Star Health Senior Citizens Red Carpet Insurance

Senior Citizen Red Carpet insurance review

• FeaturesBenefitsHighlightsClaimsHow to buyExclusions
• Features

  Key features of Star health insurance for Senior Citizen Red Carpet health insurance

  • Room Rent: 1% of SI per day till SI of 5 lacs / Rest between₹6,000 and ₹10,000
  • Co-pay: Between 30% and 50% for Non Pre Existing (PED) and PED claims
  • Restoration Benefit: NIL Restoration Benefit

  Senior Citizen Red Carpet health insurance plan - key highlights

  • For Senior citizens aged between 60 to 75 years.
  • Available in 10 different Sum Insured options – 1 lac, 2 lacs, 3lacs,4 lacs,5 lacs,7.5 lacs, 10 lacs,15 lacs, 20 lacs and 25 lacs
  • No pre-insurance medical test required.
  • Covers Pre-Existing Diseases (PED) from the 13th Month onwards.
  • Policy can be issued both on Individual and Floater Basis
  • Policy is available for 1 / 2 / 3 years
  • Guaranteed Lifetime Renewals
  • No Age based Premium Revision – Premium is Sum Insured based
  • All Day Care Procedures covered
  • Cost of Health Check-up for every claim free year upto the limits specified
  • Pre-Hospitalization expenses up to 30 days and Post-hospitalisation paid as lump-sum upto ₹10,000 depending on the plan opted for
  • Expenses on Medical Consultations as an Out Patient in a Network Hospital up to the limits specified.
• Benefits

  Benefits of Senior citizen red carpet health plan (All Amounts in ₹ INR)

  1 Lac	2 Lac	3 Lac	4 Lac	5 Lac	7.5 Lac	10 Lac	15 Lac	20 Lac	25 Lac
  Policy Term
  Can be purchased for 1/2/3 year which can be renewed.
  Available Coverage options
  Plans available for individual are 1 lacs to 25 lacs, Plans available for Family Floater Basis are 10 lacs to 25 lacs.
  Hospitalisation - Room Rent limit per day
  upto 1% of the Sum Insured	upto 1% of the Sum Insured	upto 1% of the Sum Insured	upto 1% of the Sum Insured	upto 1% of the Sum Insured	6,000	6,000	7,000	8,500	10,000
  ICU / Operation Theatre Charges
  Upto 2% of the Sum Insured	Upto 2% of the Sum Insured	Upto 2% of the Sum Insured	Upto 2% of the Sum Insured	Upto 2% of the Sum Insured	Actual	Actual	Actual	Actual	Actual
  Professional Fees (Surgeon, Anaesthetist, Medical Practioner, Consultants
  upto 25% of the Sum Insured
  Other Medical Expenses (Anaesthesia, Blood, Oxygen, Theatre Charges etc)
  upto 50% of the Sum Insured
  No of Daycare Treatments / Procedures Covered
  All day care procedures are covered.
  Sub Limits for Treatment of Cataract as Daycare (per episode / per policy period)
  Upto 25% of Sum Insured and maximum of 25,000.
  Ambulance Charges by Road (per policy period)
  Upto 600 per hospitalisation and maximum of 1,200 per policy period			Upto 1,000 per hospitalisation and maximum of 2,000 per policy period			Upto 1,500 per hospitalisation and maximum of 3,000 per policy period
  Pre Hospitalisation Expenses incurred
  Upto 30 days
  Post Hospitalisation Expenses incurred
  7% of Hospitalisation Expenses upto maximum of 5,000						7% of Hospitalisation Expenses upto maximum of 7,000		7% of Hospitalisation Expenses upto maximum of 10,000
  Medical Consultations as an Outpatient (on Individual Basis)
  	-	600	800	1,000	1,200	1,400	1,800	2,200	2,600
  Medical Consultations as an Outpatient (on Floater Basis) - Limit Per Person / Per Policy Period
  -	-	-	-	-	-	1,400 / 2,400	1,800 / 3,000	2,200 / 3,800	2,600 / 4,400
  Cost of Health Check Up (Limit per person on Individual Basis)
  -	-	-	-	1,000	1,000	2,000	2,000	2,500	2,500
  Cost of Health Check Up (Limit per person on Floater Basis) - Limit Per Person / Per Policy Period
  -	-	-	-	-	-	2,000 / 3,500	2,000 / 3,500	2,500 / 4,500	2,500 / 4,500
  Co Payment
  PED Claims : 50% of each and every admissible claim Non PED Claims : 30% of each and every admissible claim							PED and Non PED Claims - 30% of each and every admissable claim

