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Presentation on
Senior Citizens Red Carpet
Health Insurance
Star Health and Allied Insurance Co. Ltd.
For People aged Between 60 and 69 Years
Guaranteed renewals beyond 69 years
No Pre Insurance Medical Test required
Covers Pre Existing Diseases
Major Product Features
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
60 Years – 69 Years
Proposals from persons 60 and above, age proof in the form of DL, Pass Port, Ration Card or School Certificate is required.
Guaranteed Renewals beyond 69 years
Presentation on Senior Citizens Red Carpet Health Insurance
Age Limits
Star Health and Allied Insurance Co. Ltd.
No Pre – Insurance Medical Test is required
However 10% discount on premium will be allowed if the following reports are produced to the satisfaction of the Insurer
Stress Thallium Report BP report Sugar (Blood & Urine) Blood urea & creatinine Self-declaration or certification that surgeries related to
Heart / Brain / Cancer has / have not been done in the past.
The tests should have been taken not before 45 days from the date of proposal
Pre - Insurance Medical Test
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Hospitalization Expenses incurred as an inpatient for
Sickness/Illness/Diseases
Accidental injuries
Presentation on Senior Citizens Red Carpet Health Insurance
Coverages
Star Health and Allied Insurance Co. Ltd.
Pre – Existing Diseases are covered except those
for which treatment was recommended or received during 12 Months preceding the date of proposal
Diseases mentioned under First year exclusions and first two year exclusions
The cover is subject to 50% Co-payment
Pre Existing Diseases Cover
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Hospital, Nursing Home means any institution in India established for indoor care and treatment of sickness and injuries and which
Either It has been registered with the local authorities
and is under the supervision of a registered and qualified Medical Practitioner
or Should comply with minimum criteria as under It should have at least 15 inpatient beds (10 in Class ‘C’
Towns). Fully equipped operation theatre of its own wherever
surgical operation is carried out. Fully qualified nursing staff under its employment round
the clock Fully qualified Doctor(s) should be in charge round the
clock.
What is a Hospital?Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
The following Sum Insured options are available
Rs. 1,00,000/-
Rs. 2,00,000/-
Sum Insured
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Room rent & boarding charges @ 1% of the sum insured per day
ICU expenses Per Day @ 2% of the Sum Insured
Nursing charges
Surgeons, Anesthetist, Medical Practitioner, Consultants, Specialists fees subject to a maximum of 25% of the Sum Insured per hospitalisation
Allowable Expenses
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Anaesthesia, Blood, Oxygen, Operation Theatre charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and X-ray Dialysis, Chemotheraphy, Radiotherapy, Cost of Pacemaker and similar expenses subject to a maximum of 50% of the Sum Insured per hospitalisation.
Emergency Ambulance charges to go to Hospital for treatment @ Rs 600/- per hospitalisation upto a maximum of Rs 1,200/- per policy period
Allowable Expenses (Contd.)
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Post hospitalization expenses on a lump-sum basis @ 7% of the actual hospitalization expenses (excluding room rent and hospital registration charges), subject to a maximum of Rs. 5,000/-.
Note: The policy does not cover Pre- Hospitalisation expenses
Allowable Expenses (Contd.)
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Minimum of 24 hours Hospitalization is not necessary for the following
Dialysis, Chemotherapy, Radiotherapy, Cataract surgery, Dental Surgery, Lithotripsy (Kidney stone removal), Tonsillectomy, Cutting and Draining of Abscess, Liver Aspiration, Pleural Effusion Aspiration, Colonoscopy, Sclerotheraphy, The above treatment shall be taken in the Hospital /
Nursing Home and the Insured is discharged on the same day.
