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Star Cardiac Care Insurance

Star Cardiac Care Insurance. A first of its kind policy exclusively designed to cover Heart patients who have undergone CABG / PTCA. Age Limits 10 years – 65 Years . Lifetime renewals Sum Insured options – Rs.300,000 & Rs.400,000 Plan Options Gold option Silver option. Benefits.

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Star Cardiac Care Insurance

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  1. Star Cardiac Care Insurance A first of its kind policy exclusively designed to cover Heart patients who have undergone CABG / PTCA

  2. Age Limits 10 years – 65 Years. Lifetime renewals Sum Insured options – Rs.300,000 & Rs.400,000 Plan Options • Gold option • Silver option

  3. Benefits • Hospitalization Benefit under two sections: Section 1 – Expenses incurred as an inpatient for treating Sickness/Illness/Diseases and Accidental injuries Section 2 – Expenses incurred as an inpatient for treating Cardiac ailments. • Pre Hospitalization ( Section 1 & 2) • Post Hospitalization ( Section 1 & 2) • Day care procedure (Section 1)

  4. Gold Plan Section 1 - Expenses incurred as an inpatient for treating Sickness/Illness/Diseases and Accidental injuries Section 2 - Expenses incurred as an inpatient for Surgical interventionof and also Medical Management of Cardiac ailments Silver Plan Section 1 - Expenses incurred as an inpatient for treating Sickness/Illness/Diseases and Accidental injuries Section 2 - Expenses incurred as an inpatient for only surgical management of cardiac ailments

  5. Co pay10% co pay on every admissible claim for fresh proposals above 60 years of age.Waiting period for section 2 claims – 90 daysAllowable Expenses • Room rent & boarding charges @ 2% of the sum insured up-to a maximum of Rs. 5,000/- per day • Nursing charges • Surgeons, Anesthetist, Consultants and Specialists fees • Operation Theatre charges, drugs and medicines diagnostic materials, cost of pace maker etc

  6. Allowable Expenses… • Emergency Ambulance charges to go to Hospital for treatment @ Rs 750/- per hospitalization up to a maximum of Rs 1,500/- per policy period • Pre-hospitalization expenses incurred for a period of 30 days prior to the date of hospitalization • Post hospitalization expenses incurred for a period of 60 days 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/-

  7. Day care Procedure • Minimum of 24 hours Hospitalization is not necessary for 101 specified procedures. • The standard exclusions and waiting period are applicable to all of the specified day care procedure. • Sublimit for Cataract is Rs.20,000 per eye subject to maximum of Rs.30,000 Per policy period

  8. Underwriting guidelines: • Pre acceptance medical screening for all persons • irrespective of the age. • Centralized underwriting at Corporate Office. • The following documents are mandatory • Discharge Summary of PTCA/CABG already undergone • and CD given at the time of discharge • Echo Cardiogram not older than 3 months. • (If older, a fresh Echo & ECG required at Company’s cost). • All investigations done prior to, during hospitalization and • at the time of follow up. • Serum Creatinine and Urine routine tests • All other tests as per package applicable for Mediclassic

  9. Exclusions Treatments Payable after first two years of insurance cover • Cataract, Glaucoma, Retinal detachment/ macular • degeneration, • PIVD (other than caused by accident), • Varicose veins and varicose ulcers, • Benign prostatic Hypertrophy, Hydrocele, • Deviated Nasal septum, Sinusitis, • Tonsillitis, Nasal polyps, • Chronic SupparativeOtitis Media and related disorders, • Stapedectomy, • Hernia, Fistula/Fissure in ano and hemorrhoids • Congenital internal disease/defects

  10. Exclusions Contd., • All treatments -conservative, interventional, • laparoscopic and open for • Hepatobillary • gall bladder / pancreatic calculi and • genitourinary calculi • Uterine prolapse, • Dysfunctional Uterine Bleeding, • Fibroids, Pelvic Inflammatory Diseases, • all diseases of fallopian tubes and ovaries.

  11. Exclusions contd., • Conservative and operative treatment of joint diseases • [other than caused by accident] • All types of joint replacement • (other than caused by accident) • Degenerative disc and vertebral diseases • degenerative diseases of the musculo-skeletal system • All PED other than Cardiac covered after 48 months of • continuous coverage with STAR. • Any disease contracted by the insured person during the • first 30 days from the commencement date of the policy

  12. Other ImportantPermanent Exclusions • Naturopathy Treatment • Maternity Related Expenses • Dental Treatments • Stem cell implantation and / or therapy • Expenses incurred on Enhanced External Counter Pulsation therapy and related therapies and Rotational Field Quantum Magnetic Resonance Therapy and such other similar therapies • Cost of spectacles and contact lens, hearing aids including cochlear implants, walkers, and crutches wheel chairs including CPAP, CAPD, infusion pump and such other similar aids. • Expenses incurred for Diagnostic treatments • All other permanent exclusions remain the same.

  13. Thank You

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