Who Can Be Covered?
You can cover: ( Premium may vary according to the members covered )
• Self
• Spouse
• Children
• Parents
• Parents-in-law
Family Floater can cover up to 6 Adults + 3 Children.
Sum Insured Options
Choose coverage from:
₹5 Lakh – ₹2 Crore
Hospitalisation Cover
Medical expenses for eligible hospitalisation due to illness, injury or accident are covered up to the applicable policy limits.
This includes eligible:
• Doctor fees
• Surgeon fees
• Nursing expenses
• ICU charges
• Operation theatre charges
• Medicines
• Diagnostic tests
• Chemotherapy
• Radiotherapy
• Dialysis
• Pacemaker and stent expenses
Room Rent Eligibility
₹5 Lakh & ₹7.5 Lakh Cover:
Room rent up to 1% of Sum Insured per day.
₹10 Lakh to ₹25 Lakh Cover:
Any Room — except Suite or above category.
₹50 Lakh to ₹2 Crore Cover:
Any Room.
Choosing a room above your eligible limit may result in proportionate deductions on certain associated medical expenses.
All Day Care Treatments Covered
Eligible Day Care treatments requiring hospitalisation for less than 24 hours are covered.
Pre & Post Hospitalisation Cover
60 Days Pre-Hospitalisation
180 Days Post-Hospitalisation
Eligible related medical expenses are covered as per policy terms.
AYUSH Treatment Covered
Eligible inpatient treatment under:
• Ayurveda
• Unani
• Siddha
• Homeopathy
is covered up to the Sum Insured.
Yoga and Naturopathy claims require prior approval from the company.
Modern Treatments Covered
Eligible Modern Treatments are covered up to the Sum Insured, subject to policy terms.
Road Ambulance Cover
Eligible road ambulance expenses are covered for:
• Going to the hospital for medical reasons
• Shifting from one hospital to another
• Hospital to residence in the same city, when medically certified
Subject to an admissible hospitalisation claim.
Air Ambulance Cover
Air Ambulance expenses are covered up to 10% of the Sum Insured per policy year, subject to an admissible hospitalisation claim.
Organ Donor Expenses
Eligible hospitalisation expenses related to organ transplantation are covered.
Certain donor complications requiring Redo Surgery or ICU admission are also covered as per policy conditions.
Home Care Treatment
Specified treatments taken at home are covered up to:
10% of Sum Insured
Maximum ₹5 Lakh per policy year.
Domiciliary Hospitalisation
Treatment at home for more than 3 days may be covered when:
• The patient cannot be moved to a hospital
OR
• Hospital rooms are unavailable
Subject to policy conditions and exclusions.
Cumulative Bonus
For every claim-free year:
25% of Sum Insured is added as Cumulative Bonus.
Maximum Bonus: 100% of Sum Insured.
Unlimited Automatic Restoration
If the Sum Insured is partially or fully used:
100% of the Sum Insured can be restored unlimited times during the policy year.
Restoration is subject to policy conditions and claim limits.
Maternity / Delivery Expenses
Delivery expenses, including Caesarean Section, are covered up to:
10% of Sum Insured
Waiting Period: 24 Months
Available for a maximum of 2 deliveries during the lifetime of the policy.
Both Self and Spouse must meet the continuous coverage conditions mentioned in the policy.
In-Utero Fetal Surgery
Listed fetal surgeries and interventions are covered after a 24-month waiting period.
The waiting period does not apply to treatment related to congenital internal disease or defects of the unborn, as specified in the policy.
Assisted Reproduction Treatment
Eligible Assisted Reproduction Treatment for sub-fertility is covered after 24 months.
Coverage Limit:
₹5L / ₹7.5L SI → Up to ₹1 Lakh
₹10L to ₹25L SI → Up to ₹2 Lakh
₹50L to ₹2Cr SI → Up to ₹4 Lakh
One treatment cycle per policy year.
Newborn Baby Cover
Eligible hospitalisation expenses for the newborn are covered from Day 1 of birth until policy expiry.
The benefit is available if:
• Delivery Expense claim is paid under the policy
OR
• Mother has continuous policy coverage for 12 months without a break.
Policy sub-limits and conditions apply.
Preventive Health Check-up
Preventive Health Check-up is available through Network Providers.
The limit depends on your Sum Insured and Individual/Floater policy type.
Free Second Medical Opinion
Get an E-Domestic Second Medical Opinion from a doctor in the company’s network through the Star Health Mobile App.
Unlimited Tele-Consultation
Unlimited tele-consultations are available through the Star Health mobile application or digital platforms.
AI Face Scan Facility
Check vital parameters such as:
• Heart Rate
• Oxygen Saturation
• Respiration Rate
Available up to 2 times per month per insured person through the Star Health App.
Wellness Discount
Earn Wellness Points through eligible wellness activities.
Renewal Premium Discount:
200–350 Points → 4%
351–600 Points → 10%
601–750 Points → 14%
751–1000 Points → 20% Discount
Available for insured persons aged 18 years and above.
Know Your Waiting Periods
First 30 Days
Illness claims are generally not covered during the first 30 days.
Accidental claims are exempt from this waiting period, subject to policy terms.
Specific Diseases / Procedures
Waiting Period: 24 Months
This includes specified conditions such as:
• Cataract and specified eye diseases
• ENT diseases
• Thyroid-related diseases
• Carpal Tunnel Syndrome
• Trigger Finger
• Lipoma
• Joint diseases and Joint Replacement
• Degenerative Disc Diseases
• Gall Bladder Stones
• Kidney Stones
• Hernia
• Uterus and Ovary-related diseases
• Prostate diseases
• Hydrocele
• Piles
• Fissure
• Fistula
• Varicose Veins
Please refer to the full policy wording for the complete specified disease/procedure list.
Pre-Existing Diseases
1 & 2 Year Policy Term: 36 Months
3 Year Policy Term: 30 Months
Pre-existing diseases must be properly declared and accepted by the insurer.
Important Things to Remember
Always disclose your complete medical history.
• Check your room rent eligibility before hospital admission.
• Emergency hospitalisation should be intimated within 24 hours.
• Planned hospitalisation should be intimated at least 48 hours in advance.
• Cashless treatment is available wherever possible at Network Hospitals.
• At Non-Network Hospitals, you may need to pay first and apply for reimbursement.
• Policy renewal has a 30-day Grace Period, but coverage is not available during the Grace Period.
• Always read your Policy Schedule, endorsements and full Policy Wordings for exact coverage applicable to you.
