Star Family Health Optima Insurance Plan

*Please note that the quotes shown will be from our partners

Star Health Family Health Optima Insurance Overview:

Family Health Optima from Star Health is a health insurance plan that gives protection to individual family member for a single premium under a single sum insured that covers all family members.

Star Family Health Optima Eligibility:

Minimum: 18 years and Maximum: 65 years of age at the time of entry (Infant can be covered from 16th day).
Applicable for renewal for the whole lifetime of the Insured individual.
On a Floater Basis the entire sum insured floats among all covered family (self, spouse and not exceeding 3 dependent children).

Special Features of Star Family Health Optima Policy:

Recharge Benefit: When the sum insured is exhausted/ exceeded, it provides additional cover up to a certain limit.
400 Day Care procedures/Expenses for Health Check-up.
Covers expenses for new born Baby/ Domiciliary hospitalization.
Donor expenses against organ transplantation: Up to a limit of 10% of the Sum Insured or Rupees One lakh, whichever is less
Bonus: Bonus is given for a claim-free year subject to a certain limits.
Automatic Restoration of Sum Insured: Upon exhaustion of the limit of coverage during the policy period subject to the limits, the basic sum would be automatically restored. This restored sum insured may be utilized in the remaining policy period.

Star Health Family Health Optima Policy Benefits:

Expenses including room rent, nursing and boarding charges during hospitalisation of the insured are covered for a maximum of 24 hours.
Fees of Anaesthetist, Surgeon, Medical Practitioner, Consultants and Specialist Fees, Anaesthesia, Blood, Oxygen, and Operation Theatre charges, Cost of Pacemaker, Cost of Medicine and drugs etc. are also taken for coverage.
For emergency transportation, ambulance charges up to a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period are covered
Pre Hospitalisation expenses up to 60 days prior to admission in the hospital.
Post Hospitalisation expenses up to 90 days after discharge from the hospital.

Co-Payment:

A co-payment of 20% for every claim is applicablefor fresh as well as renewed policies for insured persons (age above 60 years at the time of entry).
Pre-Existing Diseases/Illness: Are covered after 48 months of continuous Insurance

Pre- Acceptance medical screening: Persons above 50 years will be required to undergo medical screening at the Company nominated centres, cost of which is borne by the Company.

Tax Benefits Amount paid by any mode other than by cash for this insurance is eligible for relief under Section 80D of the Income Tax Act

Free look period:

It is a period for reviewing terms and conditions and making a judicious review. Cancellation in case of dissatisfaction can also be opted for in which case company will make due refunds.

Portability:

If the insured wants to port the policy to another towards renewal, application in the appropriate form should be made to the Company at least 45 days before from the date of renewal.

Premium chart for ZONE 1:

