Star Health Senior Citizen Insurance Policy Details

Thursday, June 15, 2017

LIC Of INDIA

Star Health Senior Citizen Insurance Policy Details | Features, Benefits Reviews, Premium, Maturity and Risk Cover

Star Health Senior Citizen Red Carpet Insurance Policy 

  • This plan is for Senior citizens aged between 60 to 75 years.
  • No pre-insurance medical test required.
  • Covers pre-existing diseases from the second year onwards.
  • Medical Consultations as an Out Patient in a Network Hospital.
  • Higher Sum Insured coverage up to Rs.10 Lakhs.
  • Guaranteed lifetime renewals.


Coverage Hospitalisation Expenses incurred as in-patient for Sickness / Disease / Illness and Accidental Injuries for a minimum period of 24 hrs.
Type of Cover Individual.
Entry Age 60 yrs to 75 yrs. & 364 days
Renewals Life time
Co-pay Co-Pay is a cost sharing requirement that provides the policyholder / insured will bear a specified percentage of the admissible claim amount
For Pre-existing Disease claims- 50 % of each and every claim and 30% of each and every claim for all other claims and renewals thereafter
Sum Insured Options  1 / 2 / 3 / 4 / 5 / 7.5 & 10 Lakhs
Policy & Grace Period One year and with 30 days Grace Period to renew the policy. (Renewal during Grace Period - Declaration of Good Health is required).
Medicals Medical is not a must.
Age Proof Age Proof is compulsory.
Free look Period 15 days with refund of Premium on Pro-rata Basis.
Any Disease Contracted 1st 30 days (Accidents Exempted )
Certain Procedures / Diseases First two years, including Congenital Internal Defects / Diseases - 50 procedures / diseases
Pre Existing Diseases (PED) 12 months

Allowable Expenses

Non- allopathic Treatment (Other than Naturopathy) No Provision
Pre - Hospitalizations No Provision
Post - Hospitalizations Amount will not exceed 7% of Hospital Bill (Minus Room Rent) subject to Max of Rs.5000/- Per hospitalization.
Ambulance Rs. 600 Per occurrence / Rs. 1200 Policy Period
Day care Procedures and Sub Limits 12 Procedures. 24 hrs. hosp. is waived and the sub-limits in bracket will apply for following day care procedures - Lithotripsy (20K), Tonsillectomy (7.5K), Cutting & draining of Subcutaneous abscess (1.5K), Liver aspiration (2K), Pleural Effusion Aspiration (2K), Colonoscopy (2K), Sclerotherapy (5K)}, Cataract limit varies based on the Sum Insured. Dialysis, Chemotherapy, Radiotherapy and Dental Surgery due to accident only
Other excluded expenses 203 Items as per Printed Policy Clause.
Automatic Restoration of Sum Insured No Provision
Package Charges No restrictions in respect of Package Charges
Room Rent (Inclusive of Boarding & Medical expenses) on Per Day Basis Whichever is lower Up to 1% of Basic Sum Insured subject to a Max. Of Rs.6000 per day.
Doctor's Fee Actuals or subject to a Maximum of 25% of Sum Insured, Per Hospitalisation
Medicine Charges Actuals or subject to a Maximum of 50% of Sum Insured, Per Hospitalisation

Note

Expenses relating to the Hospitalisation will be considered in proportion to the room rent stated in the policy. Treatment taken in Non-Networking Hospital exclusion has been removed.
No Claim Bonus for Every Claim Free Year No Provision
Portability This policy is portable.
80 D Benefit Tax Benefit Premium Paid by any mode other than cash is eligible for relief under section - 80D of the IT Act.


Star Health Senior Citizen Red Carpet Insurance Sub-limit

Sum insured 100000 200000 300000 400000 500000 750000 1000000
Particulars Limit of Company's Liability Rs.
Cataract 15000 15000 18000 20000 21500 23000 25000
CVA 75000 150000 200000 225000 275000 300000 350000
CVD 75000 150000 200000 225000 275000 300000 350000
Cancer 75000 150000 200000 225000 275000 300000 350000
Treatment for Breakage of Bones 75000 150000 200000 225000 275000 300000 350000
Renal Complications 75000 150000 200000 225000 275000 300000 350000
All other Major Surgeries 60000 120000 150000 200000 225000 250000 275000

Medical Consultation

Sum insured 100000 200000 300000 400000 500000 750000 1000000
Medical Consultation as OPD in Network Hospital @ Rs.200 per consultation No Provision No Provision Rs.600 Rs.800 Rs.1000 Rs.1,200 Rs.1,400
Premium Rates Incl. ST of 14%
Sum insured 100000 200000 300000 400000 500000 750000 1000000
In Rs. 5073 9640 14706 17671 20520 23940 25650

Additional Benefits in Sr. Citizen Red Carpet Policy Revised
1. High Sum Insured of Rs.7.5 lakhs and Rs.10 lakhs
2. First two years, including Congenital Internal Defects / Diseases - 50 Procedures / Diseases
3. Increase of Room Rent - 1% of Basic SI subject to a Max. of Rs.6000 per day
4. Increase of Sub-limit in Cataract Procedure
5. Increase of Sub-limits in Major Surgeries, no changes in sum insured of Rs.1 lakh and Rs.2 lakh
6. OPD - Medical Consultation
7. Treatment taken in Non Networking Hospital exclusion has been removed
8. No restrictions in respect of Package Charges


First Two Year Exclusions under Sr. Citizen Red Carpet Policy Revised
a. Cataract, Glaucoma, Diseases of anterior segment and posterior segment of the eyes, All diseases related to ENT, Diseases related to Thyroid, Prolapse of intervertebral disc (other than caused by accident), Varicose veins and Varicose ulcers, all diseases of Prostrate, Stricture Urethra, all types of Hernia, Varicocele, Hydrocele, Fistula / Fissure in ano, Hemorrhoids, Pilonidal Sinus and Fistula, Rectal Prolapse, Stress Incontinence and Congenital Internal disease / defect
b. Gall Bladder and Pancreatic diseases and all treatments (conservative, interventional, laparoscopic and open) related to Hepato-pancreato-biliary disease including Gall Bladder and Pancreatic Calculi. All types of management for Kidney and Genito-urinary tract calculi.
c. All treatments (conservative, interventional, laparoscopic and open) related to all diseases of Uterus, Fallopian Tubes, Cervix and Ovaries, Dysfunctional Uterine Bleeding, Pelvic Inflammatory Diseases, Benign Breast diseases.
d. Conservative, operative treatment and all types of intervention for diseases related to Tendon, Ligament, Fascia, Bones and Joint (other than caused by accident).
e. Degenerative disc and vertebral diseases including replacement of Bones and Joints and Degenerative diseases of the Musculo-skeletal system.
f. Subcutaneous benign lumps, Sebaceous cyst, Dermoid Cyst, Lipoma, Neuofibroma, Fibro adenoma, Ganglion and similar pathology.
g. Any transplant and related surgery.
This waiting period shall not however apply in the case of the insured person/s having been covered under any individual health insurance scheme with any of the Indian Insurer for a continuous period of preceding 24 months without any break.
The Claim for such illnesses/diseases/disabilities contracted/suffered if admitted will be processed as per the Sum Insured of immediately preceding 24 months policy only. Where there is a change in the sum insured in the second continuous policy year the lower of the sum insured will apply.