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Plan Overview

Star Outpatient Care Insurance Policy is designed to cover outpatient medical expenses, providing easy and hassle-free recovery without hospitalization. It covers doctor consultations, diagnostic tests, pharmacy bills, physiotherapy, non-allopathic treatments, dental, and ophthalmic treatments incurred at any networked facility in India.

Policy Term & Plans

  • Policy Term: 1 year
  • Sum Insured Options: ₹25,000; ₹50,000; ₹75,000; ₹1,00,000
  • Plans: Silver, Gold, and Platinum
  • Sum Insured Basis: Individual and Family Floater

Coverage Details

  • Outpatient consultation expenses at networked facilities
  • Non-Allopathic treatment including Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy recognized by the Government of India
  • Diagnostic tests, physiotherapy, and pharmacy expenses
  • Dental treatment expenses due to accidents
  • Ophthalmic treatment expenses due to accidents

Eligibility

  • Adults between 18 to 50 years
  • Dependent children from 31 days up to 25 years (economically dependent on parents)
  • Family size up to 6 members
  • Dependent children covered if at least one parent is insured

Exclusions Highlights

  • Pre-existing diseases covered after specified waiting periods depending on the plan (Silver: 36 months, Gold: 24 months, Platinum: 12 months)
  • 30-day waiting period for illnesses except accidents
  • Cosmetic or plastic surgery except reconstructive surgery after accidents
  • Treatments related to obesity, sterility, infertility, and maternity
  • Hazardous sports-related treatments
  • Treatment for alcoholism, drug or substance abuse
  • Treatments not recognized or unproven therapies
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Benefits

  • No Third Party Administrator (TPA), direct in-house claim settlement
  • Faster and hassle-free claim process
  • Cashless treatment in network hospitals
  • Tax benefits under Section 80D of the Income Tax Act

Renewal & Discounts

  • Renewal is generally allowed unless denied for fraud or misrepresentation
  • 25% renewal discount after every two continuous claim-free years
  • Grace period of 30 days for renewal to maintain continuity

Claim Process

  • Cashless facility available with ID card at network hospitals
  • Reimbursement process with submission of claim form, medical certificates, bills, and KYC documents

Additional Information

  • Free look period of 30 days to review the policy terms with refund option
  • Option for policy migration and portability as per IRDAI guidelines
  • Policy termination on death of insured or exhaustion of sum insured

How to Buy

  • Available online with a 5% discount on first purchase and renewals
  • Contact details for grievance redressal and customer support provided
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