Health insurance providers have accurately identified the need to craft customised plans for women. While standard comprehensive policies cover diverse health scares, they fail to cater to some ailments since they are specific to women only. These include reproductive health coverage, maternity and newborn care, gynaecological care, etc.
Various providers, including Star, have introduced women-specific health insurance policies in response to this demand. Despite being a well-established insurer, Star has faced recent issues with complaint volume, Claim Settlement Ratio, and overall track record, raising concerns among policyholders.
Star Women Care health insurance plan fulfils essential coverage criteria for women, providing funds for various ailments and additional benefits like Oocyte Donor Cover, Surrogacy Cover, and Star Mother Cover. Despite these advantages, like other Star health insurance policies, this plan has considerations that may impact your decision to purchase.
So, should you opt for the Star Women Care Health Insurance Plan? Here’s what you need to know!
Quick Verdict on Star Women Care Health Insurance Plan
Star Women Care health insurance is an excellent package of women-centric features that could have made it a great pick. However, the multiple disease-wise sub-limits, room rent restrictions, and terms and conditions have complicated the product. Moreover, Star’s general reputation regarding hassles in claim settlement, rejection of valid claims, delisting of network hospitals, and high complaint volume has made it difficult to go for any of their plans, irrespective of their features.
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Star Women Care Health Insurance Plan: Brief Overview
Star Health Insurance was founded in 2006 and is the country's oldest standalone health insurance company. While Star remains one of the few insurers offering health insurance plans to the ones with critical ailments (like Cancer), the insurer’s extensive track record is discouraging. Over the years, Star’s
- Deteriorating Claim Settlement Ratio (average of 3 years is 82.01% as compared to the industry average of 90.97%),
- Increasing complaint volume (average of 3 years is 29.04 as compared to the industry average of 24.029)
- Reports of valid claims being outright rejected
- Sudden discontinuation of policies
- Delisting of network hospitals
-have all led to the insurer losing out on new policyholders. Moreover, the plans from Star are comparatively more expensive than similar policies from credible health insurers. As a consequence, we are cautious about recommending Star’s policies. However, if you still want a rundown of the features, here it is.
Star Women Care health insurance plan, available individually or as a floater, offers coverage from ₹5 lakhs to ₹1 crore. Despite the seemingly comprehensive coverage, hidden clauses and sub-limits in the fine print restrict the use of the sum insured. While the policy lists various women-specific health concerns, it has limitations, including the capping on IVF treatment under Assisted Reproductive treatment coverage, room rent restrictions, and sub-limits on modern treatments. Features like OPD coverage, assisted reproductive treatment, surrogacy, and oocyte donor coverage come with sub-limits and waiting periods.
Overall, the policy falls short of expectations due to high premiums, multiple sub-limits, room rent restrictions, and exclusions, making it an unfavourable choice for policyholders.
Features of Star Women Care Health Insurance Plan
| FEATURES | DETAILS |
| Coverage | ₹5 lakhs to ₹1 crore |
| Room rent restrictions | Yes (up to ₹25 lakhs) None (above ₹50 lakhs) |
| Waiting period |
Initial: 30 days Specific illness: 24 months Pre-existing disease: 24 months |
| Daycare coverage | Yes |
| AYUSH coverage | Yes |
| Pre & Post Hospitalisation | 60/90 days |
| Modern Treatment | Yes (with sub-limits based on the chosen sum insured) |
Should You Buy Star Women Care Health Insurance Plan?
- Star as an insurer: Despite being India's first standalone health insurance provider with a vast network of 14,000+ partner hospitals, Star Health has faced some backlash from prospective customers due to rejected claims, blacklisting hospitals, delisting network hospitals, claim settlement hassles, and plan withdrawals.
On the one hand, Star is still one of the few health insurance providers in the market that offers policies to Cancer patients, which is worth mentioning, considering most insurers shy away from such plans due to the high risk of payouts. However, on the other hand, considering how the insurer withdrew the plan (and relaunched it later) from the market, you, as policyholders, should consider the insurer's credibility before buying their plans.
