Presentation on
Senior Citizens
Red Carpet
Health Insurance
Presentation on Senior Citizens Red Carpet Health Insurance
Major Product Features
For People aged Between 60 and 74 Years
 Guaranteed renewals beyond 74 years
 No Pre Insurance Medical Test required
 Covers Pre Existing Diseases
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Age Limits
 60 Years – 74 Years
Guaranteed Renewals beyond 74 years
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Pre - Insurance Medical Test
No Pre – Insurance Medical Test is required
 However 10% discount on premium will be allowed if the
following reports are produced to the satisfaction of the
Insurer
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Stress Thallium Report
BP report
Sugar (Blood & Urine)
Blood urea & creatinine
Self-declaration or certification that surgeries related to Heart / Brain /
Cancer has / have not been done in the past.
The tests should have been taken not before 45 days from the date of
proposal
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Coverages
Hospitalization Expenses incurred as an
inpatient for
 Sickness/Illness/Diseases
 Accidental injuries
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Pre Existing Diseases Cover
Pre – Existing Diseases are covered except
those
 for which treatment was recommended or
received during 12 Months preceding the date of
proposal
 Diseases mentioned under First year exclusions
and first two year exclusions
 The cover is subject to 50% Co-payment
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
What is a Hospital?
 Hospital, Nursing Home means any institution in
India established for indoor care and treatment of
sickness and injuries and which
Either
 It has been registered with the local authorities and is
under the supervision of a registered and qualified
Medical Practitioner
or
 Should comply with minimum criteria as under
 It should have at least 15 inpatient beds (10 in Class ‘C’ Towns).
 Fully equipped operation theatre of its own wherever surgical
operation is carried out.
 Fully qualified nursing staff under its employment round the
clock
 Fully qualified Doctor(s)
should be in charge round the clock.
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Sum Insured
The following Sum Insured options are
available
Rs. 1,00,000/Rs. 2,00,000/Rs. 3,00,000/Rs. 4,00,000/Rs. 5,00,000/Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Allowable Expenses
 Room rent & boarding charges @ 1% of the sum
insured per day Max. Rs. 4000/- Per Day
 ICU expenses Per Day @ 2% of the Sum Insured
 Nursing charges
 Surgeons, Anesthetist, Medical Practitioner,
Consultants, Specialists fees subject to a maximum
of 25% of the Sum Insured per hospitalisation
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Allowable Expenses (Contd.)
 Anaesthesia, Blood, Oxygen, Operation Theatre
charges, Surgical Appliances, Medicines and Drugs,
Diagnostic Materials and X-ray Dialysis,
Chemotheraphy, Radiotherapy, Cost of Pacemaker
and similar expenses subject to a maximum of 50%
of the Sum Insured per hospitalisation.
 Emergency Ambulance charges to go to Hospital for
treatment @ Rs 600/- per hospitalisation upto a
maximum of Rs 1,200/- per policy period
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Allowable Expenses (Contd.)
Post hospitalization expenses on a lump-sum
basis @ 7% of the actual hospitalization
expenses (excluding room rent and hospital
registration charges), subject to a maximum
of Rs. 5,000/-.
Note: The policy does not cover PreHospitalisation expenses
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Day Care Treatment
Minimum of 24 hours Hospitalization is not necessary for the
following
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Dialysis,
Chemotherapy,
Radiotherapy,
Cataract surgery,
Dental Surgery,
Lithotripsy (Kidney stone removal),
Tonsillectomy,
Cutting and Draining of Abscess,
Liver Aspiration,
Pleural Effusion Aspiration,
Colonoscopy,
Sclerotheraphy,
The above treatment shall be taken in the Hospital / Nursing
Home and the Insured Star
is discharged
theInsurance
same day.
