YOUR INSURANCE GUIDE: COMMON QUESTIONS
Your Questions, Answered
Helpful Answers to Common Queries
Health insurance will protect you and your family against any financial risks arising due to a medical emergency. Buying a proper health plan would help you in saving your hard earned savings and other assets.
We would be sending you a renewal notice informing you of the expiry of your health policy via courier. However the Company is under no obligation to send renewal notice and its absence thereof shall not tantamount to deficiency in services. Hence Customer has the prime responsibility to renew his policy.
Any number of claims is allowed during the policy period. However the sum insured is the maximum limit under the policy.
One single policy takes care of the hospitalization expenses of your entire family. Family Floater Health Plan takes care of all the medical expenses during sudden illness, surgeries and accidents.
Yes, you can cover the entire family under one policy. Your health insurance policy is in force across India.
Health Insurance covers all diagnostic test like X- ray, MRI, blood tests etc as long they are associated with the patients stay in the hospital for at least 24 hours. Any diagnostic tests which does not lead to treatment or which have been prescribed as Outpatient are generally not covered.
Normally health plans exclude treatment of any pre-existing disease / condition. At Star the treatment of any such pre-existing disease/ condition is covered after 48 months of continuous renewals with Star.
Star Criticare Plus provides for both hospitalization benefits under section 1 and lump sum compensation in case of diagnosis of any major critical illness as specified in the policy under section 2. In case of diagnosis of any one of the major illness as specified in the policy, the lump sum compensation is 100% of the sum insured. Acceptance of the policy is subject to pre medical screening and all other terms and conditions apply.
Yes you can take a family policy from us also mentioning about the existing policy details. You could also choose to take our Star super Surplus Policy which provides for hospitalization benefits after a deductible option of Rs.300000 or Rs.500000. This deductible is applicable to each hospitalization.
Cashless Hospitalization is available only in Network Hospitals. While it’s recommended that you choose a network hospital you are at liberty to choose a non-network hospital also. In case you avail of treatment in a Non Network hospital, Star Health will reimburse you the amount of bills subject to the policy taken by the policyholder. The Policy Holders attention is drawn to the definition of Hospital in the Mediclaim policy. Star Health should be contacted within 24 hours from the time of admission with details of Star Health ID card number, nature of illness, name & address of the Hospital/ Nursing Home/ Clinic, Room Number etc. The claim will be registered by Customer Care and a claim number will be provided to the Policy holder. Claim form will be sent to the Policy holder address. This claim form must be filled fully and sent to Star Health office along with the following documents in original. Main Hospital Bill with Receipt for payment along with the break up. Doctor’s prescription and medicine bills. Discharge summary sheet from the hospital. Investigation reports along with the X ray film other relevant details and documents connected to hospitalization.
A Hospital, which has an agreement with us for providing Cashless treatment, is referred to as a ‘Network Hospital’. Cashless facility is provided ONLY at the network hospitals. Non-network hospitals are those with whom we do not have any agreement and any policyholder seeking treatment in these hospitals will have to pay for the treatment and later claim as per reimbursement procedure.
Yes, a request for authorization for cash less access may be rejected by Star Doctors based on various reasons. Some common reasons are. The ailment/ disease for which hospitalization is required is not covered at all by insurance policy. The person does not have insured amount left to cover the hospitalization costs. This means that cashless claim access is rejected, AND policy holder cannot come for reimbursement as well.
Cashless claim procedure for customers to be followed during hospitalization
Cashless Claim: a six step process
- Show your Star Health ID card for identification purpose at the hospital reception.
- Submit to the hospital Pre admission investigations and Doctor’s consultation papers
- Network hospitals will verify your identity and submit duly filled pre – authorization form with Star Health.
- Our doctors verifies all the submitted documents before processing the claim as per terms and conditions.
- An assigned field doctor may visit the patient at the hospital if required.
- After discharge, the hospital will send the claim documents to the company and the authorized amount will be settled directly to the hospital.
Cashless Hospitalization is available only in Network Hospitals. While it’s recommended that you choose a network hospital you are at liberty to choose a non-network hospital also. In case you avail of treatment in a Non Network hospital, Star Health will reimburse you the amount of bills subject to the policy taken by the policyholder. The Policy Holders attention is drawn to the definition of Hospital in the Mediclaim policy. Star Health should be contacted within 24 hours from the time of admission with details of Star Health ID card number, nature of illness, name & address of the Hospital/ Nursing Home/ Clinic, Room Number etc. The claim will be registered by Customer Care and a claim number will be provided to the Policy holder. Claim form will be sent to the Policy holder address. This claim form must be filled fully and sent to Star Health office along with the following documents in original. Main Hospital Bill with Receipt for payment along with the break up. Doctor’s prescription and medicine bills. Discharge summary sheet from the hospital. Investigation reports along with the X ray film other relevant details and documents connected to hospitalization.
