Benefits | Health Wallet- Apollo | Health On- Apollo | ENERGY | Star Health Gain Insurance Policy-Star Health |
Plans | Silver Plan cost for wellness tests is excluded , Gold plan cost for wellness tests is included, | |||
Sum Insured (in Lakhs) | 3, 5, 10, 15, 20, 25 & 50 Basic Sum Insured per Insured Person per Policy Year (Rs. in Lakh) | Rs. 200,000; 300,000; 500,000 and 10,00,000 | 1/2/3/4/5(In Lakhs) | |
Policy Type | Individual / Family floater – relationships spouse, dependent children and dependent parents and dependent in laws. |
Individual | Individual/Family | |
Entry age | 91 days to 65 years Children between 91 days and 5 years can be insured provided either parent is getting insured under this policy. 91 days to 25 years if unmarried | 18 years to 65 years. maximum entry age is restricted upto 65 years. at entry, who are currently diagnosed with Type II Diabetes or Pre-Diabetes (Impaired Fasting Glucose/ Impaired Glucose Tolerance) or Hypertension. |
proposer; 18 years and 65 years dependent children from 91 days up to 25 years |
|
Policy Term | 1 year | 1 year, 2 years | 1 year | 1 year |
Relationship members covered under one policy | Individual / Family – relationships spouse, dependent children and dependent parents and dependent in laws. Maximum 6 members under single policy; In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included in a single policy. The 4 adults can be a combination of Self, Spouse, Father, Father in law, Mother or Mother in law. i) In a family floater policy, a maximum of 2 adults and a maximum of 5 children can be included in a single policy. The 2 adults can be a combination of Self, Spouse, Father, Father in law, Mother or Mother in law. |
individual only on individual Sum Insured basis. |
Self ,Spouse, Dependent Child | |
Inpatient Treatment | Covered | Covered | Covered | Covered |
Day Care Procedures | Covered | Covered | Covered | covered |
Pre-Hospitalisation | Covered, upto 60 days | Covered, upto 90 days | Covered, upto 30 days | 30 days |
Post-Hospitalisation | Covered, upto 90 Days | Covered, upto 180 Days | Covered, upto 60 Days | 60 days |
Domiciliary Treatment | Covered | Covered | NA | Not Covered |
Organ Donor | Covered | Covered | Covered | Not Covered |
Ambulance | Upto Rs.2,000 per Hospitalisation | Upto Rs.2,000 per Hospitalisation | Rs. 2000 per Hospitalisation. | Covered Ambulance charges for transporting the patient to the hospital upto a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period. |
Dental Treatment in case of Accidents | NA | NA | covered | |
AYUSH Benefit | Covered-This benefit is not applicable if optional Deductible is chosen | NA | Not Covered | |
Daily Cash for accompanying an Insured child | NA | Covered | NA | NA |
Vaccination (in case of Post Bite Treatment) | NA | NA | Covered | |
Out-Patient Treatment Cover after waiting period of 3 years | NA | NA | Covered | |
a) Out-patient Consultation | Covered | |||
b) Diagnostic Tests | ||||
c) Dental Treatment | Covered | |||
d)Spectacles, Contact Lens, Hearing Aids | ||||
Convalescence Benefit | NA | NA | NA | |
Maternity Expenses | NA | NA | NA | |
New Born Baby cover | NA | NA | NA | |
Restore Benefit | Equal to 100% of Basic Sum Insured | Equal to 100% of Basic Sum Insured | NA | NA |
Cover for People Suffering from HIV | NA | NA | ||
Cumulative Bonus | Multiplier Benefit: Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%. In case of claim, bonus will be reduced by 50% of the Basic Sum Insured at the time of renewal | Multiplier Benefit: Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%. In case of claim, bonus will be reduced by 50% of the Basic Sum Insured at the time of renewal |
NA | NA |
Health Check-up Coupon | Preventive Health Check-up: As per grid mentioned in the benefit | 3 lacs -5 lacs-Upto Rs. 2500 per policy at the end of each year at renewal. (Individual & family floater)
10 lacs- 15 lacs-Upto Rs. 5000 per policy at the end of each year at renewal.(Individual & family floater) 20 lacs – 50 lacs-Upto Rs. 10000 per insured person at the end of each year at renewal.(Individual) Upto Rs. 10000 per policy at the end of each year at renewal.(Family floater) |
NA | NA |
Dial a Doctor | NA | NA | NA | |
Health Educational Library for People(HELP) | NA | NA | NA | |
Second Option | NA | E-Opinion in respect of a Critical Illness | NA | NA |
Specialist Consultation with Two follow up session | NA | NA | NA | |
Wellness Package | NA | Wellness Offer with a discount or as part of a special scheme, at our discretion. |
NA | |
Newsletter | NA | NA | NA | |
Personal Accident | NA | NA | NA | |
Critical Illness | USD 250,000, USD 500,000 & USD 10,00,000 Offered if base policy Sum Insured is Rs. 10 lacs & above Illness covered under the rider are as following a. Cancer Treatment: b. Coronary Artery by-pass surgery: c. Heart Valve replacement or repair: d. Neurosurgery: e. Live-donor organ transplant: f. Bone Marrow Transplant: g. Aorta Graft Surgery h. Pulmonary artery graft surgery |
NA | NA | |
Hospital Daily Cash | NA | NA | NA | |
Sub limits Applicability | NA | NA | NA | |
Treatment only in tiered Network | NA | NA | NA | |
Family Discounts on Individual Sum Insured Basis | NA | 10% if 2 or more family members are covered under a single Health On Policy. | NA | NA |
Long Term Discount | NA | 7.5% will be provided if insured person is paying two year premium in advance as a single premium. | NA | NA |
Pre-existing diseases | 36months | 36months | 48months | 48 month |
Specified Diseases | 24months | 24 months | 24 months and 36 months | 24 months |
Other benefits | Reserve Benefit Sum Insured: Rs. 5000; 10,000; 15,000; 20,000; 25,000 per Insured Person per Policy Year ( Rs). Optional Deductible: 2 Lac; 3Lacs; 5 Lacs & *10 Lacs (*10 Lacs deductible available for SI of 20 lacs and above)per Insured Person per Policy Year ( Rs in Lakh) Recovery Benefit: Rs 10,000 for hospitalisation exceeding consecutive 10 days (This benefit is not applicable if optional Deductible is chosen) Worldwide Emergency Care: 50% of Sum Insured upto a maximum of Rs.20 lacs |
Co-payment: 20% of eligible claim amount payable if claim benefits In-patient Treatment, Pre & Post Hospitalisation Expenses, Day Care Procedures , Organ Donor and Emergency Ambulance Wellness Discount- Upto 25 % discount as indicated in Wellness Programme on renewal premium for better management of health condition. |
NA |