Health and on
Allied
Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Name of the Ailment /
Surgery / Procedure
Cataract surgery
Sub Limits
Rs. 15,000/- in respect of one eye
or both eyes in the entire policy
period
Lithotripsy (Kidney stone
removal)
Rs. 20,000/-
Tonsillectomy
Rs. 7,500/-
Cutting and Draining of Abscess Rs. 1,500/Liver Aspiration
Rs. 2,000/-
Pleural Effusion Aspiration
Rs. 2,000/-
Colonoscopy
Rs. 2,000/-
Sclerotheraphy
Rs. 5,000/-
Presentation on Senior Citizens Red Carpet Health Insurance
Cardio-Vascular Diseases /
Cerebro-Vascular Accident /
Cancer and breakage of bones
Renal Complication
All other Major Sugeries
1Lac -75,000/2 Lacs - 1,50,000/3 Lacs - 1,60,000/4 Lacs - 1,70,000/5 Lacs - 1,80,000/1Lac -75,000/2 Lacs - 1,50,000/3 Lacs - 1,60,000/4 Lacs - 1,70,000/5 Lacs - 1,80,000/1Lac -60,000/2 Lacs - 1,20,000/3 Lacs - 1,30,000/4 Lacs - 1,40,000/5 Lacs - 1,50,000/-
Presentation on Senior Citizens Red Carpet Health Insurance
Major Surgeries
Includes but not limited to
Intestinal obstruction – both acute and
sub-acute, colon surgeries, bladder
surgeries including Urethra, nephrectomy,
pancreatic surgery, GJ Vagotomy,
Knee/hip surgery
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Premium Rating
Sum
100000 200000 300000 400000 500000
Insured
Age
60 to 69
4908
Yrs
9326
14229
17097
19854
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Co-payment
50% co-payment applicable for PreExisting Diseases / Conditions
30% co-payment applicable for all other
claims
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Exclusions
Treatment taken in Non Network Hospitals
 Pre Existing Diseases for which treatment was recommended or
received during 12 months preceding the date of proposal
 Any Disease contracted during first 30 days
 First Year Exclusions
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Benign prostate hypertrophy
Hernia, Hydrocele, Fistula in Anus, Piles
Congenital Internal Disease/defect
Sinusitis
Renal stone and Gall stone removal
First Two Years Exclusions
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Cataract
hysterectomy following menorrhia or fibromyoma
Knee Replacement Surgery
Joint Replacement Surgery
Prolapse of intervertibral
Vericose veins/ulcers
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Exclusions (Contd.)
 Pre Hospitalisation Expenses
 Injury / Disease arising due to War, Invasion, Act of
Foreign Enemy, Warlike operations
 Circumcision unless necessary for treatment of a
disease
 Cost of spectacles and contact lens, hearing aids,
walkers, crutches wheel chairs and such other aids
 Dental treatment or surgery
 Convalescence, general debility, Run-down condition
or rest cure, congenital external disease or defects or
anomalies, sterility, venereal disease, intentional self
injury and use of intoxicating drugs/alcohol
 Naturopathy Treatment
 Expenses incurred on Lasik Laser or Refractive Error
Correction treatment
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Exclusions
Hospital registration charges, record charges,
telephone charges and such other similar charges.
Expenses for Non Allopathic treatment
Declined Risks
1. Cancer
2. Chronic Kidney Disease
3. CVA / Brain Stroke
4. Alzheimer Disease
5. Parkinson’s Disease
Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Other Benefits
Benefits under Section 80-D of the IT Act
Cashless Service without intervention of TPA
Direct Tie up with hospitals on an All India Basis
24 X 7 In-House Call center (044-2826 3300)
Toll Free Telephone line assistance
(1800 425 2255) – only from BSNL and MTNL
Full knowledge based website to offer medical
information, including Health Tips.
Frequent health meets to disseminate information on
health related topics
Star Health and Allied Insurance Co.
Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance
Claim Procedure
Immediate intimation to the Call Centre
(1800 425 2255/044-28263300)
The insured has to send a request for ‘Pre
Authorization Form’ signed by the Doctor in the
Network Hospital
Based on the intimation a field visit will be done by
the Star Doctor
Pre Authorization will be issued to the Hospital
Based on the Pre Authorization and the Report by the
Star Doctor, Cash Less Treatment will be given by
the Network Hospital
Star Health and Allied Insurance Co.
Ltd.
Thank You
Star Health and Allied Insurance Co.
Ltd.