A health card is a card that comes along with the Health Policy. It is similar to an Identity card. This card would entitle you to avail cashless hospitalization facility at any of our network hospitals. A health card mentions the contact details and the contact numbers of the TPA. In case of a medical emergency, you can call on these numbers for queries, clarifications and for seeking any kind of assistance. Moreover, you need to display your health card at the time of admission into the hospital.
In the event of hospitalization, the patient or their family will have a bill to pay the hospital. Under Cashless Hospitalization the patient does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by Star Health Insurance. This is to reduce the financial burden on insured individual at the time of hospitalization.
Premium paid under the Health insurance Policy is exempted from Income Tax under section 80D of the Income Tax Act up to Rs.25,000 for individual covering his family and dependent Children. In case the proposer intends to cover his parents below 60 years under medical insurance, he is eligible for a deduction of another Rs.25000 under section 80D. In case the age of parent to be covered is above 60 years, the deduction available is Rs.50000 under section 80D.
Yes. The scope of coverage shall be restricted to treatment taken in hospitals in India during the policy period.
No, Normally Health policies cover only expenses incurred as Inpatient. But Star Health Gain Policy also covers reimbursement of expenses incurred as Outpatient subject to terms and conditions of the policy.
Yes. You can take any individual policy with us in which the existing condition of diabetes would be excluded. At the same time, you can cover yourself with a Diabetes Safe policy which covers the complications arising due to Diabetic Retinopathy, Diabetic Nephropathy and Diabetic Foot Ulcer. However this policy requires a pre medical screening even if the proposer is less than 50 yrs. of age.
Yes, you can cover your mother under our Star Senior Citizen policy. If she has not undertaken any IP treatment in the last 12 months, she shall be covered for Diabetic also at 50% co pay.
Children are not covered individually in our policies but can be covered with either of the parent.
Yes, foreigners living in India can be covered under a health insurance policy. However, the coverage would be restricted to India.
The request for Pre- Authorization form for planned treatment has to be signed by the customer and sent by Hospital. This request must reach Star Health at least 2 days before hospitalization. Any change in the date of hospitalization, hospital, nature of illness or surgeon who is going to perform the procedure will make the authorization invalid. A fresh authorization will have to be taken. The authorization is valid only for Network Hospitals. The authorization will be addressed and faxed to the hospital.
The Mediclaim Policy allows reimbursement of medical expenses incurred towards the ailment/ disease for which hospitalization was necessitated prior to hospitalization and up to a certain number of days after discharge. This is subject to the limits as described in the policy. The medical expenses incurred prior to Hospitalization are called pre- hospitalization expenses and those incurred subsequent to discharge as post Hospitalization expenses.
YOUR INSURANCE GUIDE: COMMON QUESTIONS
Your Questions, Answered
Helpful Answers to Common Queries
Health insurance will protect you and your family against any financial risks arising due to a medical emergency. Buying a proper health plan would help you in saving your hard earned savings and other assets.
We would be sending you a renewal notice informing you of the expiry of your health policy via courier. However the Company is under no obligation to send renewal notice and its absence thereof shall not tantamount to deficiency in services. Hence Customer has the prime responsibility to renew his policy.
Any number of claims is allowed during the policy period. However the sum insured is the maximum limit under the policy.
One single policy takes care of the hospitalization expenses of your entire family. Family Floater Health Plan takes care of all the medical expenses during sudden illness, surgeries and accidents.
Yes, you can cover the entire family under one policy. Your health insurance policy is in force across India.
Health Insurance covers all diagnostic test like X- ray, MRI, blood tests etc as long they are associated with the patients stay in the hospital for at least 24 hours. Any diagnostic tests which does not lead to treatment or which have been prescribed as Outpatient are generally not covered.
Normally health plans exclude treatment of any pre-existing disease / condition. At Star the treatment of any such pre-existing disease/ condition is covered after 48 months of continuous renewals with Star.
Star Criticare Plus provides for both hospitalization benefits under section 1 and lump sum compensation in case of diagnosis of any major critical illness as specified in the policy under section 2. In case of diagnosis of any one of the major illness as specified in the policy, the lump sum compensation is 100% of the sum insured. Acceptance of the policy is subject to pre medical screening and all other terms and conditions apply.
Yes you can take a family policy from us also mentioning about the existing policy details. You could also choose to take our Star super Surplus Policy which provides for hospitalization benefits after a deductible option of Rs.300000 or Rs.500000. This deductible is applicable to each hospitalization.
Cashless Hospitalization is available only in Network Hospitals. While it’s recommended that you choose a network hospital you are at liberty to choose a non-network hospital also. In case you avail of treatment in a Non Network hospital, Star Health will reimburse you the amount of bills subject to the policy taken by the policyholder. The Policy Holders attention is drawn to the definition of Hospital in the Mediclaim policy. Star Health should be contacted within 24 hours from the time of admission with details of Star Health ID card number, nature of illness, name & address of the Hospital/ Nursing Home/ Clinic, Room Number etc. The claim will be registered by Customer Care and a claim number will be provided to the Policy holder. Claim form will be sent to the Policy holder address. This claim form must be filled fully and sent to Star Health office along with the following documents in original. Main Hospital Bill with Receipt for payment along with the break up. Doctor’s prescription and medicine bills. Discharge summary sheet from the hospital. Investigation reports along with the X ray film other relevant details and documents connected to hospitalization.
