Rs.3,000 per day for Class B cities & 1% of the sum insured up to a maximum of Rs.1,000 per day for other locations.

Sub-Limits
Definition
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Sub-Limits

Includes the limits up to which specific conditions are covered under your policy. These limits are applicable for packaged treatments or some specific ailments listed in the policy.

This plan has sub-limit of 80% for packaged treatments. Sub-limits of Rs.15,000 for the entire policy period is applicable for Cataract treatment.

Waiting Period

Cooling Off Period
Definition
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Cooling Off Period

The period begins right after commencement of the policy within which you cannot claim for any illness except claims related to accident. This period is not applicable for subsequent renewals.

A 30 days cooling off period for all claims except any arising out of accidental injuries.

Specific Illnesses
Definition
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Specific Illness

The ailments of specific severity listed in the policy document are included under this category.

The policy covers some specific diseases/treatments only after either 12 months or 24 months. These include Cataract, Glaucoma, Gall Bladder & Pancreatic Diseases and treatments, and so forth.

Pre-Existing Illnesses
Definition
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Pre-Existing Illnesses

The ailments that the insured was already diagnosed with before taking the policy.

You can claim for any pre-existing conditions after 48 months from the policy start date.

Permanent Exclusions

The Plan will not cover any liabilities towards the treatments of following conditions-

  • Attempted suicide
  • Use of alcohol or drug
  • AIDS
  • Congenital disease
  • Naturopathy treatment
  • Infertility and in vitro fertilization.
  • Hospitalization out of war, riot, strike and nuclear weapons

The detailed list of what the policy does not cover is available in the policy wording.

Review of Star Health Gain Policy

With various benefits like OPD cover, No Claim Bonus, compensation towards the emergency ambulance charges, etc.; Star Health's Gain Policy is designed to provide coverage for individual and floater basis. However, lack of some valuable benefits like maternity cover and strict limits on room rent is a bit restraint.

**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.

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