Star Health Insurance Pre-Existing Disease Buy Back – How does it work?

Star Health Insurance Pre-Existing Diease Buy Back – How does it workOne of the unique features in the Star Health Insurance policy is that it offers buy back of pre-existing disease waiting period. There are over 25 insurance companies offering health insurance plans. However, one of the major problems with these health plan is high waiting period for pre-existing diseases (PED). Some health insurance companies offer plans with 4 year waiting period and some offers for 3 years. In Star Health Comprehensive Health Insurance Plan, they is buy back option for PED. In this article we would provide Start Health Insurance buy back of pre-existing disease waiting period, features, terms and conditions and major exclusions from such option.

Also Read: Best Health Insurance Plans in India in 2022

Key Features of Star Health Comprehensive Health Insurance

Before we get into the PED T&C, let me provide you the key features of Star Health Comprehensive Health Insurance.

Any individual in the age group of 3 years to 65 years is eligible to take this plan.

Life long renewals available.

It covers pre – hospitalization expenses up to 60 days

It covers post hospitalization expenses up to 90 days

One can take health insurance coverage between Rs 5 Lacs to 1 Crore

Sum Insured would get restored for 100% in a financialyear.

There is 10% Co-Payment applicable for above 60 years

Free Health checkups every year

Network hospitalization coverage for over 11,000 hospitals

Pre-existing diseases (PED) waiting period is 36 months

Personal accident cover against death and total disablement benefit with no additional cost

Cash Benefit / Daily Allowance benefit up to 7 days in case of hospitalization.

Air Ambulance benefit Upto 2.5 Lacs per hospitalization and Max 5 Lacs in a year.

Income Tax Benefits u/s 80D for the premium paid.

Star Health Latest Incurred Claim Ratio (ICR) for 2022 is 94.44%.

What is a Pre-Existing Disease Waiting Period in Star Health Insurance?

Every health insurance plan would cover all hospitalization expenses, except for any pre-existing diseases which would be covered only after a specific waiting period. This waiting period would range between 2 years to 4 years.

Like I indicated above, there is pre-existing disease waiting period of 36 months / 3 years in the Star Health Insurance.

However, when you are purchasing Star Health plan, there is an option to indicate whether you want to buy back the pre-existing disease waiting period or not.

Features and T&C – Buy back of Pre-Existing Disease Waiting Period in Star Health Insurance

Here are the key features, terms and conditions in this option.

1) Buyback of pre-existing disease waiting period is OPTIONAL COVER. It is not mandatory. When you are buying health insurance, you can indicate as no if you are not interested.

2) This buy back comes with additional premium. This would depend on the pre-existing disease and the age.

3) The reduction of pre-existing disease waiting period would be from 36 months to 12 months. Means even if you are opting this feature, you need to wait for 1 year time frame to cover pre-existing diseases.

4) This buy back option is available only during first time purchase of the Star Health Comprehensive Plan. Means if someone already purchased this plan earlier and want to opt this feature during renewal, it is not possible.

5) The pre-existing disease coverage would be on the sum insured. Means, it would not cover restore benefit.

6) This buy back PED option is not available for policies that are ported from other insurance companies.

7) The insured person who has pre-existing disease has to undergo pre-acceptance medical screening at company nominated diagnostic centre. Currently, 100% cost of such pre-acceptance medical screening will be borne by Star Health Insurance. However, it may ask the insured person to share the cost (maximum 50%).

You can refer more info at Section 12 of the policy document.

You may like: Latest Incurred Claim Ratio of 2022 for Health Insurance Companies

What are the exclusions in this buy back with PED option?

Once the insured person purchase the buy back option of PED of the waiting period, below would be exclusions in the plan.

1) Hospitalization expenses related to the treatment of pre-existing diseases shall be excluded from the period of 12 months / 1 year.

2) In case the sum insured is increased during renewals the exclusion would apply afresh to the extent of that increase. E.g. if the sum insured is increased from 5 lac to 8 lac during renewal, the incremental 3 lac coverage of pre-existing disease would have 1 year waiting period.

3) List of specific diseases / procedures would have waiting period of 24 months from the date of the policy. This list includes Cataract, ENT diseases, Thyroid, Benign disease of breast, bening lump, Lipoma etc.,  One should refer to policy document for the complete list of specific disease that would be excluded for 24 months.

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Suresh KP

2 comments

  • Kamal Garg

    If there is no ‘loading’ of the premium due to declaration/medical screening finding of PED, then, I think this is a good product. Waiting period would reduce from 30 months to 12 months.

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