Star Health Premier Insurance Policy

Last Updated : March 25, 2022, 6:38 p.m.

Star Health Insurance offers this policy to people aged 50 years and above. Under this policy, the insured gets coverage for hospitalization expenses incurred due to illness/injury. A maximum cover of INR 1 Crore is available under the Star Health Premier Insurance Policy. And the company shall also cover home care, AYUSH treatment, modern treatment, non-medical items, etc. So, for your today or tomorrow, get the best health coverage with Star Health Premier Insurance Policy. Read this page below and learn about the policy details and benefits.

Coverage for Medical Expenses Under Star Health Premier Insurance Policy

The insurance company will take care of the following expenses during the policy term.

Basic Cover

Expenses arising due to your stay in the hospital –

• Room, Boarding and Nursing – Coverage up to 1% of sum insured, subject to a maximum of INR 20,000 per day
• Anesthetist, Medical Practitioner, Surgeon, Specialist Fees, Consultants
• Anesthesia, Blood, Oxygen, ICU charges, Operation theater charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials, X-ray, Diagnostic imaging modalities, dialysis, chemotherapy, radiotherapy, cost of pacemaker, stent and such other expenses.
• In the case of coronary stents, medicines, implants and other similar items, Star Health will cover the cost of the stent as per the Drug Price Control Order (DPCO) or National Pharmaceuticals Pricing Authority (NPPA) Capping.
• Daycare

Treatment of Cataract will be covered up to a specified limit as shown below –

Non-medical Items Coverage

If a claim is admissible for the basic cover, the company shall also cover the non-medical items. Such items are – mineral water, food (other than the one provided by the hospital), braces/belts, laundry, attendant charges, thermometer, Nebuliser kit, etc.

Cover for Road Ambulance Expenses

In case of an accident or a situation where the patient can’t reach the hospital on his own, ambulance service is provided. And at an age of 50 years and above, the human body strength decreases. So, taking care of the insured, this cover is provided. The insurer shall cover this if the insured has made an admissible hospitalization claim. Road ambulance expenses are payable for transportation to the hospital, from one hospital to another for better medical treatment or from the hospital to home. A medical practitioner needs to certify the same to get transportation coverage.

Air Ambulance

If you’re evacuated through an air ambulance, you can later seek reimbursement of expenses incurred towards the same for up to INR 2,50,000 per hospitalization. And this benefit is subject to a maximum of INR 5 Lakh per policy year. You can avail of this benefit by filing an admissible hospitalization claim.

Pre and Post-hospitalization Expenses

The medical bills of 60 days before the hospitalization will be reimbursed to you. You’ll get the same benefit for the expenses incurred up to 90 days following the discharge from the hospital.

Organ Donor Expenses

Star Health Premier Insurance Policy covers organ transplantation where the donor incurs expenses for complications requiring a redo surgery or ICU admission. The coverage limit under this benefit is over and above the sum insured. The additional sum insured is for the donor and not the insured.

AYUSH Treatment for the Insured

Treatment of diseases, illness or accidental injuries by AYUSH treatment (Ayurveda, Yoga, Unani, Siddha and Homeopathy) are covered up to the sum insured under this policy.

Bariatric Surgery of the Patient

When the insured undergoes a bariatric surgical procedure, the company will cover its cost as well as its complications thereof. This benefit is available after a waiting period of 24 months. For a sum insured of INR 10 and 20 Lakh, the limit is INR 2.5 Lakh. And if the sum insured is more than INR 20 lakh, the limit rises to INR 5 Lakh.

Coverage for Modern Treatment

Star will cover the following treatments up to 50% of the sum insured –

• Uterine artery Embolization and HIFU
• Balloon Sinuplasty
• Deep Brain Stimulation
• Oral Chemotherapy
• Immunotherapy-Monoclonal Antibody to be given as an injection
• Robotic surgeries
• Intra Vitreal injections
• Stereotactic radio surgeries
• Bronchial Thermoplasty
• Vaporization of the prostate (Green laser treatment or holmium laser treatment), IONM-(Intra Operative Neuro Monitoring)
• Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions

Domiciliary Hospitalization Coverage for Insured

If a medical treatment including AYUSH at home lasts for more than three days, the insurer will cover it. However, the policy shall not cover –

• Asthma
• Bronchitis
• Chronic Nephritis and Nephritic Syndrome
• Diarrhea
• All types of Dysenteries including Gastro-enteritis
• Diabetes Mellitus and Insipidus
• Epilepsy
• Hypertension
• Influenza
• Cough and Cold
• All Psychiatric or Psychosomatic Disorders
• Pyrexia of unknown origin for < 10 days
• Tonsillitis and Upper Respiratory Tract infection – Laryngitis and Pharyngitis, Arthritis, Gout and Rheumatism
• Rehabilitation & Pain Management

Under this section, the medical expenses are covered up to 10% of the sum insured. For rehabilitation benefits, you need to take treatment at an authorized center if you file an in-patient hospitalization claim for any of the following.

• Polytrauma
• Head Injury
• Spine Ailments
• Stroke

Star Health Premier Insurance Policy Hospice Care

Up to 10% of the sum insured is payable, subject to a maximum of INR 5 Lakhs, when you visit the Star network facility for treatment. This benefit is payable once in a lifetime for each insured. To get this benefit, you need to spend 24 months continuously under the Star Health Premier Insurance Policy. The decision of the medical panel will be final for this benefit.

Home Care Treatment

At old age we suffer from many diseases and the recovery can take a lot of time. If you seek treatment at home as per the doctor’s advice, up to 10% of the sum insured, subject to a maximum of INR 5 Lakhs, will be payable to you.

Health Check-up Benefit

The company will take care of the expenses of your health check-up up to the limit as mentioned below –

Outpatient Medical Expenses

If you’re admitted as an outpatient, the payable amount from day one is as follows.