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Star Health Special Care Gold Policy

Special Care Gold Policy by Star Health Insurance is a special product designed especially for people with disabilities and those who are HIV/AIDS positive is called. This policy has been implemented by Star Health’s founding principle of providing quality healthcare to all, including those with the most disregarded illnesses and disabilities. According to the 2016 Rights of Persons with Disabilities Act, this policy has been specifically created for people with disabilities.

The policy provides its holders with a variety of advantages. It offers a lump sum amount based on the sum assured in the event of metastasis, recurrence, or a second cancer unrelated to the first cancer. Depending on the amount the insured chose, the policyholders also receive the benefit of indemnity coverage for non-surgical and non-interventional therapy in addition to surgical and interventional therapy.

Eligibility Criteria

Here are the eligibility criteria for the Star Special Care Gold Policy.

ParametersDetails
Age

For Adults – Minimum – 18 years & Maximum – Up to 65 years

For Dependent Children – Newborn to 17 years

Sum Insured OptionsRs.4,00,000/- and Rs. 5,00,000/
Type of PolicyIndividual
Policy Term1 Year
Pre-Policy Medical check-up

There are no pre-medical tests irrespective of age. The previous

medical records including details of treatment to be submitted along with the proposal.

Instalment Facility availablePremium can be paid Quarterly or Half-yearly
Waiver of CopayAvailable on payment of additional premium
Cataract TreatmentUp to Rs. 40,000/- per each eye in one policy year

Key Features & Benefits of the Star Special Care Gold Policy

Here are the important features and benefits of choosing the Star Special Care Gold Policy.

  1. In-Patient Hospitalisation

Hospitalization costs incurred for stays of more than 24 hours are covered.

  1. Room Charge

Up to 1% of the Sum Insured is paid out daily for all-inclusive room, board, and nursing costs provided by the hospital or nursing home.

  1. ICU fees

Up to 2% of the Sum Insured is covered per day for Intensive Care Unit (ICU) and Intensive Cardiac Care Unit (ICCU) fees provided by the hospital or nursing home.

  1. Pre-hospitalization

Medical costs incurred up to 30 days before the date of admission to the hospital are also covered, in addition to in-patient hospitalization.

  1. Post-hospitalization

Up to 60 days after being discharged from the hospital, post-hospitalization medical expenses such as consultation costs, diagnostic costs, medications, and drugs prescribed by the hospital or medical practitioner are covered.

  1. Emergency Road Ambulance

Up to Rs. 2000 in ambulance costs are covered for each hospitalization.

  1. Daycare Procedures

Due to technological advancements, medical treatments and/or surgical procedures that call for less than 24 hours in the hospital are covered.

  1. Cataract Treatment

Cataract treatment costs are covered up to Rs. 40,000 for each eye per policy year.

  1. Co-payment

Every claim made under this policy will be subject to a 20% co-payment that will be applied to the claim amount that is admissible and payable by the policy’s terms and conditions.

  1. Waiver of Co-payment

On payment of an additional premium by the terms and conditions, the co-payment may be waived.

  1. HIV Cover

People with HIV/AIDS, as defined by the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act of 2017, are eligible for this policy. Only those with a CD4 count above 350 and an official HIV/AIDS diagnosis from a medical professional will be covered by this policy.

Key Exclusions Under the Star Special Care Gold Policy

The Company is not obligated to pay any reimbursements under this policy for any costs incurred by the insured person in connection with or related to

  1. Pre-existing disease (PED) treatment costs and their direct complications are excluded from coverage until 48 months have passed continuously since the first policy with the insurer began, except in the case of disability or HIV/AIDS.
  1. Regarding HIV/AIDS: Until the end of 90 days of continuous coverage following the date of the first policy’s insurer’s issuance, expenses related to the treatment of HIV/AIDS and its direct complications shall be excluded.
  1. Applicable for Disability Cover: Until the end of 24 months of continuous coverage following the date of the first policy’s issuance with an insurer, costs associated with the treatment of a pre-existing disability and its direct complications shall be excluded.
  1. If the amount insured is increased, the exclusion will reapply to the extent of the increased amount insured.
  1. The waiting period for the same would be shortened to the extent of prior coverage if the insured person maintains continuous coverage, as defined by the portability norms of the current IRDAI (Health Insurance) Regulations, without a break.
  1. Any pre-existing condition that is not a disability or HIV/AIDS will not be covered under the policy after 48 months unless it is disclosed and accepted by the insurer at the time of application.

Waiting Periods Under the Star Special Care Gold Policy

The following are the waiting periods under the Star Special Care Gold Policy.

