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HDFC

Family Health Optima

Family Health Optima from Star Health Insurance is a cover that provides protection for the entire family. It offers valuable benefits like the cover for 405 Day-care Procedures, Domiciliary Hospitalization, Donor Expenses for Organ Transplantation, Coverage for Newborn Baby, and so on.

Sum Insured

2,00,000 to 15,00,000

Premium starts from

7,228

Key Highlights

    Cashless Treatment at 7900+ Network Hospitals

    You don’t have to pay even a single paisa from your own pocket in more than 7900+ network hospitals, for all the treatments that are covered by the policy. The Insurer shall pay for your treatment directly to the hospital, maximum up to Sum Insured.

    Recharge Benefit

    If the limit of the coverage under the policy is exhausted / exceeded during the policy period, additional indemnity upto specific limits would be provided once for remaining policy period. Such additional indemnity can be utilized for the same hospitalization or for the treatment of diseases/illness/injury/ for which claim was paid.

    Cover your Newborn Baby

    You can cover your Newborn baby from 16th day after birth, provided you intimate the company about the newborn and endorse him in the policy. Generally insurers cover children from 91 days of age.

    Key Product Benefits to Check

      Day Care Treatment

      Insurance company will pay for more than 405 treatments that would require hospitalization for less than 24 hours. (Due to advancement in Technology). Please refer the terms for exact list of procedures.

      Expenses before and after Hospitalization

      You will get covered for all your claim related medical expenses 60 days before your hospitalization and upto 90 days after your discharge. This list may include follow-up visits, medication, diagnosis… etc.

      Organ Donor Cover

      You can cover hospitalization expenses of the organ donor in case of transplant upto a limit of 10% of sum insured of Rs. 1,00,000 whichever is less.

      Health Checkup

      In order to encourage you to stay healthy, Star Health provides a comprehensive health check-up for all insured persons above 18 years once every 3 continuous claim free years, upto a maximum of 1% of Sum Insured or Rs.5000 whichever is less.

      Automatic Restoration of SumInsured

      The Insurance company shall restore your sum insured once in a policy year, if base sum insured and bonus is insufficient to settle a claim, subject only if the Restored Sum Insured shall not be available for claims towards an Illness/ disease/ Injury (including its complications) for which a claim has been paid in the current Policy Year for the same Insured Person.

      ..read

      Exclusions to note

        Pre exisiting diseases

        In the first 4 years of subscription, Star will not pay for treating medical conditions that you may have been suffering from before purchasing the policy.

        30 days waiting period

        You can only claim for treatments of accidental injuries for the first 30 days after taking the policy

        2 years waiting period

        This policy covers some diseases/treatments like Cataract, Hysterectomy, Kidney Stone, Varicose veins, surgery of Tonsils and sinuses …etc., only after 2 years.

        Assets to be Covered

          icontwo

          Your Health

          You need to take care of yourself so that you can provide your loved ones with all they need. Protect your health from any unwarranted financial troubles by opting for a health insurance plan.

          icontwo

          Family Health

          Your family means the world to you and is the most precious thing in your life. You would want to protect it at all costs. Protect your family with health insurance plan so that no financial problem can burden your family.

          Risks to be Covered

          Family

          Organ donor expenses

          There are mainly 6 types of medical expenses incurred as far as the organ donor is concerned: Organ screening for compatibility, Pre-hospitalization costs, Hospitalization Costs, Organ transplantation surgery, Post-surgery complications & recovery, Post Hospitalization Costs for the Donor

          70% Complete

          8/10
          Family

          Ambulance Charges

          The charges for transporting the insured person via ambulance before and after the hospitalization are covered under ambulance charges.

          70% Complete

          7/10
          Family

          Hospitalization expenses

          Hospitalisation Expenses means the medical treatment costs that is necessary andreasonable in scope to treat the condition for which the Insured Person was Hospitalisedto the extent that such cost does not exceed the reasonable charges. The patient has to be in the hospital for at least 24 hours. Generally covers ICU charges, surgery, anaesthesia, doctor's charges etc.