2. Room rent restrictions: Under the Star Women Care health insurance plan, you can access exhaustive coverage ranging from ₹5 lakhs to ₹1 crore. However, while the sum insured is extensive, your choice of coverage amount will influence the room rent restriction that you have on your plan -
| Coverage Amount | Room Rent Restriction Applicable |
|---|---|
| ₹5 lakhs | Up to 1% of Sum Insured per day |
| ₹10 lakhs/₹15 lakhs/₹20 lakhs/₹25 lakhs | Any Room (except suite or above category) |
| ₹50 lakhs and ₹1 crore | No room rent restrictions |
So, to have access to a policy with no room rent restrictions, you must avail a sum insured that is ₹50 lakhs and above. However, not everybody needs such a high health insurance cover. In that case, you are looking at room rent and type restrictions, and in case you opt/are forced to choose a room fancier than the limit assigned, you will end up paying substantially towards your total incurred bill on a pro-rata basis.
3. Women-Centric coverage:
a. Assisted reproduction coverage: Star Women Care's health insurance plan covers assisted reproductive treatments (even if they’re not in-patient treatments). However, there is a sub-limit on this coverage.
| Sum Insured | Assisted reproduction coverage limit |
|---|---|
| ₹5 lakhs | ₹50k |
| ₹10 lakhs | ₹1 lakh |
| ₹15 lakhs | ₹1.5 lakhs |
| ₹20 lakhs and ₹25 lakhs | ₹2 lakhs |
| ₹50 lakhs | ₹2.5 lakhs |
| ₹1 crore | ₹3 lakhs |
Additionally, there is a 36-month waiting period associated with this feature.
b. Star Mother cover: If you have opted for a floater policy and the patient in question is an insured child less than 12 years old, Star will cover the room rent charges of the mother (up to a Single Private A/c room ) during the entire hospital stay. However, this feature also has some terms and conditions.
- This feature only applies if the insured hospitalised child is undergoing treatment in the ICU.
- If no rooms are available in the hospital where the child is admitted, and the mother stays in a hotel within 2 km of the hospital, Star will offer reimbursement of ₹2500 per day up to a maximum of 7 days.
c. Voluntary Sterilisation Expenses: Under this policy, you are covered for Tubectomy / Vasectomy, provided you wait 24 months. On the other hand, your insurer won’t cover you for any expenses incurred during the reversal of sterilisation.
d. Surrogacy Cover and Oocyte Donor Cover: In the case of surrogacy, the surrogate mother’s post-partum delivery complications are covered for 36 months. However, here are a few terms and conditions that you need to remember -
- The ante-natal and delivery expenses of a surrogate mother are not covered under the Star Women Care health insurance policy.
- The intending couple, the surrogate mother, and the surrogacy clinic have to comply with the Surrogacy Act and ART Act.
- You have to make the proposal for the insurance at least 30 days before the embryo transfer.
- After the completion of the 36 months, the cover for a surrogate mother is removed from the policy.
- There is a sub-limit on the surrogacy cover under this policy upto a defined amount.
In the case of Oocyte Donor cover, after 12 months, the Oocyte Donor cover will be excluded for the Oocyte Donor. Additionally, you must inform your insurer about the impending claim, or 30 days before ovarian stimulation for an oocyte donor. For this feature, too, there is a sub-limit on the perk up to a pre-defined amount.
e. Delivery Expenses, Newborn Cover, and Natal Care: The maternity perk under the Star Women Care health insurance policy covers delivery, pre and post-natal expenses, and the newborn’s care. Here’s a look at these features in detail -
- Delivery Expenses: While the Women's Care health insurance plan from the Star stable offers coverage for delivery expenses and pre and post-natal expenses for c-section deliveries, there is an associated waiting period and sub-limit on the funding offered.
