Star Outpatient Care Insurance Policy

Star Outpatient Care Insurance Policy is a popular plan from Star Health Insurance especially designed for covering outpatient expenses. The plan covers medical practitioner expenses, laboratory tests, bills for prescribed medication, etc.  

Star Outpatient Care Insurance Policy: Key Highlights

Coverage Offered

 Star Outpatient Care Insurance Policy is available in Individual or Family Floater basis with sum insured amount of Rs 25,000, Rs 50,000, Rs 75,000 and Rs 1 lakh.

The coverage provided are:

Outpatient Consultation: This includes expenses not covered for in-patient specialist visits or day care visits. This considers consultation taken at any network hospital under the insurer.

Expenses for Diagnostics, Physiotherapy, and Pharmacy: The insurance policy covers such costs at a specific diagnostic test or examination to be done at an external laboratory. Additionally, if a patient is recommended physiotherapy treatment for physical injuries, the same will be covered under the policy. Both in-house and external treatment expenses are financed.

Inclusions of the Policy

In addition to the basic coverage provided, the inclusions for the Star Outpatient Care Insurance policy are as follows:

• AYUSH Coverage- Any form of consultation, recommended testing, and treatment provided under Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy is covered by the policy.
• Dental Treatment- Dental check-up or outpatient treatment sought at any network institute throughout India is financed.
• Ophthalmic Therapy- For any eye examination with related surgery and treatment, the coverage is provided at any network hospital throughout India.

Exclusions of the Plan

The following are the exclusions under Star Outpatient Care Insurance Policy:

• Pre-existing diseases
• Obesity and weight management
• Cosmetic surgery and hormone therapy
• Injuries due to adventure sports or activities
• Treatment related to alcohol and drug addiction
• Treatment for infertility and sex change surgery
• Pregnancy wellness, miscarriage and related complications
• Self-injury and sexually transmitted diseases (other than HIV)
• Injuries due to war, rioting, and acts of violence
• Vaccination and external medical equipment
• Treatment taken out of India
• Robotic or stem cell therapy
• Therapy for genetic disorders

*Please refer to the policy document for a detailed list of exclusions.

Features & Benefits of the Star Outpatient Care Insurance Policy

The features and benefits of the Star Outpatient Care Insurance Policy are:

• Flexibility of coverage is offered by three different plans – Silver, Gold, and Platinum.
• The waiting period applies for pre-existing ailments; this is variable depending on the plan taken
• Silver – 48 months
• Gold – 24 months
• Platinum – 12 months

In the event of portability, the waiting period is reduced accordingly.

• Upon policy renewal, the waiting period is waived off.
• Claims settlement is done directly by the insurance provider with no third party involvement.
• Policy renewability is lifelong.
• Cashless reimbursement is offered at more than 9900+ hospitals throughout India.
• Tax exemption applies to the premium paid under Section 80D of the Income Tax Act, 1961. 

Eligibility Criteria

The minimum eligibility criteria to buy this policy are:

Cancellation of the Policy

The Star Outpatient Care Insurance Policy is cancelled if -

• If the insured not agreeable to the policy terms during the free look period (15 days)
• Non-disclosure or misrepresentation of facts affecting policy terms and coverage
• Under individual coverage, the insured passes away.
• The sum insured during the policy tenure is exhausted.

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