          70% Complete

          10/10
          Family

          Pre & Post Hospitalization Expenses

          Pre-hospitalization expenses include various charges related to medical tests before an individual gets hospitalized. Post hospitalization expenses include all expenses or charges incurred by an individual after he or she is hospitalized.

          70% Complete

          8/10
          Family

          Day Care Treatment expenses

          Day Care Treatment refers to medical treatment and/or surgical procedure which is undertaken under General or Local Anaesthesia in hospital / day care centre in less than 24 hours because of technological advancements. The expenses for these tratments are day care treatments.

          70% Complete

          8/10
          Family

          Domiciliary treatment expenses

          Domiciliary Hospitalization is the treatment of the patient taken at home due to lack of accommodation in the hospital/nursing home or the patient's condition being such that he/she cannot be shifted to the hospital

          70% Complete

          8/10
          Family

          Health Check up expenses

          Many insurers these days provide health check up feature for its insured members per some number of years. Many insurers also provide these check-ups as cashless at their network hospitals

          70% Complete

          7/10
          ..read

          Our Expert Says

            Hi Dr. Mamtaa Goel, I am looking for a Health Insurance cover. Can you please brief me about this product

            Anonymus

            Mamtaa Goel

            Family Health Optima is the bestseller standard family health insurance product from Star Health. With a very large agent/advisor force that Star has, Family Optima, today is one of the popular products in the Health Insurance market. Premium of this product is very competitive and a very good Hospital Network makes this product stand out from the rest.

            Thank you so much for your help...

            Anonymus

            Mamtaa Goel

            It’s my pleasure. Please feel free to ask whatever questions you have. Myself or my friends will try our best to answer. Just click the below button and ask your questions.

            Our Experts Panel

              user

              Dr. Nandagopal Pothula

              Dr. Nandagopal Pothula has been in the field of Finance and Insurance for the past 19 years. He was the Senior Vice Presidentat Birla Sun Life Insurance and also served as the CEO of Reliance Life Insurance before founding India First Life Insurance Company. He is the CEO of Insurance Inbox.

              user

              Dr. Kamalakar Sai

              Kamalakar Sai has 22 years of experience in finance and insurance background. He has held key managerial positions at Birla Sun Life Insurance, Reliance Insurance, India First Insurance and is currently serving as the Director of Geosansar Insurance Brokerage Private Limited

              user

              Dr. Mamtaa Goel

              Mamtaa Goel is the Business Director at Insurance Inbox. She has an excellent 12 year record in the field of Insurance having served in senior managerail capacities at Reliance Insurance, TTK Healthcare and IndiaFirst Life Insurance.

              FAQ’s

                Does health insurance cover diagnostic charges like X- ray, MRI or ultrasound?

                Health Insurance covers all diagnostic test like X- ray, MRI, blood tests etc as long they are associated with the patients stay in the hospital for at least 24 hours. Any diagnostic tests which does not lead to treatment or which have been prescribed as Outpatient are generally not covered.

                I am a Foreign Citizen? Can I take a health policy for my father who is in India?

                Yes. The scope of coverage shall be restricted to treatment taken in hospitals in India during the policy period.

                What do you mean by Network /Non-network Hospitalization?

                A Hospital, which has an agreement with us for providing Cashless treatment, is referred to as a 'Network Hospital'. Cashless facility is provided ONLY at the network hospitals. Non-network hospitals are those with whom we do not have any agreement and any policyholder seeking treatment in these hospitals will have to pay for the treatment and later claim as per reimbursement procedure.

                Does any health policy cover the treatment for existing disease also?

                Normally health plans exclude treatment of any pre existing disease / condition. At Star the treatment of any such pre existing disease/ condition is covered after 48 months of continuous renewals with Star.

                Is there an Income Tax exemption under Health policy?

                Premium paid under the Health insurance Policy is exempted from Income Tax under section 80D of the Income Tax Act up to Rs.15,000 for individual covering his family and dependant Children.In case the proposer intends to cover his parents under medical insurance, he is eligible for a deduction of another Rs.25,000 under section 80D.In case the age of parent to be covered is above 65 years, the deduction available is Rs.30,000 under section 80D.
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