Star Health - Gain Policy

Purchase mode: Online

Options available: Individual and Family Floater

Recommendation about Mediclaim: Yes

Premium: Gain insurance has fixed premium of Rs 15,000 only.

Product Features:

Parameter

Value

Entry age

5 months to 60 Years

Renewal

Upto 60 Years

Policy tenure

Yearly

Pre existing illness cover

Pre existing illness covered after 48 months

Cashless Facility

To network hospitals

Sum Insured

Rs.1,00,000 to 5,00,000

Family Combination

Maximum 2 Adults and 3 Children

Hospitalization cover

Covered

Pre & post hospitalization medical expenses

Pre-hospitalization medical expenses upto 30 days prior to the date of admission.

Post-hospitalization - a lumpsum calculated at 7% of the hospitalization expenses (excluding room charges) subject to a maximum of Rs.5,000/-.

Domiciliary treatment

Covered

Sub limits

Room Rent, Nursing Charge, Surgeons, consultants and anaesthetists fees etc

 

What does this policy cover

In-patient: Gain Insurance provides medical expenses incurred during hospitalization including pre and post hospitalization expenses, day care procedures, and domiciliary treatment. The Sum insured is dependent upon the plan type opted.

Out-patient: Gain insurance provides medical expenses even if policyholder is not hospitalized. Out-patient includes expenses incurred for illness as outpatient, treatment of pre existing diseases, dental treatment, prenatal and postnatal care. The unutilized amount can be carried forward to next year.

Tax benefits: You can avail tax benefits under Section 80D to maximum amount of Rs 15,000. For senior citizens, the maximum amount is Rs 20,000.

Exclusions :

Gain Insurance, a truly different plan has some exclusions:

  • Any illness diagnosed within 30 days of inception of policy is not covered, however accidental injuries will be covered
  • There is 1 year waiting period for- Benign Prostrate, hypertrophy, hernia, hydrocele and related disorders
  • There is 2 year waiting period for particular diseases like cataract, joint replacement etc
  • Pre existing diseases will be covered after 4 years of continuous coverage
  • Investigative treatments
  • Cosmetic treatments or plastic surgery
  • Naturopathy treatment
  • Treatment of external congenital diseases

There are few more exclusion’s which can be verified from the policy document.

Special features of the policy

  • Coverage for both in-patient and out-patient 
  • Flat premium regardless of age and Sum Assured

Suggestion and Better alternatives of mediclaim:

Gain Insurance is a health insurance plan for the family. For people looking for low priced family health plan with good coverage, Gain Insurance is certainly a good option. Even if premium is same whatever be the age, Sum Assured should be opted as per your needs. With increasing Sum Assured in Gain Insurance, the out-patient amount decreases.

Explain With Example:

For example: Ramesh aged 35 takes Sum Assured of Rs 1 lacs and get out-patient amount limit of Rs 8,700. Ravi aged 35 takes Sum Assured of Rs 5 lacs and get out-patient limit of Rs 5,750 only.
Hence one should consider whether in-patient or out-patient would be required by them more before buying Gain insurance.

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