(Updated on 09-04-2013)
With estimated 32 million cardiac patients, India is the world’s capital for Cardiac Ailments.
Surveys say that 60% of the Heart patients in the world are expected to be from India by as early as 2016! This is the sad news.
Till date if you were a heart patient, it was difficult to get a health insurance policy, especially with Private Players. Government Insurance Companies did provide coverage reluctantly, and mostly with a Permanent Exclusion (as against coverage from the 5th year).
There is good news for all Cardiac Patients who have gone through PTCA (Angioplasty) or Bypass surgery in the last 2-3 years. Star Health is providing coverage over Cardiac ailments from 91 days of coverage. Read further to know more.
Who can buy this plan?
- People between 10 years and 65 years.
- Who have gone through PTCA (Angioplasty) or CABG (Bypass Surgery) only once
- Application for this plan has to be made, after 6 months of the surgery to maximum 3 years post the [date of surgery] and not later.
If Mr. Jha has gone through a Bypass surgery on 1st June 2013, he can apply for this plan on 2nd December 2013, upto 31st May 2016, and not later.
If Mr. Nair has gone through an Angioplasty in May 2011, he can apply for this plan upto April 2014.
- Acceptance of proposal would be subject to medical tests.
- All applicants have to go through medical tests.
What does the plan cover?
The policy covers the following:
- Standard health insurance coverage: for hospitalizations. This is the normal mediclaim cover.
- Health Insurance coverage for Cardiac Ailments: from the 91st Day. All hospitalizations related to Cardiac ailments would be covered from the 91st Day.
- Medical Management for all Cardiac related complications: Medical Management, here, is when a patient is required to be hospitalized for monitoring and managing complications with drugs in ICU.
For instance, if a heart patient has excruciating chest (angina) pain. The doctor examines the patient and advises admission in ICU for monitoring and maintaining the patient. Once the patient is normal, he is discharged without any surgery.
Note, This is covered only under Gold Plan.
- Pre Hospitalization Coverage of 30 days.
- Post Hospitalization Coverage of 60 days, subject to 7% of hospitalization expenses or Rs. 5000 whichever is lower.
- This is an individual policy. There is no floater option available. You will have to cover the member with Cardiac history in this separate policy.
- Renewable for Lifetime.
How much does it Cost?
Premium for Star Cardiac Care:
Other Important Features:
- Pre-existing diseases other than Cardiac will be covered from 5th Year, like any standard mediclaim plan.
- 2 years standard exclusions for specific ailments like Hernia, Cataract, Piles, Stones, Sinus, Knee replacement and more.
- Important to note, that Thyroid and Varicose Veins are also include in the 2 years exclusions. This ailment generally does not feature in the 2 years exclusions.
- 10% Copay, if you enter the policy at the age of 61 and above.
- Medical Management, where patient is hospitalized only for monitoring and management, and no surgery is required is not covered under Silver Plan. It is covered only under Gold Plan.
- EECP Therapy for Angina or Heart Failure is excluded. Please check with your Consulting Cardiologist whether this is important for you, and the impact if it is not covered.
- RFQMR Therapy for Osteoarthritis is excluded.
- Other standard exclusions like cosmetic surgeries, dental treatments, maternity etc.
- Sum Insured will be restricted to 80% of the amount, where the hospital has billed as a Package. Hospitals have packages for common surgeries like Cataract, Bypass Surgery etc. - where they charge a lumpsum for all expenses during the hospitalization treatment, as against billing separately for Room, Pharmacy, Diagnostic Tests, Doctor Fees etc.)
Our Take: Star Cardiac Care - Review
A heart surgery in the family is a big jolt to the entire family. Being an over reactive population, most Indians (and their families) would get a serious realization post a serious heart surgery, and start taking good care (to extreme care) of themselves, or their family member who has gone through a heart surgery. This results in better health for many patients.
In spite of excellent health, with all reports normal, most of the times such members were denied coverage due to the past history of a critical illness, or given a permanent exclusion on cardiac ailments. Star Health seems to have understood this Indian psychology and introduced this need-of-the-hour-product.
The premium seems quite reasonable too.
Look at a member who is 58 years old. His premium for coverage at 3 Lakhs for standard mediclaim plus coverage of cardiac ailments is Rs. 20225/-
A standard mediclaim plan (without coverage for cardiac ailments) would cost around Rs. 11000 to Rs. 15000. So you would end up paying around Rs. 5000 to Rs. 10000 to cover all heart related hospitalization treatments, which is a good deal.
Hat’s off to Star Health for churning out yet another innovative and relevant health insurance plan for Indian customers.
Know more or Buy Star Cardiac Care:
You can buy this product from Medimanage.com. Speak to our experts on 08767911666 or write to firstname.lastname@example.org with your contact details and preferred time to call and we will arrange a call from our experts.
About the Author:
Mahavir Chopra is the Head - Personal Lines & eBusiness at Medimanage.com, a specialist health insurance advisory service for Individuals, Families and Corporates. Know more about Medimanage's free advisory services here:
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