Plan	Age in years /	2 LACS	3 LACS	4 LACS	5 LACS	10 LACS	15 LACS
	Sum Insured
	(in Rs.)
	16days-35	5,595	5,895	6,770	7,535	9,800	11,610
	36-45	6,955	7,320	8,120	9,165	11,915	14,120
	46-50	10,595	11,150	11,640	14,500	18,850	22,335
2A	51-55	13,240	13,940	14,550	18,125	23,565	27,920
2A	56-60	15,890	16,725	17,460	21,750	28,275	33,505
	61-65	20,655	21,745	22,700	26,100	33,930	40,205
	66-70	24,785	26,090	27,240	31,320	40,715	48,250
	71-75	29,745	31,310	32,685	37,585	48,860	57,900
	76-80	35,690	37,570	39,220	45,100	58,630	69,480
	Above 80	42,830	45,085	47,065	54,120	70,355	83,375
	16days-35	6,930	7,295	8,315	9,850	12,215	14,475
	36-45	8,070	8,495	9,500	10,850	14,105	16,715
	46-50	11,400	12,000	13,230	15,750	20,475	24,265
2A+1C	51-55	14,250	15,000	16,440	19,690	25,595	30,330
2A+1C	56-60	17,100	18,000	19,725	23,625	30,715	36,395
	61-65	22,230	23,400	24,655	28,350	36,855	43,675
	66-70	26,675	28,080	29,590	34,020	44,225	52,410
	71-75	32,010	33,695	35,505	40,825	53,070	62,890
	76-80	38,415	40,435	42,605	48,990	63,685	75,465
	Above 80	46,095	48,520	51,125	58,785	76,425	90,560
	16days-35	8,885	9,355	10,225	12,350	15,560	18,440
	36-45	10,160	10,695	11,300	13,500	17,550	20,795
	46-50	13,205	13,900	14,995	17,950	23,335	27,650
2A+2C	51-55	16,505	17,375	18,445	22,440	29,170	34,565
2A+2C	56-60	19,810	20,850	22,135	26,925	35,005	41,480
	61-65	23,770	25,020	26,560	32,310	42,005	49,775
	66-70	28,525	30,025	31,870	38,770	50,405	59,730
	71-75	34,225	36,030	38,245	46,525	60,485	71,675
	76-80	41,075	43,235	45,895	55,830	72,580	86,010
	Above 80	49,285	51,880	55,075	67,000	87,095	1,03,210
	16days-35	10,220	10,760	11,760	14,200	18,465	21,205
	36-45	11,685	12,300	12,995	15,525	20,185	23,915
	46-50	15,185	15,985	17,245	20,645	26,835	31,800
2A+3C	51-55	18,980	19,980	20,890	25,805	33,545	39,750
2A+3C	56-60	22,780	23,975	25,110	30,965	40,255	47,700
	61-65	27,335	28,775	30,545	37,155	48,305	57,240
	66-70	32,800	34,530	36,650	44,590	57,965	68,690
	71-75	39,360	41,435	43,980	53,505	69,555	82,425
	76-80	47,235	49,720	52,780	64,205	83,470	98,910
	Above 80	56,680	59,665	63,335	77,050	1,00,160	1,18,690
	16days-35	5,040	5,305	6,095	6,785	8,820	10,450
	36-45	5,785	6,090	6,910	7,790	10,130	12,710
	46-50	8,905	9,375	9,635	12,235	15,905	20,105
1A+1C	51-55	10,935	11,510	11,930	14,900	19,370	24,970
1A+1C	56-60	13,865	14,595	14,995	18,490	24,035	30,155
	61-65	18,590	19,570	20,230	23,490	30,535	36,185
	66-70	22,310	23,480	24,275	28,190	36,645	43,425
	71-75	26,770	28,180	29,130	33,825	43,975	52,110
	76-80	32,125	33,815	34,955	40,590	52,770	62,530
	Above 80	38,550	40,575	41,945	48,710	63,320	75,035
	16days-35	6,235	6,565	7,485	8,865	11,525	13,025
	36-45	7,005	7,375	8,550	9,645	12,540	15,045
	46-50	10,195	10,730	11,490	14,175	18,430	21,835
1A+2C	51-55	12,825	13,500	13,940	17,720	23,035	27,295
1A+2C	56-60	15,390	16,200	17,040	20,290	26,375	32,755
	61-65	20,005	21,060	22,190	25,515	33,170	39,305
	66-70	24,010	25,270	26,630	30,620	39,805	47,165
	71-75	28,810	30,325	31,955	36,740	47,765	56,600
	76-80	34,570	36,390	38,345	44,090	57,315	67,920
	Above 80	41,485	43,670	46,015	52,910	68,780	81,505

Plan	Age in years /	2 LACS	3 LACS	4 LACS	5 LACS	10 LACS	15 LACS
	Sum Insured
	(in Rs.)
	16days-35	7,940	8,360	9,205	11,735	14,300	16,595
	36-45	8,695	9,150	9,570	12,825	15,675	18,715
	46-50	11,505	12,110	12,520	17,055	22,170	24,885
1A+3C	51-55	13,905	14,640	15,055	20,195	26,250	31,110
1A+3C	56-60	16,860	17,745	18,175	23,200	30,155	37,330
	61-65	21,390	22,520	23,405	29,080	37,805	44,795
	66-70	25,670	27,020	28,085	34,895	45,365	53,755
	71-75	30,805	32,425	33,700	41,875	54,435	64,505
	76-80	36,965	38,910	40,440	50,250	65,325	77,410
	Above 80	44,360	46,695	48,530	60,300	78,390	92,890

Premium chart for ZONE 2:

Plan	Age in years /	2 LACS	3 LACS	4 LACS	5 LACS	10 LACS	15 LACS
	Sum Insured
	(in Rs.)
	16days-35	4,510	5,010	6,095	6,405	8,820	10,450
	36-45	5,600	6,225	7,310	7,790	10,725	12,710
	46-50	8,530	9,480	10,475	12,325	16,965	20,105
2A	51-55	10,660	11,845	13,595	15,405	21,205	25,130
2A	56-60	13,505	14,215	16,215	18,490	25,450	30,155
	61-65	17,925	18,480	20,430	23,490	30,535	36,185
	66-70	22,975	23,480	24,515	26,620	36,645	43,425
	71-75	27,335	28,180	29,415	31,945	43,975	52,110
	76-80	32,800	33,815	35,300	38,335	52,770	62,530
	Above 80	39,360	40,575	42,360	46,005	63,320	75,035
	16days-35	5,580	6,200	7,485	8,375	10,995	13,025
	36-45	6,500	7,220	8,550	9,225	12,695	15,045
	46-50	9,180	10,200	11,905	13,390	18,430	21,835
2A+1C	51-55	11,475	12,750	14,795	16,735	23,035	27,295
2A+1C	56-60	14,380	15,300	18,740	21,265	27,640	32,755
	61-65	19,295	19,890	22,190	24,100	33,170	39,305
	66-70	24,730	25,270	26,630	27,310	39,805	47,165
	71-75	29,415	30,325	31,955	32,775	47,765	56,600
	76-80	35,300	36,390	38,345	39,325	57,315	67,920
	Above 80	42,360	43,670	46,015	47,195	68,780	81,505
	16days-35	7,155	7,950	9,205	10,500	14,005	16,595
	36-45	7,700	8,555	10,170	11,475	15,795	18,715
	46-50	10,635	11,815	13,495	15,260	21,000	24,885
2A+2C	51-55	13,290	14,770	16,600	19,070	26,250	31,110
2A+2C	56-60	16,305	17,725	19,920	22,885	31,500	37,330
	61-65	20,630	21,265	23,905	27,465	37,805	44,795
	66-70	26,440	27,020	28,685	31,125	45,365	53,755
	71-75	31,455	32,425	34,420	37,350	54,435	64,505
	76-80	37,745	38,910	41,305	44,820	65,325	77,410
	Above 80	45,295	46,695	49,565	53,785	78,390	92,890
	16days-35	8,230	9,145	10,585	12,070	16,615	19,085
	36-45	9,410	10,455	11,695	13,195	18,165	21,525
	46-50	12,230	13,585	15,520	17,545	24,150	28,620
2A+3C	51-55	14,385	15,985	18,800	21,935	30,190	35,775
2A+3C	56-60	18,225	19,180	22,600	26,320	36,230	42,930
	61-65	22,865	24,455	27,490	31,585	43,475	51,515
	66-70	29,310	31,075	32,985	35,795	52,170	61,820
	71-75	34,865	37,290	39,585	42,955	62,600	74,185
	76-80	41,840	44,750	47,500	51,545	75,120	89,020
	Above 80	50,205	53,695	57,000	61,850	90,145	1,06,825

Plan	Age in years /	2 LACS	3 LACS	4 LACS	5 LACS	10 LACS	15 LACS
	Sum Insured
	(in Rs.)
	16days-35	3,820	4,245	5,485	5,765	7,935	9,405
	36-45	4,190	4,870	6,220	6,625	9,115	11,440
	46-50	6,225	7,500	8,670	10,400	14,315	18,095
1A+1C	51-55	7,550	9,205	10,735	12,590	17,435	22,470
1A+1C	56-60	9,980	11,675	13,495	15,715	21,630	27,140
	61-65	14,970	16,635	18,205	19,965	27,485	32,570
	66-70	19,185	21,135	21,845	22,630	32,980	39,080
	71-75	22,825	25,360	26,215	27,155	39,575	46,900
	76-80	27,390	30,435	31,460	32,585	47,490	56,275
	Above 80	32,865	36,520	37,750	39,100	56,990	67,530
	16days-35	5,025	5,580	6,735	7,535	10,370	11,725
	36-45	5,580	6,270	7,695	8,200	11,285	13,540
	46-50	7,640	8,585	10,345	12,050	16,585	19,655
1A+2C	51-55	9,290	10,800	12,545	15,060	20,730	24,565
1A+2C	56-60	11,290	13,770	15,335	17,245	23,735	29,480
	61-65	15,880	17,900	19,970	21,690	29,855	35,375
	66-70	20,350	22,745	23,965	24,580	35,825	42,450
	71-75	24,210	27,295	28,760	29,495	42,990	50,940
	76-80	29,050	32,755	34,510	35,395	51,585	61,130
	Above 80	34,860	39,305	41,415	42,475	61,900	73,355
	16days-35	6,395	7,105	8,280	9,975	12,870	14,935