A Hospital, which has an agreement with us for providing Cashless treatment, is referred to as a ‘Network Hospital’. Cashless facility is provided ONLY at the network hospitals. Non-network hospitals are those with whom we do not have any agreement and any policyholder seeking treatment in these hospitals will have to pay for the treatment and later claim as per reimbursement procedure.
Yes, a request for authorization for cash less access may be rejected by Star Doctors based on various reasons. Some common reasons are. The ailment/ disease for which hospitalization is required is not covered at all by insurance policy. The person does not have insured amount left to cover the hospitalization costs. This means that cashless claim access is rejected, AND policy holder cannot come for reimbursement as well.
Cashless claim procedure for customers to be followed during hospitalization
Cashless Claim: a six step process
- Show your Star Health ID card for identification purpose at the hospital reception.
- Submit to the hospital Pre admission investigations and Doctor’s consultation papers
- Network hospitals will verify your identity and submit duly filled pre – authorization form with Star Health.
- Our doctors verifies all the submitted documents before processing the claim as per terms and conditions.
- An assigned field doctor may visit the patient at the hospital if required.
- After discharge, the hospital will send the claim documents to the company and the authorized amount will be settled directly to the hospital.
Cashless Hospitalization is available only in Network Hospitals. While it’s recommended that you choose a network hospital you are at liberty to choose a non-network hospital also. In case you avail of treatment in a Non Network hospital, Star Health will reimburse you the amount of bills subject to the policy taken by the policyholder. The Policy Holders attention is drawn to the definition of Hospital in the Mediclaim policy. Star Health should be contacted within 24 hours from the time of admission with details of Star Health ID card number, nature of illness, name & address of the Hospital/ Nursing Home/ Clinic, Room Number etc. The claim will be registered by Customer Care and a claim number will be provided to the Policy holder. Claim form will be sent to the Policy holder address. This claim form must be filled fully and sent to Star Health office along with the following documents in original. Main Hospital Bill with Receipt for payment along with the break up. Doctor’s prescription and medicine bills. Discharge summary sheet from the hospital. Investigation reports along with the X ray film other relevant details and documents connected to hospitalization.
A health card is a card that comes along with the Health Policy. It is similar to an Identity card. This card would entitle you to avail cashless hospitalization facility at any of our network hospitals. A health card mentions the contact details and the contact numbers of the TPA. In case of a medical emergency, you can call on these numbers for queries, clarifications and for seeking any kind of assistance. Moreover, you need to display your health card at the time of admission into the hospital.
In the event of hospitalization, the patient or their family will have a bill to pay the hospital. Under Cashless Hospitalization the patient does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by Star Health Insurance. This is to reduce the financial burden on insured individual at the time of hospitalization.
Premium paid under the Health insurance Policy is exempted from Income Tax under section 80D of the Income Tax Act up to Rs.25,000 for individual covering his family and dependent Children. In case the proposer intends to cover his parents below 60 years under medical insurance, he is eligible for a deduction of another Rs.25000 under section 80D. In case the age of parent to be covered is above 60 years, the deduction available is Rs.50000 under section 80D.
Yes. The scope of coverage shall be restricted to treatment taken in hospitals in India during the policy period.
No, Normally Health policies cover only expenses incurred as Inpatient. But Star Health Gain Policy also covers reimbursement of expenses incurred as Outpatient subject to terms and conditions of the policy.
Yes. You can take any individual policy with us in which the existing condition of diabetes would be excluded. At the same time, you can cover yourself with a Diabetes Safe policy which covers the complications arising due to Diabetic Retinopathy, Diabetic Nephropathy and Diabetic Foot Ulcer. However this policy requires a pre medical screening even if the proposer is less than 50 yrs. of age.
Yes, you can cover your mother under our Star Senior Citizen policy. If she has not undertaken any IP treatment in the last 12 months, she shall be covered for Diabetic also at 50% co pay.
Children are not covered individually in our policies but can be covered with either of the parent.
Yes, foreigners living in India can be covered under a health insurance policy. However, the coverage would be restricted to India.
The request for Pre- Authorization form for planned treatment has to be signed by the customer and sent by Hospital. This request must reach Star Health at least 2 days before hospitalization. Any change in the date of hospitalization, hospital, nature of illness or surgeon who is going to perform the procedure will make the authorization invalid. A fresh authorization will have to be taken. The authorization is valid only for Network Hospitals. The authorization will be addressed and faxed to the hospital.
The Mediclaim Policy allows reimbursement of medical expenses incurred towards the ailment/ disease for which hospitalization was necessitated prior to hospitalization and up to a certain number of days after discharge. This is subject to the limits as described in the policy. The medical expenses incurred prior to Hospitalization are called pre- hospitalization expenses and those incurred subsequent to discharge as post Hospitalization expenses.