Star Health Women Care

Star Health Women Care is a health insurance policy offered by Star Health and Allied Insurance Company Limited. 

The Star Health Women Care Plan is carefully designed to cater to the specific healthcare requirements of women. It provides comprehensive coverage for pregnancy, newborn care, infertility treatment, bariatric surgery, and more, ensuring the well-being of women. However, it's important to note that the plan does not offer the option to pay premiums on a monthly basis. Furthermore, our research indicates that the insurer has received a higher number of complaints regarding claim settlements and policy purchases. This indicates that their performance in terms of both purchase and claims service experience is unsatisfactory.

What are the benefits offered by the Star Health Women Care Plan?

• Inpatient hospitalisation coverage: Inpatient hospitalisation expenses refer to the costs you may need to bear when you are admitted to the hospital for a period exceeding 24 hours. These expenses encompass various aspects such as charges for room boarding and nursing services, fees for medical practitioners, the cost of prescribed medications and drugs, charges for intensive care unit (ICU) facilities, and other related expenditures. The Star Health Women Care Plan provides coverage for these expenses.
• Pre-hospitalisation coverage: Pre-hospitalisation expenses refer to the costs that you encounter prior to being admitted to the hospital. These expenses encompass consultations, tests, physical examinations, lab reports, and more. It's important to note that the insurer will only cover these expenses if they are directly related to the medical condition for which you are subsequently hospitalised. Additionally, the approval of your claim is contingent upon it being part of your inpatient hospitalisation coverage. Rest assured that the Star Health  Women Care Plan has got you covered when it comes to your pre-hospitalisation expenses. The plan will take care of these expenses for up to 60 days before your hospitalisation, up to the sum insured.
• Post-hospitalisation coverage: Post-hospitalisation expenses refer to the costs you may encounter after being discharged from the hospital. These expenses encompass various aspects such as follow-up consultations with your doctor, medical check-ups, rehabilitation sessions, physiotherapy, and more. It is important to note that these expenses should be directly associated with the condition for which you were hospitalised, and the claim must be approved under inpatient hospitalisation. The Star Health  Women Care Plan offers comprehensive coverage for post-hospitalisation expenses up to the sum insured. This coverage extends for a generous duration of 90 days after your hospital stay.
• Daycare treatment coverage: A daycare treatment refers to a medical procedure that previously required a prolonged hospital stay but can now be completed within 24 hours, thanks to impressive advancements in medical technology. With the Star Health  Women Care Plan, you can enjoy coverage for all daycare treatments, without any limitations. 
• Domiciliary treatment coverage: Domiciliary treatments are medical procedures and treatments that need urgent attention at a hospital but can be provided in the comfort of your own home. This option is available if you are unable to be transported to a hospital due to the seriousness of your illness or injury, or if there are no available beds at a nearby hospital. However the Star Health  Women Care Plan does not provide this benefit.
• Organ donor coverage: The Star Health Women Care Plan provides coverage for the inpatient costs related to organ harvesting from the donor during organ transplantation, up to the specified sum insured, when you are the recipient.
• Modern treatment coverage: With the continuous progress of medical technology, remarkable advancements in treatments that were once unimaginable have now come to fruition. Procedures such as stem cell therapy and radio surgeries, which were previously deemed untreatable, can now be effectively utilised. The Star Health Women Care Plan is meticulously designed to keep pace with these groundbreaking developments. It provides coverage for expenses related to these modern treatments, up to 50% of the sum insured as a limit.
• Non-medical expenses coverage: The Star Health Women Care Plan also provides coverage for non-medical expenses. These expenses include the costs of consumables like gloves, nebulisation kits, oxygen masks, and more. With this plan, you can rest assured as it covers these non-medical expenses up to the sum insured without any limitations.
• No Claim Bonus: If you go through a policy year without making any claims, you will be eligible for a No Claim Bonus as a token of appreciation. With the Star Health Women Care Plan, you can receive 20% of the sum insured as a No Claim Bonus, with a maximum limit of 100% of the sum insured. Even if you do make a claim during the policy year, your accumulated bonus will not be reduced. Please note, that the no claim bonus will remain unaffected if only the base sum insured is utilised for claim settlement. However, if the already accrued bonus is utilised, it will decrease at the rate at which it has been accrued.
• Super No Claim Bonus: Essentially, the Super No Claim Bonus is an enhanced version of the No Claim bonus. It is important to mention that the Star Health Women Care Plan does not include a Super No Claim Bonus.
• Restoration benefit: The Star Health Women Care Plan offers a valuable feature known as the restoration benefit. This feature ensures that your sum insured is replenished to its original amount when it is fully utilised during a policy year. What makes this benefit even more impressive is that it applies to both related and unrelated illnesses. The restoration benefit kicks in when there is a partial depletion of the sum insured and no claim bonus. It's worth noting that this benefit can be availed once for subsequent claims within a policy year.