	36-45	6,590	7,320	8,615	10,390	14,105	16,845
	46-50	8,885	9,870	11,270	13,640	19,950	22,400
1A+3C	51-55	10,735	11,930	13,400	16,460	23,625	28,000
1A+3C	56-60	12,870	14,460	16,265	19,020	27,140	33,595
	61-65	16,845	19,140	21,065	24,715	34,020	40,315
	66-70	21,590	24,320	25,275	28,015	40,825	48,380
	71-75	25,680	29,185	30,330	33,615	48,990	58,055
	76-80	30,820	35,020	36,395	40,340	58,790	69,665
	Above 80	36,980	42,025	43,675	48,405	70,550	83,600

Premium chart for ZONE 3:

Plan	Age in years /	2 LACS	3 LACS	4 LACS	5 LACS	10 LACS	15 LACS
	Sum Insured
	(in Rs.)
	16days-35	4,060	4,510	5,485	5,765	7,935	9,405
	36-45	5,040	5,600	6,580	7,015	9,655	11,440
	46-50	7,675	8,530	9,430	11,095	15,270	18,095
2A	51-55	9,595	10,660	12,235	13,865	19,085	22,615
2A	56-60	12,155	12,795	14,595	16,640	22,905	27,140
	61-65	16,135	16,635	18,385	21,140	27,485	32,570
	66-70	20,680	21,605	22,060	23,960	32,980	39,080
	71-75	24,600	25,360	26,475	28,750	39,575	46,900
	76-80	29,520	30,435	31,770	34,500	47,490	56,275
	Above 80	35,425	36,520	38,125	41,405	56,990	67,530
	16days-35	5,025	5,580	6,735	7,535	9,895	11,725
	36-45	5,850	6,500	7,695	8,300	11,425	13,540
	46-50	8,260	9,180	10,715	12,050	16,585	19,655
2A+1C	51-55	10,330	11,475	13,315	15,060	20,730	24,565
2A+1C	56-60	12,945	13,770	16,865	19,135	24,875	29,480
	61-65	17,365	17,900	19,970	21,690	29,855	35,375
	66-70	22,255	23,250	23,965	24,580	35,825	42,450
	71-75	26,475	27,295	28,760	29,495	42,990	50,940
	76-80	31,770	32,755	34,510	35,395	51,585	61,130
	Above 80	38,125	39,305	41,415	42,475	61,900	73,355

Service Tax Extra
To calculate premium, age of the oldest family member covered should be taken in consideration.

*The above rates may vary. Please check the policy wordings for more details.

Zone 1: Delhi including National Capital Region, Mumbai including Thane and the State of Gujarat

