• Sum insured

Star Out Patient Care Insurance Policy provides sum insured options ranging from ₹25000 , ₹50,000, ₹75,000 and ₹ 1 lakh under all the plans – Silver, Gold, and Platinum.

• Product type

Star Out Patient Care Insurance Policy is available on both individual and family floater coverage basis.

• Policy term

The tenure of the Star Out Patient Care Insurance Policy is 1 year and is renewable for a lifetime.

• Variants

Star Out Patient Care Insurance Policy has three different plans, with varied benefits on the waiting periods. They are the Silver, Gold and Platinum plans.

• Waiting periods

Except in the case of an accident, any disease developed within 30 days of the policy’s inception is not covered.

1. Silver plan: Pre-existing diseases are covered after 48 months from the Date of inception of the policy.
2. Gold plan: Pre-existing diseases are covered after a waiting period of 24 months from the Date of inception of the policy.
3. Platinum plan: Pre-existing diseases are covered after a waiting period of 12 months from the Date of inception of the policy.
• Lifelong renewal option

The Star Out Patient Care Insurance Policy offers a lifelong renewal option. If the insured renews the policy, within the due date, he can enjoy continuity of benefits like a reduced waiting period on coverage of PED’s and cumulative bonus. A grace period of 30 days is provided to renew the policy and for continuity benefits. The insured is also eligible for a discount of 25% of the premium after every two continuous claim-free years.

Star Out Patient Care Insurance Policy covers out-patient consultation and treatment expenses incurred at any network hospital in India within limits specified in the policy. The OPD treatments that are covered are:

• Out-patient medical consultation

Avail coverage for all out-patient consultation expenses in any of our 14000+ network hospitals in the country.

• Non-allopathic treatment expenses

The Star Out Patient Care Insurance Policy covers non-allopathic treatment, such as Ayurveda, Unani, Sidha and Homeopathy systems of medicines (AYUSH) in any institute recognised by the Indian government and at any centers accredited by the quality council of the National Accreditation Board on Health.

• Diagnostics, physiotherapy and pharmacy expenses

The policy covers expenses incurred due to diagnostics, physiotherapy and pharmacy expenses in any of the 12,000+ Network Hospitals of Star Health Insurance.

• Dental and ophthalmic treatment expenses

Dental check-ups or treatment sought at any network institute throughout India is financed. In addition, ophthalmic (eye) treatments, consultations and related surgeries are also covered.

Day Care Treatments:

Generally, in order to make a claim against your health insurance, you must be hospitalized for a minimum of 24 hours. However, certain treatments are no longer require 24 hours of hospitalisation as they used to be due to technological advancements. In the past, for example, a patient receiving a cataract operation would be required to stay in the hospital for several days after surgery. As a result of technological advancement, surgery can now be performed on the same day as the patient is discharged from the hospital.

Such type of treatment falls under the policy definition of covered treatment if it is included in your policy.

OPD Treatments:

Outpatient Department, or OPD, treatment refers to the situation in which a patient may visit a doctor or medical practitioner for the purpose of seeking advice, tests, X-rays, investigations, diagnostics physiotherapy etc.

It might seem that Day Care and OPD treatments are similar because they involve a shorter amount of time.

Hospitalization is the most significant difference between the two. A Day Care procedure, even if it takes less time, is performed in a hospital and only then you will be able to claim your medical expenses under a Day Care treatment. Treatments for OPD do not require hospitalisation. The nature of OPD treatment is that it is possible to get the treatment without being admitted to a hospital or clinic.

A root canal treatment is a good example to understand the same. A root canal can be done either in a hospital or clinic without actually being admitted, and therefore falls under the OPD category. A dental surgery done in the event of an accident, however, may result in a day care treatment.

The cost of medical care is rising at an unabated pace in India, and it makes health insurance a necessity than a choice. OPD treatments have become very normal today. Who isn’t visiting a doctor for fever, blood sugar test, ECG, x-rays, or frequenting a family physician or a consultant?

Usually, outpatient treatments come as an add-on to existing policies or benefit from accompanying a standard policy because every person has their requirements and needs when choosing a health insurance policy that suits their pocket. By having an OP cover and an in-patient cover, the person is completely covered. On the contrary, even a healthy person is more likely to visit a doctor for medical conditions, which are not serious enough for hospitalisation, for instance, tooth filling or a few appointments with your general practitioner. As age advances, regular health checkups become a part of life. If you are a person taking regular health check-ups, such expenses are covered under OP care. Unfortunately, the cost of dental treatments, diagnostic tests, periodic doctor consultation, preventive check-ups and medicines can range anywhere from a thousand to 1 lakh. Having said that, the outpatient cover will be more apt for a healthy person and for anyone who frequently visits the hospitals and clinics, and the expenses you incur no longer need to be paid from your pocket.

Here is a list of features that are unique to the Star Out Patient Care Insurance Policy

• The plan covers all dental and ophthalmic treatment expenses, including expenses arising from accidental injuries at any Star Health network medical facility in India.
• You can enjoy a discount of 25% of the premium after every block of two continuous claim-free years which means you will be given a discount of 25% on your premium when no claims are made for two successive years.
• You can claim outpatient expenses on pre-existing diseases from the 2nd year (12 months waiting period), and you can submit multiple claims within the same year until the limit is reached.

The following is a partial listing of policy exclusions. A detailed list of all exclusions is included in the policy document.

• Cash-less facility at Network Hospitals

  We provide access to an ever-increasing network of hospitals where you can opt for cashless facility. Our aim is that you should have easy access to a network hospital near you in times of planned or unplanned medical expenses. Star Health Insurance has a network of over 14,000+ hospitals. For the complete list, visit here.

• Online discount

  You can enjoy a 5% discount for direct online purchases from starhealth.in . Renewal discount – 25% on the premium after every block of 2 continuous claim free years

• Hassle-free claim process

  Insurance processes can often be long and document-heavy. However, Star Health Insurance offers digital-friendly, zero-touch, quick and convenient options that work better for you during this pandemic situation.

• Tax benefits

  Individual and family members below 60 years can get Rs. 25,000 deductions from taxable income, and the deductible amount can extend up to Rs. 50,000 for senior citizens on premiums paid as per Section 80D of Income Tax Act, 1961. If two family members above the age of 60 are insured under one policy, then the deductible amount extends to Rs 1 lakh. In contrast, if there is one family member below the age of 60 and his parents are also insured under the same policy, then they can avail of a deduction of Rs 75,000.