Star Health Young Star (Gold)

Star Health Young Star (Gold) is a health insurance policy offered by Star Health and Allied Insurance Company Limited, which has been designed specifically to meet the special medical needs of young people between the age bracket of 3 months and 40 years. This policy offers financial protection against sudden medical costs so that necessary medical care can be ensured without denting one's pocket. It consists of numerous features, benefits, a wellness program, and discounts for early starters.  

In addition to hospitalisation cost, it covers maternity cost, cost of consumables, and offers extra cover against road traffic accidents requiring inpatient treatment. But it's worth mentioning that although reasonably priced in relation to other similar products, it doesn't include some core benefits such as organ donor cover, domiciliary care, and has sub-limits on modern treatments if the appropriate add-on is not opted for.

The plan does provide the convenience of a monthly premium payment option. But according to our analysis, the insurer has faced a relatively greater volume of complaints pertaining to both the settlement of claims and the buying of policies. This reflects that the insurer has a poor record when it comes to both the purchase experience as well as claims service.

Next, let’s take a closer look at the Star Health Young Star (Gold) Plan.

What are the benefits offered by the Star Health Young Star (Gold) Plan?

Here are the key product benefits that define what the Star Health Young Star (Gold) Plan offers:

• Inpatient hospitalisation cover: The Star Health Young Star (Gold) policy covers the majority of the expenses when you are hospitalized for more than 24 hours. These include room charges, nursing care, prescribed medicine, doctor consultation fees, ICU rates, and other medical charges incurred during your hospitalization. The policy protects you from the expense of these charges.
• Pre-hospitalisation expenses cover: Before you are hospitalised, you might be spending money on doctor's checks, laboratory tests, X-rays, CT scans, etc. All these are referred to as pre-hospitalisation charges. Under this policy, all such expenses are reimbursed for 60 days or up to the sum insured. But only if such charges are directly related to the disease that made you go for hospitalisation and only if the claim is approved under inpatient care.
• Post-hospitalisation expenses cover: After you're discharged, there may be follow-up visits, medical check-ups, and other expenses. They are referred to as post-hospitalisation charges. The policy covers them for 90 days up to the amount insured. Similar to pre-hospitalisation, they will be covered only if they're linked to the ailment for which you were hospitalised, and your inpatient claim is settled.
• Daycare treatment coverage: Daycare treatments are medical procedures or operations that were once requiring extended hospitalisation, but are now possible in less than 24 hours because of advancements in medical technology. All daycare treatments are covered under the Star Health Young Star (Gold) plan up to the extent of the sum insured, so you do not have to worry about the cost incurred by you.
• Domiciliary treatment coverage: Domiciliary treatment is when one receives medical care at home due to a serious disease or injury, where hospitalisation is impossible. This could be due to the patient's health status or the unavailability of a hospital bed. This plan does not give the benefits of domiciliary treatment coverage.
• Organ donor cover: This plan does not include coverage of organ donor expenses, i.e., it does not cover the organ harvesting and related expenses.
• Modern treatment coverage: Modern treatments are advanced and complex procedures. Under this policy, these treatments are covered up to the sum insured, if the appropriate add-on is opted for, as long as they are medically needed and are listed. 
• Non-medical expense coverage: The non-medical expenses are also included under the Star Health Young Star (Gold) plan without any money limit, up to the extent of the sum assured, but as an add-on. It includes coverage for consumables that were utilised in the procedure, including a nebulisation kit, gloves, an oxygen mask, and other important medical equipment.
• No Claim Bonus: When you don't make any claims during the policy term, the insurance company rewards you with a No Claim Bonus (NCB). Under the Star Health Young Star (Gold) plan, you are eligible for a maximum bonus of 100%. Even if you make a claim, the bonus earned during the previous year will not be deducted if you opt for an add-on. Every claim-free year, you can get a 20% bonus annually so that you can enhance your coverage over time. Claims made under road traffic accident coverage will impact the No Claim Bonus
• Super No Claim Bonus: The Super No Claim Bonus is an upgraded form of the No Claim Bonus and operates in exactly the same way. The Star Health Young Star (Gold) policy does not have a Super No Claim Bonus feature.
• Restoration benefit: Restoration benefit assists in restoring your sum insured once it becomes insufficient in the course of a policy year. Under the Star Health Young Star (Gold) policy, it provides for one refill during a policy year. The restoration benefit gets triggered on partial exhaustion of cover amount for subsequent claims. This benefit applies to both related and unrelated ailments.