Day Care Treatment Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Sub LimitsPresentation on Senior Citizens Red Carpet Health Insurance
Rs. 60,000/- - for 1 Lakh PolicyRs. 120,000/- for 2 Lakhs Policy
All other Major Sugeries
Rs. 75,000/-- for 1 Lakh PolicyRs. 150,000/- for 2 Lakhs Policy
Renal Complication
Rs. 75,000/- for 1 Lakh PolicyRs. 150,000/- for 2 Lakhs Policy
Cardio-Vascular Diseases / Cerebro-Vascular Accident / Cancer and breakage of bones
Rs. 5,000/-Sclerotheraphy
Rs. 2,000/-Colonoscopy
Rs. 2,000/-Pleural Effusion Aspiration
Rs. 2,000/-Liver Aspiration
Rs. 1,500/-Cutting and Draining of Abscess
Rs. 7,500/-Tonsillectomy
Rs. 20,000/-Lithotripsy (Kidney stone removal)
Rs. 15,000/- in respect of one eye or both eyes in the entire policy period
Cataract surgery
Sub LimitName of the Ailment / Surgery / Procedure
Star Health and Allied Insurance Co. Ltd.
Includes but not limited to
Intestinal obstruction – both acute and sub-acute, colon surgeries, bladder surgeries including Urethra, nephrectomy, pancreatic surgery, GJ Vagotomy, Knee/hip surgery
Major Surgeries
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Premium Rating
Presentation on Senior Citizens Red Carpet Health Insurance
9,326/-(8455 + 871)2,00,000/-
4,908/-(4450 + 458)
1,00,000/-
Premium Including S. Tax of 10.30%
(Rs.)
Sum Insured (Rs.)
Star Health and Allied Insurance Co. Ltd.
50% co-payment applicable for Pre-Existing Diseases / Conditions
30% co-payment applicable for all other claims
Co-payment
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Renewal Loading
50%Above 150%
30%126% to 150%
20%100% to 125%
Loading Past Two Consecutive Years Claims Experience
Star Health and Allied Insurance Co. Ltd.
Treatment taken in Non Network Hospitals
Pre Existing Diseases for which treatment was recommended or received during 12 months preceding the date of proposal
Any Disease contracted during first 30 days First Year Exclusions Benign prostate hypertrophy Hernia, Hydrocele, Fistula in Anus, Piles Congenital Internal Disease/defect Sinusitis Renal stone and Gall stone removal
First Two Years Exclusions Cataract hysterectomy following menorrhia or fibromyoma Knee Replacement Surgery Joint Replacement Surgery Prolapse of intervertibral Vericose veins/ulcers
ExclusionsPresentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Pre Hospitalisation Expenses Injury / Disease arising due to War, Invasion, Act
of Foreign Enemy, Warlike operations Circumcision unless necessary for treatment of a
disease Cost of spectacles and contact lens, hearing aids,
walkers, crutches wheel chairs and such other aids
Dental treatment or surgery Convalescence, general debility, Run-down
condition or rest cure, congenital external disease or defects or anomalies, sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol
Naturopathy Treatment Expenses incurred on Lasik Laser or Refractive
Error Correction treatment
Exclusions (Contd.)Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Hospital registration charges, record charges, telephone charges and such other similar charges.
Expenses for Non Allopathic treatment
Policy cannot be issued to persons suffering from following diseases
1. Cancer
2. Chronic Kidney Disease
3. CVA / Brain Stroke
4. Alzheimer Disease
5. Parkinson’s Disease
Exclusions (Contd.)
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Benefits under Section 80-D of the IT ActCashless Service without intervention of TPADirect Tie up with hospitals on an All India Basis24 X 7 In-House Call center (044-2826 3300)Toll Free Telephone line assistance
(1800 425 2255) – only from BSNL and MTNLFull knowledge based website to offer medical information, including Health Tips. Frequent health meets to disseminate information on health related topics
Other Benefits
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Immediate intimation to the Call Centre (1800 425 2255/044-28263300)
The insured has to send a request for ‘Pre Authorization Form’ signed by the Doctor in the Network HospitalBased on the intimation a field visit will be done by the Star DoctorPre Authorization will be issued to the HospitalBased on the Pre Authorization and the Report by the Star Doctor, Cash Less Treatment will be given by the Network Hospital
Claim Procedure
Presentation on Senior Citizens Red Carpet Health Insurance
Star Health and Allied Insurance Co. Ltd.
Thank You
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