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Star Family Health Optima Health Insurance

35 reviews Rate This
Family Health Optima
Claim Settlement Ratio85.47%
COVID-19 CoverYes
In-House Claim SettlementAvailable
Network Hospitals9,900+
Policies Sold37,34,365
RenewabilityLifelong

About Star Family Health Optima Health Insurance

Star Health Optima Plan is a super saver plan, which provides coverage for the entire family members at reasonable costs, including spouse, and dependent kids between 16 days and 25 years of age. People from 18 years to 65 years of age, who live in India, can buy this policy. Beyond the age of 65 years, the health plan can be renewed for a lifetime. Health check-up is gifted for every claim free year under this policy. The plan brings 3 times automatic restoration of the sum insured by 100% for every complete exhaustion.

Further, the Star Health Optima offers wide coverage such as cover for hundreds of day-care procedures, pre-hospitalisation and post-hospitalisation, domiciliary hospitalisation, donor expenses for organ transplantation, coverage for newborn baby cover from the 16th day, and so on. Policyholders can get the additional sum insured by spending a little more.

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Key Inclusions and Exclusions of the Plan

What's Included

  • In-patient hospitalisation like room charges, nursing expenses, ICU, surgeon’s fee, etc.
  • Domiciliary hospitalisation (treatment at home) for a period exceeding three days
  • All sorts of day care procedures are covered that take less than 24 hours
  • Air ambulance charges up to 10% of the basic sum insured during the policy period
  • Pre and post hospitalisation expenses 60 days and 90 days respectively

What's Not Included

  • Injury or ailment caused due to warlike situations, invasion of enemy etc.
  • Expenses arising due to self-inflicted injury or suicide attempt etc.
  • Venereal disease and sexually transmitted diseases
  • Dental treatments, unless required due to accidental injuries
  • Vaccinations except for post-bite and other medical treatment

Family Health Optima Plan Details

Features/PlanStar Family Health Optima (3,4 lakh)Star Family Health Optima (5, 10, 15, 20, 25 lakh)
Restoration Benefit
Up to 300% of SI
Up to 300% of SI
No Claim Bonus
Up to 100% of SI
Up to 100% of SI
Room Rent
Up to Rs. 5000
Single standard A/C room
ICU Charges
Actual
Actual
Pre and Post Hospitalization
60 & 90 days
60 & 90 days
Day Care Procedure
All
All
Free Health Checkup
After every renewal
After every renewal
Organ Donor
Up to 10% of SI, maximum of Rs. 100000
Up to 10% of SI, maximum of Rs. 100000
AYUSH
Up to Rs. 10000
Up to Rs. 20000
Domiciliary Hospitalization
Covered
Covered
Ambulance Cover
Up to Rs. 750 per hospitalization and overall limit of Rs. 1500 per policy period
Up to Rs. 750 per hospitalization and overall limit of Rs. 1500 per policy period
Second Opinion
Yes
Yes
Emergency Medical Evacuation
Up to Rs. 5000
For sum insured 5, 10 and 15 lakh limited up to Rs. 7500
Co-Pay
20% co pay at age 60 & above
20% co-pay at age 60 & above
Initial Waiting Period
30 days
30 days
Specific Illness Waiting Period
2 years
2 years
Waiting Period of PED
4 years, 3 years for assisted reproductive treatment
4 Years, 3 years for assisted reproductive treatment
Special Feature
Restoration benefit up to 300%, recharge benefit up to Rs. 1 lakh, shared accommodation up to Rs. 1000
Restoration benefit up to 300%, recharge benefit up to Rs. 1 lakh, shared accommodation up to Rs. 1000
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1506 Star Cashless Network Hospitals in India

Family Health Optima User Reviews

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Star Family Health Optima Expert Review

  • Expert Review

    In order to beat the soaring rates of healthcare, having the right health insurance plan for yourself and family has become a necessity. Considering the same, Star Health has come up with a comprehensive health insurance plan by the name of Family Health Optima. The plan is all you need for your family to keep their lives secured under unforeseen health emergencies. It gets you covered for regular hospitalisation benefits on floater basis thereby contributing to a stress-free life.  