| Sum Insured | Waiting Period | Sub-Limit |
|---|---|---|
| ₹5 lakhs | 24 months | ₹25k |
| ₹10 lakhs | 24 months | ₹50k |
| ₹15 lakhs | 12 months | ₹50k |
| ₹20 lakhs | 12 months | ₹50k |
| ₹25 lakhs | 12 months | ₹75k |
| ₹50 lakhs | 12 months | ₹75k |
| ₹1 crore | 12 months | ₹1 lakh |
(*perk available for a maximum of 2 deliveries)
While the waiting period of 1 or 2 years for delivery coverage is a decent offering (considering very few insurers have such a short waiting period), the sub-limit imposed is an issue. You might find the amount to fall short when planning a delivery in a reputable hospital. After confirming the pregnancy, the policy also offers you ante-natal (pre-birth/pregnancy) care. This is capped at ₹2.5k or ₹5k, based on your choice of the sum insured.
- Newborn Cover: While the newborn's hospitalisation expenses (including treatment of congenital internal and external defects/anomalies) are covered from Day 1, there is a sub-limit on this funding - the coverage is capped at 25% of the base sum insured. The treatments include -
- medical and surgical treatment expenses,
- neonatal and Postnatal surgery/repair,
- vaccination charges (₹2.5k to ₹3.5k, based on your choice of the sum insured),
- Pediatrician Consultation (up to 4 visits a year, and ₹500 per visit for a child below 12 years of age)
- Metabolic screening
For the subsequent years, if the additional premiums are paid for the child, they will be covered up to the sum insured for up to 25 years (if it’s a boy) and 30 years (if it’s an unemployed and/or unmarried girl/daughter).
4. Waiting period: Star Women Care health insurance policy comes with a set of waiting periods -
- Initial: 30 days
- Specific illness: 24 months
- Bariatric Surgery: 24 months
- Assisted Reproduction Treatment: 36 months
- Voluntary Sterilisation: 24 months
- Ante natal care: 12 months - 24 months
- In Utero Fetal surgery / Repair: 12 months - 24 months
- Delivery expenses: 12 months - 24 months
- Miscarriage due to accidents: 12 months - 24 months
- Pre-existing ailments: 24 months
In terms of waiting periods, this is a good policy. You rarely find another plan with such a short waiting period across almost all conditions.
5. Sub-Limit: If room rent restrictions are our primary concern, the disease-wise sub-limit ranks second. Most of the features that Star Women Care health insurance plans offer come with sub-limits. Such capping is a significant hurdle for you, considering that if and when the assigned amount falls inadequate, you will pay the residual amount out of your pocket despite having a health insurance plan.
Whether it is maternity expenses, reproductive assistance treatments, surrogacy features or newborn coverage - all come with sub-limits. The plan also offers OPD benefits, but as expected, that too comes with a cap. Here’s a look at the sub-limits based on your chosen cover amount -
| Sum Insured | OPD sub-limit |
|---|---|
| ₹5 lakhs to ₹15 lakhs | ₹2.5k |
| ₹20 lakhs and ₹25 lakhs | ₹3.5k |
| ₹50 lakhs and ₹1 crore | ₹5k |
Additionally, please remember that this perk is only available for a female policyholder and under this perk, one can enjoy unlimited gynaecologist consultation through the Star TeleHealth app.
What’s Unique About the Star Women Care Health Insurance Plan?
Star Women Care health insurance policy combines features like delivery expense coverage, newborn coverage, pre-and post-natal coverage, OPD benefits for insured females, surrogacy coverage, oocyte donor coverage, star mother coverage, and assisted reproductive treatment coverage. The offered coverage range is suitable for all. Only if the restrictions, sub-limits, and conditions hadn’t been there!
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Conclusion
Star Women Care's health insurance policy is a good plan if you look at the features. However, the hidden clauses and conditions will complicate the claim settlement process. Star’s track record with claim settlement reflects that they won’t be of much help either. Plus, there are issues with room rent restrictions and sub-limits, which further convinces us that this product can’t be an ideal plan for any policyholder.