  Sublimits for Policy with Sum Insured on Individual Basis

  Sum Insured in Rs.	Cataract	Cerebro Vascular Accident, Cardio Vascular Diseases, Cancer (including Chemotherapy, Radiotherapy), Medical Reneal Diseases (including Dialysis), Treatment for Breakage of Long Bones	All Other Major Surgeries
  	Limit Per Person, per Policy Period for each Disease/Condition in Rs.
  1,00,000	15,000	75,000	60,000
  2,00,000	15,000	1,50,000	1,20,000
  3,00,000	18,000	2,00,000	1,50,000
  4,00,000	20,000	2,25,000	2,00,000
  5,00,000	21,500	2,75,000	2,25,000
  7,50,000	23,000	3,00,000	2,50,000
  10,00,000	25,000	3,50,000	2,75,000
  15,00,000	30,000	4,00,000	3,00,000
  20,00,000	35,000	4,50,000	3,25,000
  25,00,000	40,000	5,00,000	3,50,000

  Sublimits for Policy with Sum Insured on Floater Basis

  Sum Insured in ₹	Cataract	Cerebro Vascular Accident, Cardio Vascular Diseases, Cancer (including Chemotherapy, Radiotherapy), Medical Reneal Diseases (including Dialysis), Treatment for Breakage of Long Bones	All Other Major Surgeries
  	Limit Per Person	Limit per policy period	Limit Per Person	Limit per policy period	Limit Per Person	Limit per policy period
  10,00,000	25,000	45,000	3,50,000	6,00,000	2,75,000	4,50,000
  15,00,000	30,000	50,000	4,00,000	7,00,000	3,00,000	5,00,000
  20,00,000	35,000	60,000	4,50,000	7,50,000	3,25,000	5,50,000
  25,00,000	40,000	70,000	5,00,000	8,50,000	3,50,000	6,00,000

  Out Patient Consultation

  Sum Insured in Rs.	Limit per person per policy period for policy with Sum Insured on Individual Basis Rs	For Policy with Sum Insured on Floater Basis
  		Limit Per Person Rs.	Limit Per Policy Period Rs.
  1,00,000 2,00,000	Not Available	Not Available
  3,00,000	600
  4,00,000	800
  5,00,000	1,000
  7,50,000	1,200
  10,00,000	1,400	1,400	2,400
  15,00,000	1,800	1,800	3,000
  20,00,000	2,200	2,200	3,800
  25,00,000	2,600	2,600	4,400

• Highlights

  Senior citizen red carpet health insurance - Eligibility

  • Starts from age 60 to 75 years.
  • Guaranteed Lifelong renewals
  • This policy can be taken by HIV positive persons - provided the CD 4 count at the time of entry is above 350 (proof to be produced). However, hospitalization for any opportunistic infections is not covered.
• Claims

  Claims settlement process for Star health insurance

  Cashless Claim Procedure during hospitalization
  Cashless Claim: a six step process

  • Step 1 - Approach the insurance desk at a network hospital. Intimation can be given either through contacting us at 1800 425 2255 / 1800 102 4477 or e-mail us at support@starhealth.in
  • Step 2 - Show your Star Health ID card for identification purpose at the hospital reception.
  • Step 3 - Submit to the hospital Pre admission investigations and Doctor’s consultation papers.
  • Step 4 - Network hospitals will verify your identity and submit duly filled pre - authorization form with Star Health.
  • Step 5 - 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.
  • Step 6 - After discharge, the hospital will send the claim documents to the company and the authorized amount will be settled directly to the hospital.

