Star Care Micro Insurance Policy: Coverage, Claim & Renewal

Published: 08-03-2019 04:39:52 AM

Would you agree that the only person suited to take care of the older person you will someday be –is the younger person you are now? Insurance has become a necessity in the chaos of the unpredictable modern world. Star Care Micro Insurance Policy is health insurance plan specifically meant for people living in Tier-1 and Tier-2 cities.

What Is Star Care Micro Insurance Policy?

Star Health Insurance provides Star Care Micro Insurance policy which gives protection to individuals as well as to their family. Any person who lives in Tier-1 and Tier-2 cities in India falling under 18-65 years can get this policy without the need of going under pre acceptance medical tests.

Types of Star Care Micro Insurance policy

Star Care Micro Policy is provided in Individual Basis and Floater Basis. Under family, the policyholder can cover him/herself, proposer, spouse, dependent children up to 25 years

Eligibility Criteria

Criteria	Eligibility
Entry Age	Min: 18 years Max: 65 years With the condition that the individual is from a Tier-1 or Tier-2 city
Dependent children	Children from 2 years can be covered
Pre Acceptance Medical Screening	Not applicable to this policy
Sum Insured	Rs.1 lakh
Policy Renewal	Lifetime renewal

What Star Care Micro Insurance Policy Covers?

• Room, boarding, nursing expenses
• ICU Charges up to Rs.2000 subject to maximum of Rs.10,000p per hospitalisation
• Cost of medicine and drugs
• Pre/post hospitalisation
• Emergency Hospitalisation
• Medical practitioner, Consultants, and specialists fees are covered.
• Operation theatre charges are covered along with blood, oxygen, and anesthesia
• X-Ray, surgical appliances, cost of pacemaker and stent expenses are also covered under this.
• Chemotherapy, dialysis, radiotherapy along with diagnostic modeling is also covered

Claim Process

The claims procedure under Star Care Micro Insurance Policy is as follows:

• Contact the customer care 24 hour [TOLL-FREE] help-line for assistance – 1800 425 2255 / 1800 102 4477
• In a scenario when hospitalization is planned, intimate the insurance company 24 hours before admission
• In a scenario when hospitalization is done under an emergency, information should be communicated to the company within 24 hours of post-hospitalization.
• All network hospitals which have listed under the company’s network provide the cashless facility
• In non-network hospitals, the payment needs to be made up front at the hospital desk which can later be reimbursed by submitting the required documents

Document Required To Claim Insurance

• Claim form to be duly completed and signed respectively
• Provide a copy of PAN card details
• Original pre-admission treatment papers and investigations associated with them if needed
• Discharge summary in original documents from the hospital
• Cash receipts of hospitals and chemists in original format
• Reports of tests conducted along with receipts
• All original receipts from the doctor, anesthetist and surgeons are to be provided
• Certificate from the doctor regarding diagnosis

Cases Where One Can’t Make Claim Under Star Care Micro Insurance Policy (Exclusions)

• Naturopathy Treatment
• Immunotherapy and Chemotherapy[Oral]
• All expenses which come under the head of “Other Expenses”
• Any and all diseases which have been contracted by the insured person within 30 days of the start of the policy
• Dental treatments unless absolutely necessary in case of accidents or an injury
• Specific time bound or lifetime exclusions which have been agreed upon by the Insured.
• Diseases/injuries due to nuclear materials/weapons
• Infusion pumps and other similar aids
• Inoculation or vaccination [except post-bite treatment and medical treatments other than prevention of diseases]

How Long Does It Take To Pay Out A Claim?

The claims need to be intimated within the duration of 24 hours [under hospitalization]. Upon getting all the required documents, the insurance company will assess and evaluate them and accordingly settle the claim within 30 days.

Renewal Process of Star Care Micro Insurance policy

Beyond 65 years, policy can be renewed for life time. The policyholder will get 30 days as a grace period from the date of expiry to renew his policy. It is recommended for an insured to pay timely premium from before his policy gets lapsed.

Advantages Of Buying Star Care Micro Insurance policy

• Hospital cash benefit will be paid to the policyholder at the rate of Rs.1000/ per day subject to 14 days where the treatment was taken in government hospital
• The ICU charges are up to Rs 2000/- and are subject to a minimum of Rs 10,000/- per hospitalization
• This policy is portable
• This policy is subject to the relief of income tax as per Section 80D as per Income Tax Act, 1961

Points To Consider Before Purchasing This Policy

1. Network Hospitals

The policyholder should check the network hospitals that are provided under the respective policy. This helps them to determine whether the cashless facility can be availed or not. Also, the policyholder can check the network hospitals mentioned under the policy at Star Health’s website.

2. Waiting Period

It is recommended that you check the waiting periods associated with the respective policy. It is a necessary factor to be checked before taking a health policy.

3. Lifetime Renewal

It is advised to select a policy which offers Lifetime Renewal as an individual’s health tends to deteriorate more when individuals get older as compared to the younger years. Thus Lifetime Renewal is beneficial in that aspect.

4. Pre/Post Hospitalization

The policyholder should consider the Pre and the Post Hospitalization aspects with their respective policy too. This is a retrospective factor and depends on the policyholder’s requirements. The relevant brochures, prospectus need to be referred relating to the terms and conditions associated with pre and post hospitalization.

Features of this policy

Features
Claim Type (In-House or TPA)	In-house claim settlement
Pre-Hospitalization	Expenses incurred not exceeding 30 days before the date of Hospitalisation
Network Hospital Count	More than 8800+ network hospitals are covered
Post-Hospitalization	Expenses incurred up to 60 days from the date of discharge from the hospital subject to a maximum of Rs.3000/-
Room Eligibility	Room, Boarding Expenses at 0.75% of the sum insured
Share Claim Payments	NA
Restoration of Cover	NA
No Claim Bonus	NA
Worldwide Coverage	NA
Maternity Cover	NA
Hospitalization at Home	NA
Day Care Treatment	405 day care treatments are covered
Non-Allopathic Treatment Coverage	NA
Emergency Ambulance	Covered up to a sum of Rs.500/-and the overall limit of Rs.1000/- per policy period.
Health Check-up	NA

FAQ’s

Q1-What do Tier-1 and Tier-2 cities mean under this policy?

Tier-1 and Tier-2 cities are those cities where the population is between 5, 00,000-10, 00,000/5, 00,000, respectively as per census 2011.

Q2- Are psychiatric, mental or behavioral disorders covered under this policy?

No, all psychiatric, mental or behavioral disorders are excluded under Star Care Micro Insurance policy.

Q3-Is pre-acceptance medical screening mandatory under this policy?

No, pre-acceptance medical screening is not required to purchase this policy.

Q4-Is there any waiting period associated with this policy?

All pre-existing diseases will be covered after 48 months of continuous coverage.