Please note that the limits and conditions mentioned in the above benefits and features are for Rs. 10 Lakhs sum insured.

Star Health Women Care Plan: Financial Limits

• Room rent limit: The room rent limit refers to the highest amount your insurance provider will pay for the room you occupy during your hospital stay. By choosing a room within this limit, you can avoid any extra charges. However, if you decide to go for a more expensive room, you will be responsible for a portion of the total hospital bill, rather than just the difference in room rent. It's worth noting that the Star Health Women Care Plan provides room rent benefits for any room except the suite category and above.
• ICU rent limit: This refers to the maximum coverage provided by your health insurance policy for your stay in the Intensive Care Unit (ICU) of a hospital. With the Star Health Women Care Plan all expenses incurred during an ICU stay are fully covered up to the sum insured, without any limitations.
• Copayment: A copayment refers to a specific percentage of the claim amount that you are required to pay out of your own pocket. Once this payment has been made, the insurer will take care of the remaining balance. However, with the Star Health Women Care Plan, there is no copayment required.
• Deductible: A deductible refers to a specific amount that you are required to pay out of pocket before your insurance policy starts covering your medical costs. The Star Health Women Care Plan does not have a deductible, meaning you won't have to worry about any upfront payments before your medical expenses are covered.
• Limits on surgeries/treatments: This refers to the highest amount that your health insurance policy will pay for particular medical procedures or treatments. Some plans have specific limits for certain procedures, while others do not. With the Star Health Women Care Plan, there are no limits on cataract treatment and joint replacement surgeries, and they are covered up to the sum insured.

Please note that the above financial limits are taken for a 30-year-old individual opting for a sum insured of Rs. 10 Lakhs.

Star Health Women Care Plan: Waiting Periods & Exclusions

👉Waiting period

A waiting period is a designated period of time that follows the purchase of a health insurance policy. During this timeframe, certain illnesses and medical conditions are not covered. However, once this waiting period concludes, you can claim coverage for these conditions. Here are several types of waiting periods to be aware of -

• Initial waiting period: The Star Health Women Care Plan has a 30-day initial waiting period for all medical conditions, except accidents. Please note that during this period, you are unable to make claims for hospitalisation expenses, unless it is due to an accident.
• Waiting period for pre-existing diseases: A pre-existing disease refers to a medical condition or illness that you had in the 36 months prior to applying for a health insurance policy. In the Star Health Women Care Plan there is a waiting period of 24 months specifically for pre-existing diseases. It's important to note that during this waiting period, you will not be able to claim expenses related to your pre-existing disease.
• Waiting period for specific diseases: In addition to pre-existing conditions, insurance companies may impose a waiting period for certain medical conditions or illnesses, regardless of whether you have previously experienced them or not. This waiting period is determined by the insurer and is not influenced by your current state of health. For the Star Health Women Care Plan, there is a waiting period of 24 months for specific diseases.

👉Exclusions
Exclusions refer to specific situations or medical conditions that the health insurance policy does not cover. Some of them include -

• Standard permanent exclusions: Insurance companies in India are required to comply with a specific list of "standard permanent exclusions" set by the Insurance Regulatory and Development Authority of India (IRDAI). Some of these exclusions are as follows -