Please keep in mind that the limitations and conditions listed in the benefits section above pertain to a sum insured of Rs. 10 lakhs.

Star Health Young Star (Gold): Financial Limits

• Room rent limit: The limit of your room rent is the highest amount or room category your insurance plan will pay for your hospital room costs. You won't have to pay anything extra if you keep it within this limit. However, if you opt for a room that is more than what you are covered for, a proportionate deduction will be made. The room rent under the Star Health Young Star (Gold) plan is restricted to any room other than a Suite or above (categories are available as an add-on).
• ICU rent limit: ICU rent cap is the maximum that your insurance provider will pay towards your Intensive Care Unit stay. Under the Star Health Young Star (Gold) plan, there is no cap on ICU rent. The plan pays ICU charges in full up to the total sum assured.
• Copayment: Copayment is paying a fixed percentage of the claim amount from your pocket. You pay your share, and then the remaining is paid by the insurer. In the Star Health Young Star (Gold) plan, there is no requirement for a copayment.
• Deductible: Deductible is what you pay yourself before the insurer starts paying your bills. In the Star Health Young Star (Gold) plan, no deductible options are available.
• Maximum limits on surgeries/treatments: This is the maximum that can be covered for certain treatments or procedures. Certain health plans put limits on these. With the Star Health Young Star (Gold) plan, cataract operations and joint replacement operations are covered to the extent of the sum insured under the policy.

Note that the above limits are assumed for a 30-year-old person choosing a sum insured of Rs. 10 Lakhs.

Star Health Young Star (Gold): Waiting Periods & Exclusions

👉Waiting period

The waiting period is the duration that you have to wait before a few medical conditions are included in your medical insurance policy. You can only claim for these conditions after this period has lapsed.

These are the most important types of waiting periods:

• Initial waiting period: For all diseases, with the exception of those resulting from accidents, there is an initial waiting period of 30 days. You can't claim hospitalisation at this time except for an accident.
• Waiting period for pre-existing diseases: A pre-existing disease is any sickness or medical condition you had in the 36 months prior to buying the policy. For the Star Health Young Star (Gold) plan, there is a waiting period of 12 months for pre-existing diseases. You won't be able to claim any expenditure for these conditions in this period.
• Waiting period for specified diseases or procedures: Other than pre-existing diseases, insurers also have a list of certain illnesses that carry a waiting period, irrespective of your health history. The Star Health Young Star (Gold) plan has a waiting period of 12 months for certain specific diseases.

👉Exclusions

Exclusions refer to specific scenarios or situations not included under a health insurance policy. Listed below are some of the most prevalent types of exclusions:

• Standard Permanent Exclusions: According to the Insurance Regulatory and Development Authority of India (IRDAI), all health insurance providers must adhere strictly to a listed set of standard permanent exclusions. Below are some of them:
  • Investigation and evaluation: Hospitalisation is only for observation or monitoring.
  • Rest, rehabilitation, and respite care: Admission specifically for rest or convalescence, with no active medical treatment.
  • Obesity/weight control: Any procedures, surgery, or treatments for weight loss.
  • Gender reassignment: Medical interventions to change physical characteristics to fit a different gender identity.
  • Plastic/Cosmetic surgery: Procedures done to change or enhance physical appearance.
  • Adventure sports profession: Injuries accrued through professional participation in adventure sports like river rafting, mountaineering, or scuba diving.
  • Offense against the law: Treatment for injuries incurred while attempting to commit a criminal act.
  • Excluded providers: Treatment from hospitals or physicians not covered under your insurance policy.
  • Narcotics: Any treatment for substance addiction, like drugs, alcohol, etc.
  • Treatments in facilities organised for domestic use: Costs of care in facilities such as nursing homes, spas, or the like that are designed for domestic or non-medical care.
  • Dietary supplements bought over-the-counter: Vitamins, minerals, or supplements bought over-the-counter and not prescribed by a registered medical practitioner.
  • Refractive error: Fees to correct refractive errors to 7.5 diopters for visual improvement.
  • Unproven treatments: Any medical procedure or treatment that has not been unproven.
  • Sterilisation, conception, and infertility costs: Sterilisation payment, contraceptives, insemination, or advanced fertility procedures like IVF, GIFT, ZIFT, ICSI, gestational surrogate motherhood, and so on.
  • Maternal expenses: Charges related to maternity care, prenatal as well as post-delivery care.
• Additional Permanent Exclusions: Apart from the general list, insurers can also opt to add further permanent exclusions for specific diseases or conditions that are too risky to cover. These exclusions should be according to the specific list permitted by IRDAI. Insurers cannot permanently exclude any illness or condition that is not listed.
• Non-standard exclusions (Specific exclusions): Non-standard exclusions are more than the general permanent exclusions prescribed by the IRDAI. They are individual-specific and derived from the policy's detailed terms and conditions. The following are some of the specific exclusions referred to under the Star Health Young Star (Gold) plan:
  • Circumcision, except if it is required to cure a disease or injury
  • Costs incurred due to external birth defects
  • Therapy for general debility, convalescence, run-down states, and deficiency states of nutrition
  • Some treatments, like hyperbaric oxygen therapy, low-level laser therapy, and photodynamic therapy
  • Therapies that are untested, unconventional, or experimental
  • Techniques such as Platelet-Rich Plasma (PRP) therapy, Intra-articular injection treatment, and Chondrocyte Implantation
  • Biologicals, except when administered during inpatient hospitalisation
  • Vaccination or inoculation fees, apart from those done after an animal bite or administered for therapeutic purposes
  • Expenses for such things as eyeglasses, contact lenses (over and above that which is specially provided), hearing aids, walkers, crutches, wheelchairs, and other such equipment

What can you expect in terms of Claims Experience if you buy from Star Health and Allied Insurance Company Limited?

• Speed of claims: Star Health and Allied Insurance Company Limited settles around 98.86% of claims in 30 days, thus providing a quick claims process for the insured individuals.
• Claim-related complaints: According to our research, though, the percentage of complaints in the case of the company is 0.56% more than other insurers. This indicates that they do have some loopholes in their claim settlement process.
• Claims incurred ratio: The Claims incurred ratio is the claims paid in relation to the premium collected during a financial year. For Star Health and Allied Insurance Company Limited, it stands at 66.47%, which reflects how effectively they are settling claims in terms of revenues earned.
• Claim settlement ratio: The claim settlement ratio is the ratio of the total no. of claims received by an insurer that are settled during a financial year in comparison to claims received. 85.32% has been reported by Star Health and Allied Insurance Company Limited as a claim settlement ratio.
• Network hospitals: Star Health and Allied Insurance Company Limited has access to more than 14,000 hospitals. Having such a large network makes it easier for the customers to undergo such a cashless treatment at different locations.

How is the Customer Service of Star Health and Allied Insurance Company Limited?

• Policy purchase complaints: Our research reveals that Star Health and Allied Insurance Company Limited has a complaint ratio of 0.06% for its after-sales service, which is much higher than that of other insurance companies.
• Response on Toll-Free: Our research indicates that the response time on toll-free for Star Health and Allied Insurance Company Limited is average compared to other players.
• Twitter response: Star Health and Allied Insurance Company Limited's Twitter response is slow compared to others in the insurance industry.

About Star Health and Allied Insurance Company Limited

Star Health and Allied Insurance Company Limited is in fact the first independent Health Insurance company in the entire country of India. Being launched in the year 2006, the headquarters of the company is set at Chennai, Tamil Nadu; the company also operates with various products that are specifically designed to serve individual, family, and business requirements as well and it is headed by Mr. V. Jagannathan as its chairman and as its CEO, in a move to drive the vision and implementation of the organisation forward.