    Star Health’s Family Health Optima Insurance Plan can be briefed as a single policy with wider coverage for the entire family at an affordable premium. If you are a resident of India aged between 18 years to 65 years and require a health insurance policy that is loaded with extra benefits, then you can confidently give this a shot. The policy is available on the family floater basis. You can include yourself, your spouse, dependent children who are economically dependent on parents if they are aged between 16 days to 25 years. The policy lets you choose from a wide range of sum insured options starting from Rs. 3 Lakh going up to Rs. 25 Lakh. 

  • Major Attractions

    The plan comes with a lot of attractive coverage features. A few to note are- AYUSH treatment, second medical opinion, the additional sum insured for Road Traffic Accident, ambulance charges for emergency hospitalisation and so on. Other areas where this policy keeps you covered are-

    • All the daycare procedures
    • Expenses of a newborn baby from the 16th day
    • Donor expenses for organ transplantation
    • Cover for the cost of health check-up for every claim free year
    • Cover for pre-existing diseases after the waiting period of 48 months
    • Domiciliary treatment expenses if the treatment exceeds 3 days
    • 60 days pre-hospitalisation expenses and 90 days post-hospitalisation expenses
    • 3 times automatic restoration of the sum insured by about 100%, every time on complete exhaustion of sum insured
    • In-patient hospitalisation expenses that include room, boarding and nursing charges, cost of medicines, etc.
    • Cover for an air ambulance for up to 10% of the basic sum insured for every policy period (for sum insured options above Rs. 5 Lakh)
  • What’s More?

    The list of benefits provided under this plan has not ended yet. With the policy, you also get the following-

    • Lifetime renewability
    • Tax benefits under Section 80D of the Income Tax Act
    • Free look period for 15 days
    • Health-related information through a free health magazine
    • Cashless hospitalisation at the network hospitals 
  • Conclusion

    The policy certainly provides a comprehensive cover for your family. You can go for it if you have a nuclear family and are looking for an economical health insurance plan to get them covered.

    Now the question is-From where should you buy this plan to get the best deal? The answer is direct-ONLINE! You can get online to any leading health insurance broker like InsuranceDekho and tell them your requirements. The customer care executives there will suggest the best suitable variant under this plan after Need Analysis. 

Star Family Health Optima Brochure

  • 846.46 KB
  • PDF Document
  • Mar 21, 2019

Claim Process at Star Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

FAQs on Family Health Optima Health Insurance Plan

  • After how much time pre-existing diseases are covered under Star Health Optima Plan?

    The pre-existing diseases are covered after 48 months of buying the policy.

  • How much coverage one can avail out of air ambulance cover? Is this feature available for every policyholder having this plan?

    The insured individuals can get only up to 10% of the basic sum insured per policy period. The air ambulance feature is available for people having a sum insured of Rs. 5 Lakh and above only.

  • Who needs to go through pre-acceptance medical screening?

    Individuals above 50 years of age or those who present adverse reports about their medical history in the proposal form are required to undergo pre-acceptance medical screening at the centers empanelled under the company. The expense of such screening will be borne by the firms. The age for screening and the cost sharing are subject to change.

  • What is the coverage of newborn baby under Star Health Optima Plan?

    The coverage for New Born Baby starts only after the 16th day of its birth till plan gets expired. This coverage is subject to an expense of 10% of the sum insured or Rs. 50,000, whichever is less, on the basis of the sum insured. It is applicable only if the mother of the baby is insured under the plan for a continuous period of 1 year without break.

  • How much co-payment is there under this policy?

    The plan is subject to co-payment of 20% of each and every claim amount for fresh as well as renewal policies for insured persons whose age at the time of entry is above 60 years.

  • Will this policy benefit us with any sort of tax benefits?

    Payment of premium for Star Health Optima Plan by any mode other than cash is eligible for relief under section 80D of the Income Tax Act 1961.

  • How much organ donor expenses are covered under the Star Health Optima Policy?

    Coverage is given up to 10% of the sum insured or Rs. 1 Lakh, whichever is less.

  • Is Domiciliary Hospitalisation available in this plan?

    Yes, Domiciliary Hospitalisation is available in under this policy. But coverage is made only for medical treatments that exceed for more than 3 days.

  • The eligibility to get a Star health insurance plan depends on what factors?

    The two basic eligibility criteria for getting the insurance policy are entry age and medical check-up.

  • What is the toll-free number where I can gain detailed information for Star Health Optima Policy?

    You can get all your policy regarding queries resolved by connecting with us on the toll-free number - 1800-120-5698.

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