Zone 2: Bangalore, Chennai, Coimbatore, Pune and State of Kerala

Zone 3: Rest of India excluding areas falling under Zone 1 and Zone 2

Plan	Age in years /	2 LACS	3 LACS	4 LACS	5 LACS	10 LACS	15 LACS
	Sum Insured
	(in Rs.)
	16days-35	6,440	7,155	8,280	9,450	12,605	14,935
	36-45	6,930	7,700	9,155	10,330	14,215	16,845
	46-50	9,570	10,635	12,145	13,730	18,900	22,400
2A+2C	51-55	11,965	13,290	14,940	17,165	23,625	28,000
2A+2C	56-60	14,675	15,950	17,925	20,600	28,350	33,595
	61-65	18,565	19,140	21,515	24,715	34,020	40,315
	66-70	23,795	24,860	25,815	28,015	40,825	48,380
	71-75	28,310	29,185	30,980	33,615	48,990	58,055
	76-80	33,970	35,020	37,175	40,340	58,790	69,665
	Above 80	40,765	42,025	44,610	48,405	70,550	83,600
	16days-35	7,405	8,230	9,525	10,865	14,955	17,175
	36-45	8,470	9,410	10,525	11,875	16,350	19,370
	46-50	11,005	12,230	13,970	15,790	21,735	25,760
2A+3C	51-55	12,950	14,385	16,920	19,740	27,170	32,195
2A+3C	56-60	16,400	17,265	20,340	23,685	32,605	38,635
	61-65	20,580	22,010	24,740	28,425	39,125	46,365
	66-70	26,380	28,590	29,690	32,215	46,950	55,635
	71-75	31,380	33,560	35,625	38,660	56,340	66,765
	76-80	37,655	40,275	42,750	46,390	67,610	80,115
	Above 80	45,185	48,330	51,300	55,665	81,130	96,140
	16days-35	3,435	3,820	4,935	5,190	7,145	8,465
	36-45	3,770	4,385	5,595	5,960	8,205	10,295
	46-50	5,605	6,750	7,805	9,360	12,885	16,285
1A+1C	51-55	6,795	8,285	9,665	11,330	15,690	20,225
1A+1C	56-60	8,985	10,505	12,145	14,145	19,465	24,425
	61-65	13,475	14,970	16,385	17,970	24,735	29,310
	66-70	17,270	19,445	21,040	21,790	29,680	35,175
	71-75	20,540	22,825	25,245	26,150	35,620	42,210
	76-80	24,650	27,390	30,295	31,380	42,740	50,650
	Above 80	29,580	32,865	36,355	37,655	51,290	60,780
	16days-35	4,520	5,025	6,060	6,780	9,335	10,550
	36-45	5,020	5,640	6,925	7,380	10,155	12,185
	46-50	6,875	7,725	9,310	10,845	14,925	17,690
1A+2C	51-55	8,360	9,720	11,290	13,555	18,660	22,110
1A+2C	56-60	10,160	12,395	13,800	15,520	21,365	26,530
	61-65	14,290	16,110	17,975	19,520	26,865	31,840
	66-70	18,315	20,925	23,080	23,670	32,240	38,205
	71-75	21,790	24,565	27,695	28,405	38,690	45,845
	76-80	26,145	29,475	33,235	34,085	46,425	55,015
	Above 80	31,375	35,375	39,880	40,900	55,710	66,020
	16days-35	5,755	6,395	7,455	8,975	11,580	13,445
	36-45	5,930	6,590	7,750	9,350	12,695	15,160
	46-50	7,995	8,885	10,140	12,280	17,955	20,160
1A+3C	51-55	9,665	10,735	12,060	14,810	21,265	25,200
1A+3C	56-60	11,585	13,015	14,640	17,120	24,425	30,235
	61-65	15,160	17,225	18,955	22,245	30,620	36,285
	66-70	19,430	22,375	24,340	26,975	36,745	43,540
	71-75	23,115	26,265	29,210	32,370	44,095	52,250
	76-80	27,735	31,520	35,050	38,845	52,910	62,700
	Above 80	33,285	37,820	42,060	46,615	63,495	75,240

Additional Features:

Automatic Restoration of Sum Insured:

Automatic Restoration of Sum Insured: Upon exhaustion of the limit of coverage during the policy period subject to the limits, the basic sum insured would be automatically restored. This restored sum insured may be utilized for the remaining policy period.

The restored sum insured cannot be carried forward.

Basic Sum Insured	% OF Restoration on the basic sum insured
up to 200000	Nil
300000 and above	100 %

Recharge Benefit:

Recharge Benefit: When the sum insured is exhausted/exceeded this provides additional cover up to a certain limit.

The recharge benefits are common for all the Zones and as follows:

For sum insured Rs. 300000 - 75000
For sum insured Rs. 400000 - 100000
Sum insured Rs. 500000 - Rs.2500000 & Rs. 150000

Recharge amount cannot be carried forward by the policyholder. Also both the Recharge & Restore benefits cannot be utilized together for a single hospitalization

Star Health Family Optima Insurance Renewal policy:

Renewal is allowed except on superfluous or fraudulent grounds.

A grace period of 30 days from the date of expiry of policy should be maintained. Changes in sum assured are applicable only at the time of the renewal.

If policy is withdrawn or modified the insured is to be informed three months before such incident.

Exclusions under plan by Star Health Family Health Optima:

Pre Existing diseases as mentioned.
Disease that creeps into the insured during the first 30 days of the policy period. Also expenses of defined and related diseases as mentioned would not be borne during the first two years of continuous operation of insurance.
Dental treatment or surgery (excluding accidental damages).
Injury due to nuclear weapons and war or breach of law on an intentional basis.
Expenses on Vitamins and tonics not part of the treatment schedule.
Hospital registration and admission charges, record and telephone charges.

Star Health Family Optima Cancellation Policy:

Misrepresentation, fraud, moral hazard or non-cooperation on behalf of the insured might lead to cancellation of policy making way for appropriate refund.

PERIOD ON RISK	RATE OF PREMIUM TO BE RETAINED
Up to one month	25% of the annual premium
Exceeding one month up to 3 months	40% of the annual premium
Exceeding 3 months up to 6 months	60% of the annual premium
Exceeding 6 months up to 9 months	80% of the annual premium
Exceeding 9 months	Full annual premium

*The above rates may vary. Please check the policy wordings for more details.

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