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Family Health Optima Plan

Star Family Health Optima Plan

Family Health Optima from Star Health Insurance means health insurance that covers more than one member of a family for a fixed sum assured. It offers valuable benefits like the cover for All Day-care Procedures, Domiciliary Hospitalization, Donor Expenses for Organ Transplantation, Restoration. Family health policy provides coverage for two or additional members in a family in the same policy and at the same time. Family health plan usually covers you and your spouse along with up to four kids. however, some insurance companies allow you to include your parents in your existing health insurance policy. A family floater health insurance is the best family health plan. The family health insurance plan is that the best key to full fills the heavy hospital bills at the time of hospitalization. Family insurance policy helps in medical emergencies.

Highlights of Star Family Health Optima Plan

  • Family Health Optima Plan offers coverage for the whole family at a fixed premium.
  • Free Health Check up costs up to Rs.3,500 once every three years of policy coverage
  • 300% automatic restoration of entire Sum Insured
  • New-born baby cover from 16th day of birth
  • Domiciliary Hospitalization Expenses for treatment above three days.
  • All day-care procedures are covered
  • 60 days Pre – Hospitalisation Expenses
  • 90 days Post – Hospitalisation Expenses
  • 25% Additional Two Wheeler Road Traffic Accident Sum Insured
  • Tax benefits on the premium paid as per the prevailing Income Tax rules
  • 1,50,000 extra sum insured

Star Family Health Optima Plan

Entry Age 18 years to 65 years
Entry Age of – Dependent Children 16 Days to 25 years
Family Size 2A, 2A+1C, 2A+2C, 2A+3C, 1A+1C, 1A+2C, 1A+3C
Sum Insured Options 3Lac, 4Lac, 5Lac, 10Lac, 15Lac, 20Lac and 25Lac
Policy Period 1 Year
Renewal Guarantee Life Long

Features of Star Family Health Optima Plan:

  1. Day Care Treatments

The plan covers the expenses towards all day-care procedures are covered that don’t require 24 hours of hospitalization.

  1. No-Claim Bonus

Depending on the sum insured you have opted, for every claim free year, you will get an additional bonus of 25% of SI for the first year and later 10% of SI – every claim free year.

  1. Organ Donor Cover

If you are the recipient, then the expenses for organ transplantation will be paid up to 10% of the sum insured and max Rs.1 lakh (whichever is less) subject to the availability of the sum insured. Provided Claim for transplantation Payable.

  1. Pre Hospitalization Expenses

Pre hospitalization expenses mean that the type of expenses incurred before a patient is admitted to a hospital for inpatient treatment. Pre-hospitalization covers between 60 days before hospitalization.

  1. Post Hospitalization Expenses

Post hospitalization expenses are referring to those medical expenses which we incurred for the follow up treatment for which you were hospitalized. Post-hospitalization covers 90 days before hospitalization.

  1. Automatic Restoration Benefit

For sum insured of Rs.3 lakh and above, there is a 300% automatic restoration of the sum. This cover can not use for illness/disease for which claims made already in the current policy year.

  1. Recharge Benefit

This the plan has recharge benefit which would get activated even when the entire sum insured is not exhausted, and the claim is raised for the same illness. This benefit is applicable for the sum insured in the range for 3 Lac SI-Rs. 75000, For 4 Lac SI-Rs. 100000; For 5 Lac & above SI-Rs. 150000.

  1. Free Health Check up

This plan offers health check-up benefits at every claim free year. This benefit is applicable for the sum insured in the range for 3 Lac SI – Rs. 750, 4Lac SI-Rs. 1000, 5Lac – Rs. 1500, 10 Lac SI – Rs. 2000, 15Lac SI Rs. 2500, 20 Lac SI Rs. 3000, 25 Lac SI – Rs. 3500.

  1. Domiciliary Hospitalization

In this you can avail treatment at home up to the base sum insured exceeding three days. There are certain terms and conditions related to the Patient that could not be moved to a hospital, non-availability of Rooms in hospital, Treatment provided at home for more than 3 days after all this condition you can be considered as hospitalization.

  1. Emergency Ambulance

In this health insurance covers ambulance charges up to Rs.750 for each and a maximum of Rs.1,500 per policy period.

  1. Additional Accident Cover

Insured riding two wheeler and meeting with road traffic accident you will get an additional sum insured of 25% and Max Rs.5 Lac.

Benefits of Star Family Health Optima Plan:

  • ICU Charges are Actual
  • Medical Professional Fees including specialist’s fee life- Surgeon, Anaesthetist, Medical PR actioner, Consultant, Specialist Fees are Actual.
  • Other Medical Expenses like- Anaesthesia, Blood, Oxygen, OT Charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials, X-ray, Diagnostic Imaging, Dialysis, Chemotherapy, Radiotherapy, Pacemaker, Stent, etc are Actual.
  • Tax Benefits
  • AYUSH Treatment Coverage Limits are 1Lac-4Lac – Rs. 10000, 5 Lac-15Lac – Rs. 15000, 20Lac&25Lac – Rs. 20000.
Terms & Conditions in the Star Family Health Optima Plan:

Room Rent

Depending on the geographical zone, you reside in and on the sum insured you have opted, there’s a room rent limit that varies from 3, 4 Lac SI Rs. 5000 per day and Single Standard AC Room for 5,10,15,20& 25 Lac SI – maximum of Rs.800 per day.


This plan has age-based co-pay equal to 20% of claimable expenses for individuals with entry age above 60 years (if they purchase the policy after 60 years).


Cataract-Depending on the sum insured you have paid for, expenses incurred on the treatment of cataract will be paid 1&2 Lac / 12000/120003Lac / 25000 / 35000, 4Lac / 30000 /45000, 5 Lac/40000/60000, 10Lac & above /50000/75000 for the Per Policy Period.

Waiting Period in Star Family Health Optima Plan:

  • 30 days waiting Period for any hospitalization except hospitalization arising due to accidents.
  • 24 months waiting Period for Diseases like Cataract, Prolapse of intervertebral Disc (Non-Accidental), Varicose-Veins &Ulcers, Hernia, Fistula/Fissure, Congenital internal Disease, etc.
  • 48 months waiting Period for Pre-Existing Diseases.

Permanent Exclusions in Star Family Health Optima Plan:

This Plan will not cover any for the treatments of following conditions-

  • Intentional self-injury
  • Mental illness
  • Cosmetic, aesthetic treatment
  • Dental surgery
  • AIDS
  • Pregnancy, childbirth, miscarriage, and abortion
  • Congenital disease
  • Infertility and in vitro fertilization.
  • Hospitalization out of war, riot, strike and nuclear weapons

Documents for Star Family Health Optima:

  • Filled in a Proposal form
  • Pass Port Size Colour Photo
  • Age proof of each family member
  • Address proof
  • Bank Details of Proposer