Overview
The Star Medi Classic plan is a comprehensive health insurance policy offering sum insured options ranging from ₹1.5 lakhs to ₹15 lakhs. Key features include coverage for modern treatments like robotic surgeries with sub-limits, non-allopathic therapies (AYUSH) (up to 25% of the Basic Sum Insured subject to a maximum of Rs 25000), and pre & post hospitalization (30-60 days respectively, however the amount payable shall not exceed the sum equivalent to 7% of the hospitalization expenses subject to a maximum of Rs.5000/- per hospitalisation). It also comes with a 200% automatic restoration of the sum insured, ensuring financial security during multiple claims. Additional benefits include a cumulative bonus for claim-free years (5% increase up to 25% of Base SI), and coverage for daycare procedures. The plan also provides cashless treatment across 14,000+ network hospitals.
Experts Review
Written by Nikhil Nair
Senior Writer
The Star Medi Classic plan has innovative features like the 200% restoration benefit, which ensures uninterrupted protection during multiple claims within the same policy year. Coverage for modern treatments such as robotic surgeries (with sub-limits depending on the Base SI & condition) and AYUSH therapies broadens the policy’s scope to address diverse healthcare needs.
That said, the plan has many limitations. Room rent is capped at 2% of the Sum Insured, subject to a maximum of Rs. 5,000/- per day, which may restrict premium accommodation choices during hospitalization.
Additionally, a co-payment of 10% applies to claims for individuals aged 61 and above, increasing out-of-pocket expenses for senior citizens. From an insurer's POV, Star Health has continually showcased subpar claim settlement ratio, complaint volume, and incurred claim ratio, which have a direct impact on the efficiency of claims processing.
Pros
Insurer has a solid track record with great claim and service metrics.
Cons
Not very feature-rich.
No coverage if you are forced to hospitalize at home, which is a notable gap.
Maternity benefits not offered, which could be a drawback for some.
Doctor consultations are not covered, which is a key feature.
Star Health
Key Insights
Founded
2006
Star Health was established 19 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
85% claims settled in 30 Days
Star Health settles only 85% of claims it receives, which is relatively low and may raise concerns about reliability during claim payouts.
Network Hospitals
14,000+
Star Health has a strong network with over 14,000 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
52 complaints per 10,000 claims registered
Star Health has a relatively high volume of complaints, which may point to ongoing issues in customer service or claim handling.
Features
All
Great
Good
Bad
Co-payment
If you bought this policy after you turned 61, you have to pay 10% of the bill every time you make a claim. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
Room Rent
Your insurer won’t let you stay in a room whose rent exceeds ₹5,000. But in the event, you breach this limit, get ready to pay a lot more.
Disease sub-limit
Your insurance cover won’t be fully available in case you are treated for cataracts, modern treatments and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge (but not exceeding 7% of the hospitalization expenses or ₹5,000 per hospitalization whichever is less). This includes the cost of medication by the way.
Add-ons
Hospital Cash
Hospital cash benefit paid out if hospitalization is at least 1 day, with a maximum payout of ₹1000 for up to 14 days.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Expenses incurred on Enhanced External Counter Pulsation Therapy and related therapies, Chelation therapy, Hyperbaric Oxygen Therapy, Rotational Field Quantum Magnetic Resonance Therapy, VAX-D, Low level laser therapy, Photodynamic therapy & other similar therapies
Autologous derived Stromal vascular fraction, Chondrocyte Implantation, Procedures using Platelet Rich plasma and Intra articular injection therapy
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Treatment of Cataract and diseases of the anterior and posterior chamber of the Eye(other than retinal detachment), Diseases of ENT, Diseases related to Thyroid, Benign diseases of the breast
Subcutaneous Benign Lumps, Sebaceous cyst, Dermoid cyst, Mucous cyst lip / cheek, Carpal Tunnel Syndrome, Trigger Finger, Lipoma, Neurofibroma, Fibroadenoma, Ganglion and similar pathology
All treatments (Conservative, Operative treatment) and all types of intervention for Diseases related to Tendon, Ligament, Fascia, Bones and Joint Including Arthroscopy and Arthroplasty / Joint Replacement [other than caused by accident]
All types of treatment for Degenerative disc and Vertebral diseases including Replacement of bones and joints and Degenerative diseases of the Musculo-skeletal system, Prolapse of Intervertebral Disc (other than caused by accident)
All treatments (conservative, interventional, laparoscopic and open) related to Hepato-pancreato-biliary diseases including Gall bladder and Pancreatic calculi.
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
What's missing in the policy
No coverage if you are forced to hospitalize at home.
Maternity benefits not offered.
Doctor consultations are not covered.
Customer Reviews
S
Santosh Mishra
Coverage for modern treatments like robotic surgeries is a good inclusion.
S
Sarala Iyer
Non-allopathic therapies (AYUSH) coverage offers more treatment choices.
S
Satish Menon
Psychiatric disorders coverage is a very important and progressive feature.
S
Shekhar Chandra
The plan has sub limits modern treatments, cataracts
S
Sharad Das
Star Health's claim settlement reputation is a significant concern.
S
Shalini Jain
Seems like a comprehensive plan covering many aspects of healthcare.
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Frequently Asked Questions
Does Medi Classic have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
Does Medi Classic have room rent restrictions?
Does Medi Classic offer a restoration benefit?
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