1. Investigation and evaluation: Hospital admission for observation or monitoring.
2. Rest, rehabilitation, and respite care: Admission to a facility for bed rest without active treatment. 
3. Obesity/weight control: Treatment or surgery related to weight control or obesity.
4. Gender reassignment: Treatments aimed at altering the body’s characteristics to match the opposite sex. 
5. Plastic/Cosmetic surgery: Treatment or surgery intended to modify body characteristics or appearance.
6. Profession in hazardous or adventure sports: Treatment expenses resulting from participating in adventurous activities such as river rafting, mountaineering, scuba diving, etc. as a professional.  
7. Breach of law: Expenses incurred in treating a person who has committed or attempted to commit a criminal act.
8. Excluded providers: Treatment received from medical practitioners or hospitals excluded by the insurance company.
9. Narcotics: Treating addiction to substances such as alcohol, drugs, etc.
10. Treatments in establishments arranged for domestic purposes: Expenses incurred for the treatment received in health spas, nursing homes, or similar establishments arranged entirely or partially for domestic reasons. 
11. Dietary supplements, substances purchased without subscription: Vitamins, minerals, etc., that a medical practitioner does not prescribe.
12. Refractive error: Expenses associated with correcting refractive errors of up to 7.5 diopters to improve eyesight.
13. Unproven treatments: Surgeries, medical procedures, or treatments that are not proven to be effective.
14. Expenses related to birth control, sterility, infertility: Contraception, sterilisation, artificial insemination, advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc. 
15. Maternity expenses: Pre/post-natal costs, childbirth-related hospitalisation expenses, etc. 

• Additional permanent exclusions: In addition to the standard permanent exclusions required by the IRDAI, insurance companies have the power to add extra exclusions for specific illnesses and circumstances. If a particular illness is deemed high-risk, insurers can decide to permanently exclude it from coverage. It is worth noting that insurers can only implement permanent exclusions for diseases that are included in the pre-approved list set out by the IRDAI.
• Non-standard exclusions (specific exclusions):  The insurance provider has the authority to apply additional exclusions that go beyond the standard permanent exclusions set by the IRDAI. These exclusions differ among insurers and are based on the specific terms and conditions of the policy. Below are a few of the particular exclusions outlined in the Star Health Women Care Plan -

1. Circumcision (excluding cases resulting from accidents), preputial dilatation, removal of smegma and the likes
2. Expenses for treatment of external birth defects (excluding coverage under the Newborn Baby coverage)
3. Treatment for general debility, convalescence, run-down condition, and nutritional deficiency states
4. Treatment for intentionally self-inflicted injuries
5. Injuries or diseases caused by war, invasion, acts of foreign enemies, and warlike operations
6. Injury or illness caused by nuclear weapons or materials
7. Specific therapies like hyperbaric oxygen therapy, low-level laser therapy, photodynamic therapy, and the like
8. Therapies that are untested, unconventional, or experimental.
9. Procedures such as Platelet-Rich Plasma (PRP) treatments, Intra-articular injection therapy, Chondrocyte Implantation, etc.
10. Biologicals are not covered unless administered during in-patient hospitalisation.
11. Vaccination or inoculation costs (excluding post-animal bite treatment and medical treatment for therapeutic reasons)
12. Spectacles, contact lens, hearing aids, walkers, crutches, wheelchairs, and other similar equipment costs.

What to 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 has a record of settling claims quickly and efficiently. It has settled 98.86% of claims in less than 30 days.  
• Claim-related complaints: As per our research, Star Health and Allied Insurance Company Limited has received 0.56% of complaints related to claims, which is significantly higher than other insurance companies. 
• Claims incurred ratio: The claims incurred ratio is a measure of an insurer's financial performance. It shows the total claims paid out in relation to the premiums received in a specific fiscal year. Star Health and Allied Insurance Company Limited has a claims incurred ratio of 66.47%.
• Claim settlement ratio: Star Health and Allied Insurance Company Limited's claim settlement ratio stands at 85.32%. This figure reflects the proportion of total claims received to those successfully settled by the company in a specific fiscal year.
• Network hospitals: Star Health and Allied Insurance Company Limited provides access to an extensive network of 14000+ hospitals. This broad network allows customers to receive cashless treatment without any financial worry.

How is the customer service of Star Health and Allied Insurance Company Limited ?

• Policy purchase-related complaints: Based on our research, Star Health and Allied Insurance Company Limited has received 0.06% of complaints related to its after-sales service, which is significantly higher than other insurance companies. 
• Response on Toll-Free: Our research suggests that Star Health and Allied Insurance Company Limited’s response time on their toll-free number is quick, as compared to other insurers.
• Response on Twitter: As per our research, Star Health and Allied Insurance Company Limited’s response time on Twitter is slow, as compared to others.

About Star Health and Allied Insurance Company Limited 

Star Health and Allied Insurance Company Limited is proud to be India's pioneering Standalone Health Insurance provider. With a diverse range of products, they cater to the needs of individuals, families, and corporations alike. Established in 2006, they are headquartered in the vibrant city of Chennai, Tamil Nadu. Leading their team is Mr. V. Jagannathan, serving as both the chairman and CEO.