Star Health Medi Classic Plan

Star Health’s Medi Classic Plan is a health insurance plan available for individuals as well as their families. The plan provides the basic coverage features and also restores the Sum Insured if it is exhausted in any policy year. There are optional add-on covers also which can be opted to make the plan more comprehensive.

Key features of the plan

• The plan has an auto restoration feature where the Sum Insured is restored back by 200% if it is exhausted in any policy year.
• Free health check-ups are allowed every 4 years of the policy
• AYUSH treatments are also covered under the plan
• Patient Care and Hospital Cash are additional coverage features which can be taken by paying an additional premium. Moreover, the policyholder can also opt for new born baby cover.
• HIV positive individuals can also buy the policy if their CD 4 count is more than 350.
• No pre-entrance health check-ups are required up to 50 years of age.

How does the plan work?

Step 1 – The policyholder chooses the Sum Assured, the policy term and the members covered.

Step 2 – The policyholder can also choose any additional coverage from the optional benefits available.

Step 3 – If the covered member (s) face any medical contingency and the related expenses are covered by the plan the expenses incurred are paid by the plan.

Step 4 – If the plan matures and no medical contingencies occur, no benefit is paid.

Example

Ritwik buys Medi Classic Plan for Sum Insured of Rs.5 lakhs for himself and his wife.

Option 1 – His wife is hospitalized and they incur a bill of Rs.10 lakhs. Rs.5 lakhs is paid by the plan and the Sum Insured is restored back to pay the remaining Rs.5 lakhs.

Option 2 – if the plan matures and Ritwik doesn’t suffer any medical emergency, the Sum Insured increases by 5% and becomes Rs.5.25 lakhs.

Plan benefits

• Medical benefits – the list of medical expenses covered by the plan and their extent is as follows:

Room rent, boarding and nursing expenses	2% of Sum Insured up to Rs.5000/day
In-patient hospitalization	Covered
Non-allopathic treatments	Up to 25% of Sum Insured up to Rs.25,000
Day care treatments	101 procedures Covered up to the Sum Insured
Pre-hospitalization	30 days
Post hospitalization	60 days
Ambulance cover	Up to Rs.750 per hospitalization up to Rs.1500 per policy period
Restoration of Sum Assured	Up to 200% of Sum Insured for individual coverage
Health check-ups	1% of the Sum Insured up to Rs.5000 once every 4 years

• Optional Coverage benefits – the plan allows the following types of additional coverage features which can be added to the plan. These features are as follows:
• Patient Care - the benefit is for senior citizens aged more than 60 years. it pays Rs.400/day for a maximum of 5 days for keeping an attendant at home after being discharged from the hospital.
• Hospital Cash – this benefit pays Rs.1000/day for each completed day of hospitalization up to a maximum of 7 days in a policy year and 14 days in a policy period.
• New born baby cover – a Sum Insured equivalent to 10% of the mother’s Sum Insured is paid for covering the new born baby under this benefit
• No Claim Bonus – if the policyholder does not make a claim in any policy year he earns a cumulative bonus of 5% increase in the Sun Insured subject to a maximum of 25%.
• Premium discounts – premium discounts are allowed for the following:
• For buying a long-term policy – 5% discount for a 2 year policy
• For including family members – 10% for covering 2 or more family members

Eligibility Criteria

What is not covered by the plan?

Illnesses suffered during the first 30 days of the plan commencement are not covered.

Pre-existing illnesses or conditions are not covered by the plan in the first 4 years of the policy

Specific illnesses are not covered in the first two years of the plan.

Illnesses or accidents caused due to genetic disorder or stem cell surgery, substance abuse, participation in adventure sports or hazardous activities, criminal acts, attempted suicide, war and hazardous substances, etc. are not covered.

Treatments like dental treatments, cosmetic treatments, artificial life support, weight loss treatments, etc. are not covered.

Premium Illustration

Below are the sample rates of premium payable by a non-smoking male living in Mumbai for different combinations of age and members covered. The policy is taken for 1 year and the Sum Inusred is Rs.3 lakhs.