Star health and allied insurance company - Family Health Optima
Purchase mode

: Online

Options available: Family Floater

Recommendation about Mediclaim: Yes

Premium: Premium charge is high for Individual level and average in case of family floater

Product Features:

Parameter

Value

Entry age

5 months to 60 years

Renewal

Upto 60 years

Policy tenure

Yearly

Pre existing illness cover

Pre existing diseases are covered after 48 months of continuous renewal of insurance

Cashless Facility

To Network hospital

Sum Insured

Rs 1, 2,3,4,5 and 10 lacs.

Family Combination

Maximum 2 Adults and 3 Children

Hospitalization cover

Covered

Pre & post hospitalization medical expenses

Post –hospitalization calculated at 7% of the hospitalisation expenses up to a maximum of Rs 5,000 .Pre-hospitalization medical expenses up to 30 days prior to the date of admission

Domiciliary treatment

Not Covered

Sub limits

Room Charge, Nursing expenses and Surgeon's fees, Fees of Consultant, Anesthetist and Specialist are also provided etc

 

What does this policy cover

  • Wide cover for treatment against illnesses and accident
  • Benefits of coverage before, during and after hospitalisation
  • The entire family gets covered by paying a single premium amount
  • No medical check up till 50 years of age and post which check up is done at the company expense
  • Pre existing diseases are covered after 48 months of continuous insurance.

Exclusions

Family Health Optima, 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   

  • No Third Party Administrator (TPA) used for claim settlement; same is done directly by in-house team
  • Free consultation by general physician over the phone
  • Offers a 10% cumulative bonus for every claim-free year

Suggestion and Better alternatives of mediclaim:

Family Health Optima is a health insurance plan for the family. For people looking for low priced family health plan with good coverage, Family Health Optima is certainly a good option.

Illustration showing premium:

No. Of Members (Individual)

Age Group

Premium Sum Insured Rs.3 lacs

2 Adults

36 - 45

Rs. 5,978

2 Adult + 2 Child

36-45

Rs. 8,140

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