  (Note: Non-Payable items would be at the insured's own cost)
  a) In case of planned hospitalization:

  • Please contact the toll-free help line: 1800 425 2255 / 1800 102 4477
  • The hospital will send the duly filled pre-authorization from through hospital portal (or) at the below number (or) Email ID
    • Call : Toll-free FAX: 1800 425 5522 (or)
    • Call : Non Toll-free FAX: 044 -28302200
    • Email : cashless.network@starhealth.in
  • Please carry your ID card.

  b) Procedures to be followed in case of emergency hospitalization:In case of Emergency like accident or sudden bout of illness may that requires immediate admission to the hospital

  • Upon receiving intimation from the insured/insured’s attender, they are contacted by the network hospital
  • Customer Care will verify the validity and coverage of the policy
  • A field visit doctor is deputed to visit the patient at the hospital if required.
  • Our medical team will process the cashless request for the insured person subject to policy terms and conditions.

  c) Cashless claim authorization process

  • Upon receiving intimation from the insured/insured’s attender, they are contacted by the network hospital.
  • Customer Care will verify the validity and coverage of the policy
  • A field visit doctor is deputed to visit the patient at the hospital if required
  • Our medical team will process the cashless request for the insured person subject to policy terms and conditions.

  d) Documents required for cashless claim submission by Hospital

  • Health card
  • Doctor's consultation papers
  • Discharge summary
  • Investigation reports (e.g. X-ray, scans, blood report, etc.)
  • Pharmacy invoices supported by respective prescriptions
  • In cases of accidents, Medico Legal Certificate (MLC) and / or FIR
  • KYC documents of the insured if claimed amount exceed Rs.1, 00,000/-

  (Note: Documents other than the Health Card should be submitted in original)
  

  When the Insured gives prior intimation about the treatment and the insured pays the expenses himself with the hospital and then claims for a reimbursement of those expenses within 15 days from the date of discharge.

  Reimbursement Claims Procedure following hospitalization

  Procedure for Reimbursement of Claim

  • All claims need to be intimated within 24 hours of hospitalization. Reimbursement facility is available at network hospitals as well as at non-network hospitals
  • Avail treatment, settle all bills and file a claim for reimbursement.
  • Submit the claim documents to the company within 15 days from the date of discharge.
  • To receive Star Health Insurance claim form, cite your policy number and intimate Star Health about hospitalization.

  Reimbursement Claim Procedure

  • Upon discharge, pay all hospital bills and collect all original documents of treatment undergone and expenses incurred.
  • Star Health Claim form has to be filled in and along with, all the relevant original documents have to be submitted at the nearest Star Office
  • We settle the claim in subject to policy terms and conditions.
  • Non-Payable items would be at the insured's own cost.

  Documents required for reimbursement claim submission

  • Copy of Health card
  • Duly filled claim form
  • Pre admission investigations and Doctor's consultation papers
  • Discharge summary from hospital in Original.
  • Investigation reports (e.g. X-ray, scans, blood report, etc.)
  • Pharmacy invoices supported by respective prescriptions
  • Case receipts from hospital, chemist
  • In cases of accidents, Medico Legal Certificate (MLC) and / or FIR
  • Copy of the KYC documents - NEFT details, Contact number and E-mail ID
• How to buy

  How can one buy a Star health insurance cover?

