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Star Criticare Plus Insurance Policy
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Star Criticare Plus Insurance Policy

Star Criticare Plus Policy is a health insurance policy by Star Health Insurance Company that covers expenses arising out of critical diseases. There are various schemes available on non-allopathic treatment and major diseases apart from hospital coverage. The policy also covers pre and post-hospitalization charges and daycare procedures. It covers pre-existing illness after 4 years of continuous insurance renewal without any break.

What is Star Criticare Plus Insurance Policy?

Star Criticare Plus Insurance Plan is a health insurance plan which reimburses for hospitalization expenditure due to critical illness and accidental injuries. On critical illness diagnosis, the plan provides a lump-sum amount. This plan covers 9 major diseases with no survival period.  In this plan, the sum assured is per individual family member.

This plan has various benefits for policyholders. They are divided into two groups: Section 1 and Section 2.

  • Section 1 - The first section covers the in-patient cost of drugs and medicines, hospitalization, emergency ambulance charges, non-allopathic treatment, and other related costs.
  • Section 2 - Under the second section, the benefits are lump-sum compensation, no survival period, and hospitalization expenses covered under Section 1 and other expenditures.

Features and Benefits of the Star Criticare Plus Insurance Policy

Features of Star Criticare Plus Insurance Policy are: 

  • The plan covers 9 specified critical illnesses or diseases.
  • On diagnosis of critical illness, a lump-sum amount will be paid.
  • This plan covers the cost of regular hospitalization.
  • On buying a family floater plan, the policyholder gets a family discount.
  • The policy provider company has a dedicated team for availing hassle-free and faster claim settlement process.
  • Star Health Insurance company has a vast network of 8400+ hospitals across India compared to other policy provider companies.
  • The plan provides 24x7 free expert medical consultation over the phone.
  • Tax benefits can be availed on premiums paid under 80C of the Indian Income Tax Act, 1981.
  • Pre-existing illnesses can also be covered under the policy after 4 years of nonstop insurance renewal.
  • The plan also covers hospitalization expenditures for every 24 hours.
  • The plan provides compensation against 30 days pre-hospitalization expenditures which are paid as lump-sum.
  • It also covers post-hospitalization up to a maximum of 60 days from the hospital's date of discharge. The amount paid can be a maximum up to 7% of the hospitalization expenses which doesn't include room charges or Rs 5,000, whichever is lower.

Benefits of the Star Criticare Plus Insurance Plan are:

  • The plan provides a minimum sum insured of Rs 2 lakh.
  • The policy comes with a 30-day grace period.
  • The sum insured is paid as a lump sum at the diagnosis of an illness.
  • It also provides a medical screening of the person assured above 45 years of age, as required.
  • The plan covers day care procedures which require less than 24 hours.
  • The plan has convenient, hassle-free and fast claims options.
  • The sum insured provided as a lump-sum amount can be used as an income replacement.
  • There is a 100% benefit provide to the policyholder on the diagnosis of a terminal illness.
  • The plan protects disability and accidental death benefits.

Inclusions of the Star Criticare Plus Insurance Policy

The major diseases covered by Star Criticare Plus Insurance Plan are:

  • The first diagnosis of Cancer
  • Chronic Kidney Disease
  • Brain tumor
  • Undergoing treatment for the 1st time- Major Organ transplant
  • Occurring for the 1st time -
    • Acute Myocardial Infarction
    • Cerebrovascular Stroke causing
    • Established irreversible coma
    • Established irreversible Paraplegia
    • Established irreversible Quadriplegia
    • Hemiplegia 

The policy also covers the cost of the following:

  • Anesthesia, blood, operation theatre charges, oxygen and cost of pacemaker
  • Cost of boarding, room, nursing expenses as provided at 2% of sum insured, a maximum of Rs 5,000/- per day
  • Covers in-patient hospitalization expenses for 24 hours of hospitalization
  • Ambulance charges in transporting the person insured to the hospital maximum up to a sum of Rs 750/- per hospitalization and overall of Rs 1500/- in one policy period
  • Anesthetist, consultants, medical practitioner, surgeon and specialist fees
  • Non-allopathic treatments up to 25% of the sum insured, a maximum of Rs 25,000/- per year
  • Pre-hospitalization expenditure covered up to 30 days before hospitalization

Exclusions of the Star Criticare Plus Insurance Policy

Any illness diagnosed during the first 1 month (30 days) from the commencement of the policy will not be covered. This exclusion will not be applicable if the person insured is already covered under health insurance policies with any of Indian insurance companies waiting for 12 months. 

Permanent Exclusions

  • Convalescence
  • Dental implants
  • Dental surgery unless due to accidents which require hospitalization
  • General debility
  • Intentional self-injury
  • Injury or disease caused due to nuclear weapons
  • Injury caused by due to war, invasion, warlike operations and the act of foreign enemy
  • Nutritional deficiency states
  • Run-down condition or rest cure
  • Psychiatric, mental and behavioral disorders
  • Use of intoxicating substances, smoking, substance abuse, alcohol, drugs, and tobacco chewing
  • Venereal Disease and Sexually Transmitted Diseases

Exclusions with a waiting period of 2 years

The expenses for treatment of the following for 2 years will not be covered:

  • All treatments for Uterine prolapse
  • All diseases of fallopian tubes and ovaries
  • All treatments for Hepatobiliary gallbladder, genitourinary calculi, and pancreatic calculi
  • Benign prostatic hypertrophy
  • Cataract
  • Conservative and operative treatment of joint diseases
  • Chronic Supportive Otitis Media and related disorders.
  • Deviated nasal septum
  • Dysfunctional Uterine Bleeding
  • Fibroids
  • Glaucoma
  • Macular degeneration
  • Nasal polyps
  • Pelvic Inflammatory Diseases
  • Prolapse of intervertebral disc except in case of an accident
  • Retinal detachment
  • Sinusitis
  • Tonsillitis
  • Varicose veins and varicose ulcers 

Eligibility Criteria to Buy the Star Criticare Plus Insurance Policy

Eligibility of Star Criticare Plus Insurance Policy are:

  • Minimum entry age of the policy: 18 years
  • Maximum entry age of the policy: 65 years
  • The maximum age for renewal: 70 years
  • Policy term: 1 year
  • Minimum sum insured: Rs 2 lakh
  • Maximum -
    • Rs 2 lakh for senior citizens
    • Rs 10 lakh for others 

Claim Process for the Star Criticare Plus Insurance Policy

The claim process of Star Criticare Plus Insurance Policy includes the following steps:

  • Contact the insurance helpdesk in any network hospital of the Star Criticare, as soon as any critical illness is diagnosed.
  • Show the insurance health card or policy number along with any identity proof like passport, voter ID, PAN Card, driving license to the hospital.
  • Submit a pre-authorization form taken from the helpdesk of the network hospital.
  • Star Criticare will convey its decision to the concerned hospital via mail and SMS.

The person insured must submit the below documents within 30 days of diagnosis of critical illness:

  • A certificate confirms that the claim is not related to any pre-existing illness diagnosed in the first 90 days
  • Filled-up claim form
  • Medical certificate that confirms the diagnosis of critical illness
  • A photocopy of indoor case papers
  • Xerox of prescriptions and first consultation letter
  • Any other document as required

Once the insurer has received the required documents, the lump sum will be paid out within a few days.

How to buy the Star Criticare Plus Insurance Policy?