  1. Pre-existing Diseases
  • Applicable for Diseases other than Disability/HIV/AIDS: After a waiting period of 48 months of continuous coverage starting on the first policy’s start date with the insurer, the costs associated with the treatment of pre-existing conditions and their direct complications are covered.
  • Concerning HIV/AIDS: After 90 days of uninterrupted coverage starting from the first policy’s start date with the insurer, costs associated with treating HIV/AIDS and its direct complications are covered.
  • Applicable for Disability: After 24 months of uninterrupted coverage starting from the first policy’s start date with the insurer, the costs associated with the treatment of pre-existing disabilities and their direct complications are covered.
  1. Specific Disease

After a waiting period of 24 months of uninterrupted coverage starting on the first policy’s inception date with the insurer, the costs associated with the treatment of the conditions, surgeries, and treatments listed are covered.

  1. Initial Waiting Period

The costs associated with treating any illness within 30 days of the first policy commencement date are excluded except for claims resulting from accidents.

Premium Illustration- How Does the Star Special Care Gold Policy Work?

Mr. Prateek Joshi who is currently working as a “Digital Marketing Manager” is looking to protect the health of his wife and family members. He made a pre-planned budget and wise decision regarding choosing the sum insured options. After conducting extensive research, he chose the Star Special Care Gold insurance plan. Therefore, here is a sample premium illustration of the policy:

AgePolicy TypePolicy TermHealth Insurance CoverPremium Amount
30 YearsIndividual1 YearRs. 5 LakhsRs. 8,278
40 YearsIndividual3 YearRs. 1 CroreRs. 74,490

Know the Complete Purchasing Process of Star Special Care Gold Insurance Policy

Looking to purchase the policy? If so, don’t forget to follow the below-mentioned steps:

  1. Visit the official website of Star Health Insurance.
  1. Hover your mouse on the “Plans” banner and then click on “View All” under the “Health” Tab.
  1. A page will emerge displaying all the health insurance plans. Then, you will need to locate the “Star Special Care Gold Insurance Policy” by scrolling down the list. After that, press “View Plan”.
  1. The next page will display all the information related to the plan. Just read it carefully and then press the “Get A Quote” button after entering your name, mobile number, and pin code.
  1. Now enter your contact details, including your name, mobile number, and email address, and then click “Next”.
  1. Provide basic information on the next page, including date of birth and policy term, and then click Next”.
  1. Now choose your insurance cover for which the premium amount details will be displayed below. Also, you can choose your payment option, either EMI or full payment. Then, click on the blue-colored “Buy Now” tab.
  1. The next page will ask you to either log in using the details like email Id/mobile number and password.
  1. Make payment either via credit/debit card/net banking and the policy detail will be sent to the registered mobile number or email address.

Claim Settlement: Know the Step-by-Step Process

Here is the complete claim process for your Star Special Care Gold Policy.

Cashless Claim:

  • At a network hospital, approach the insurance desk. You can notify the company by calling 1800 425 2255 or 1800 102 4477, or you can send an email to support@starhealth.in.
  • At the hospital reception, present your Star Health ID card for identification purposes.
  • Submit to the medical center Pre-admission inquiries and medical consultation records
  • Your identity will be confirmed by network hospitals, who will then submit a properly completed pre-authorization form to Star Health.
  • Before processing the claim in accordance with the terms and conditions, our doctors verify all of the submitted documentation.
  • If necessary, a field doctor assigned to the case may visit the patient at the hospital.
  • Following discharge, the hospital will submit the claim paperwork to the business, and the company will pay the hospital the authorized sum.

Reimbursement Claim:

Here are the steps for Reimbursing a Claim.

  • After being hospitalized, all claims must be intimated within 24 hours. Both network hospitals and non-network hospitals offer reimbursement services.
  • Accept medical care, pay all debts, and submit a claim for compensation.
  • After the date of discharge, you have 15 days to submit the claim documentation to the company.
  • Mention your policy number and inform Star Health of your hospitalization in order to receive the claim form.
  • After being released, settle all hospital bills and gather all original records of the care received and the costs incurred.
  • At the nearby Star Office, the claim form must be filled out and accompanied by all necessary original documentation.
  • Star Health Insurance will resolve the claim, subject to the clauses and requirements of the policy.
  • Items that are not payable would be at the insured’s expense.

Renewal Process Of Star Special Care Gold Insurance Policy

If you want to renew your Star Health Assure insurance policy, then you may need to follow these renewal steps.

  1. Firstly, visit the home page of Star Insurance.
  1. On the top of the page, click “Renew”.
  1. Enter your policy number and date of birth, and then press “Submit”.
  1. Your policy information will be visible on the screen. After that, you can finish paying for your premium using any of the listed payment methods.
  1. After completing the steps above, your policy will be successfully renewed, and the relevant information will be sent to the contact information you provided.

Frequently Asked Questions

Pre-medical acceptance screening is not mandatory to buy the Care Gold Insurance Policy.

Yes, all daycare treatments are permitted by this policy.

If paid in a manner other than cash, the premiums for this health insurance policy are exempt from taxation under Section 80D of the Income Tax Act of 1961.

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