  Today in the India market, it is not very difficult to purchase an appropriate Health insurance plan, on the contrary it is relatively simple if one follows the defined steps below:

  • Step 1- Visit a product comparison website like eindiainsurance to review and compare policy benefits, coverage and premium details online
  • Step 2 - Seek information and clarity on the charges, inclusions, exclusions, other terms and conditions under the policy
  • Step 3 - Fill the online Star Health Insurance proposal form stating your personal details and health profile while ensuring the information given is complete and accurate
  • Step 4 – Star Health will then process the application forwarded to them. Based on the information provided, one may be required to undergo pre-policy medical examination at Star Health’s network diagnostic centers.
  • Step 5 - Depending on Star Health team’s evaluation, if the proposal is accepted, then they will issue the policy subject to receipt of annual single premium as published on the website and remitted online through the payment gateway
  • Step 6 - Please note that the proposer will have to pay the necessary amount for undergoing the specified medical examination and such tests shall be valid for a maximum period of 30days only…however, if the policy is issued we will refund you 100% of the cost of the pre-policy medical examination
  • Step 7 - The Policy Schedule, Policy Wordings, Cashless Cards and Health Guide will be sent to the insured’s mailing address mentioned on the proposal form
• Exclusions

  Exclusions under the Star health policy

  Some of the major exclusions under the policy are listed below, kindly go through the entire list of exclusion in the policy kit which accompanies the insurance policy:

  • Congenital External Condition / Defects / Anomalies (except to the extent provided under Section specific to a New Born infant).
  • Intentional self injury.
  • Use of intoxicating substances, substance abuse, drugs / alcohol, smoking and tobacco chewing.
  • Venereal Disease and Sexually Transmitted Diseases,
  • Injury/disease directly or indirectly caused by or arising from or attributable to war, invasion, act of foreign enemy, warlike operations (whether war be declared or not)
  • Injury or disease directly or indirectly caused by or contributed to by nuclear weapons/materials
  • Expenses incurred on weight control services including surgical procedures such as Bariatric Surgery and /or medical treatment of obesity (except to the extent provided as per “Coverage” of the opted policy variant)
  • Expenses incurred on High Intensity Focused Ultra Sound, Uterine Fibroid Embolisation, Balloon Sinoplasty, Enhanced External Counter Pulsation Therapy and related therapies, Chelation therapy, Deep Brain Stimulation, Hyperbaric Oxygen Therapy, Rotational Field Quantum Magnetic Resonance Therapy, VAX-D, Low level laser therapy, Photodynamic therapy and such other therapies similar to those mentioned under this exclusion
  • Charges incurred on diagnostics that are not consistent with the treatment for which the insured is admitted in the hospital / nursing home. Admission primarily for diagnostic purpose with no positive existence of sickness / disease / ailment / injury and no further treatment is indicated
  • Unconventional, Untested, Unproven, Experimental therapies
  • Stem cell Therapy, Autologous derived Stromal vascular fraction, Chondrocyte Implantation, Procedures using Platelet Rich plasma and Intra articular injection therapy
  • All types of Cosmetic, Aesthetic treatment of any description, all treatment for Priapism and erectile dysfunctions, Change of Sex
  • Plastic surgery (other than as necessitated due to an accident or as a part of any illness)
  • Inoculation or Vaccination (except for post–bite treatment and for medical treatment for therapeutic reasons)
  • Dental treatment or surgery (in excess of what is specifically provided) unless necessitated due to accidental injuries and requiring hospitalization
  • Treatment arising from or traceable to pregnancy, childbirth, family planning, miscarriage, abortion and complications of any of these (other than ectopic pregnancy and to the extent covered under polic variant)
  • Medical and / or surgical treatment of Sleep apnea, treatment for genetic and endocrine disorders. Expenses incurred on Lasik Laser or other procedures Refractive Error Correction and its complications, all treatment for disorders of eye requiring intra-vitreal injections
  • Cochlear implants and procedure related hospitalization expenses
  • Cost of spectacles and contact lens (in excess of what is specifically provided), hearing aids, Cochlear implants and procedures, walkers and crutches, wheel chairs, CPAP, BIPAP, Continuous Ambulatory Peritoneal Dialysis, infusion pump and such other similar aids.