For purchasing Star Criticare Plus, Insurance Policy, one can follow the below steps:

Online process

  • Step A: Visit com
  • Step B: Choose Star Criticare Plus Insurance Policy to buy. Click on the 'Buy Now' option.
  • Step C: Enter details like name, email id, etc. and create an account for future use. Click on 'create an account'.
  • Step D: On the next page, one can compare online with other protection plans or click 'proceed.'
  • Step E: Fill up the policy form like name, age, number of policyholders, etc.
  • Step F: Choose the sum insured, policy tenure, and other details from the drop-down menu. After selecting the necessary option, the website's premium calculator will calculate the premium amount to be paid. After the selection of the above, click on the 'proceed.'
  • Step G: Continue with the payment process.

On payment, the policyholder will receive the policy document through the registered email id.

If not, one can visit the nearest Star Insurance branch for buying the policy offline. 

Renewal Process of the Star Criticare Plus Insurance Policy 

Star Criticare Plus Insurance Policy is issued for one year. The plan is renewable for a lifetime. For increasing the sum insured, it can be done at the time of policy renewal. The policyholder gets 30 days from the date of expiry as a grace period to renew the policy. The renewal process is as follows:

For renewing the policy online, one can visit Paisawiki.com and follow the below steps:

  • Visit the official website of Paisawiki
  • Step I: Go to Star health insurance and select the 'renew policy' option from the drop-down menu. Enter the policy number.
  • Step III: On the next page, the details like name, age, number of policyholders are shown. Click on 'continue.'
  • Step IV: On this page, a person can renew the policy or terminate it. Click on 'renew the plan.'
  • Step V: There will be various rider options shown to be added to the policy for extra coverage. The policyholder can either choose to add them or remove them. Choose the required option. After selection, the above click 'proceed.'
  • Step VI: There is an option to add or remove family members. For adding members, select 'add members'.
  • Step VII: In this page, add the necessary medical details.
  • Step VIII: Click on the proceed option.
  • Step IX: Continue with the payment process. Pay the premiums using a credit or debit card.

On payment, new policy documents will be mailed. A person can also renew the policy by visiting the nearest Star Health branch. 

Required Documents to Buy the Star Criticare Plus Insurance Policy

The documents required to apply Star Criticare Plus Insurance Policy are:

  • Age Proof: Birth Certificate, School/College Certificate, PAN card, Voter Card, Adhaar Card, Passport, Driving License and such documents
  • Address Proof: Ration Card, Electricity Bill, Bank A/C statement, Passport, Utility Bill, Telephone Bill, Postpaid Bill or Letter from Recognized Public Authority
  • Photo Identity Proof: Aadhar Card, Voter ID, PAN Card, Driving License, Passport or Public Servant with Photograph
  • Recent passport size photograph 

FAQs About Star Criticare Plus Insurance Policy

  • Q: How to claim for reimbursement?

    Ans: Once the person insured is hospitalized, visit the insurance section of the hospital.

    • Notify the insurance company
    • Once the patient is discharged, after paying all hospital bills, collect all the original documents of expenses incurred and treatment undergone
    • Fill up the claim form. The policyholder must submit all the necessary original documents to the nearest Star office branch

    The expenses will be reimbursed soon.

  • Q: How to fill up a Star Health Insurance claim form?

    Ans: The claim form can be downloaded from the insurer’s website. All the necessary guidelines and documents required are given in the form.

    There are two parts to the form.

    • Part A to be filled by the policyholder
    • Part B needs to be filled by the hospital. 

    In Part A, the policyholder is required to fill up the insurance history, personal details, details of claim details of hospitalization, and bank account.

  • Q: Does Star Health Insurance offer any top-up plan?

    Ans: Yes, Star Health Insurance has various top-up plans. The Star Health Super Surplus Insurance Policy is a rider that offers a higher sum insured at a very low premium in comparison to other critical illness plans. 

  • Q: How to check the status of Star Health Insurance Policy? 

    Ans: Visit the official website of Star Health and login with the user ID and password, and the policyholder can check all the policy details.

  • Q: Does Star Health Insurance cover Lasik?

    Ans: No, Star Health Insurance doesn’t cover any expenses due to Lasik or refractive error correction.

Written By: Paisawiki - Updated: 27 July 2020

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