This document summarizes the key features of the Family Health Optima health insurance plan from Star Health. The plan provides health insurance coverage for the entire family, including the proposer, spouse, children up to age 25, and dependent parents, under a single policy with a single premium payment. Coverage includes expenses for hospitalization, day care procedures, room rent, pre- and post-hospitalization, and other benefits. The plan offers sum insured options from 3 to 25 lakhs and covers various medical costs with certain sub-limits and waiting periods applied to some procedures.

1. IRDA Registration No : 129; Corporate Identity Number : U66010TN2005PLC056649
CORPORATE OFFICE: No.1, New Tank Street, Valluvar Kottam High Road, Nungambakkam, Chennai - 600034. Ph: 044-28288800
Help Line. 99946 12916, 93628 54443 E-mail.: dhanasekaran.p@starhealth.in
FAMILY HELATH OPTIME REVISED WITH MULTIPLE BENEFITS
02.05.2017
Family Health Optima from Star Health is a health insurance plan that gives protection for the entire family on the
payment of a single premium under a single sum insured. The sum insured floats among the family members insured.
It's just one more way to tighten the family bonds.
 A Super Saver Policy
 Single Sum Insured
 Wider Coverage
 Coverage for entire family
 Single premium
 Considerable saving in premium as the family is covered under one policy.
FEATURES FAMILY HEALTH OPTIMA
ADULTS AGE AT ENTRY Any person aged between 18 years and 65 years, residing in India, can take this
insurance (residing in India)
FAMILY Proposer, spouse, dependent children from 16 days up to 25 years, (Children who are
economically dependent on their parents)
DEPENDANT CHILDREN From 16 days to 25 years
CHILDREN AGE AT ENTRY A Child above 16 days of age can be covered as part of the family. If, at the
commencement of the policy, the new born child as defined in the policy clause is less
than 16 days of age, the proposer can opt to cover such child also in the same policy by
paying the applicable premium in full. However, the cover for such child will commence
only from the 16th day after its birth and continue till the expiry date of the policy.
LIMITS OF CATRACT
SURGERY
SI 3,00,000/- Limit per eye Rs. 25,000/- Limit per policy period Rs. 35,000/-
SI 4,00,000/- Limit per eye Rs. 30,000/- Limit per policy period Rs. 45,000/-
SI 5,00,000/- Limit per eye Rs. 40,000/- Limit per policy period Rs. 60,000/-
SI 10,00,000/-, 15,00,000/-, 20,00,000/- and 25,00,000/- Limit per eye Rs. 60,000/- Limit
per policy period Rs. 75,000/-
SUM INSURED 3, 4, 5, 10, 15,20 and 25 Lakhs
CO PAY This policy is subject to co-payment of 20% of each and every claim amount for fresh as
well as renewal policies for insured persons whose age at the time of entry is above 60
years.
RENEWALS A Beyond 65 years, It can be renewed for life time.
PREMIUM RATING Premium based on Zone 1, 1A, Zone 2, & Zone 3 to be collected as per the residential
address of the customer.
Zone 1: Mumbai, Thane, Delhi including Faridabad, Gurgaon, Ghaziabad and Noida,
Ahmedabad, Baroda Surat Zone
Zone 1A: Chennai, Bangalore, Pune, Nasik, Ernakulum, Trivandrum, Rest of Gujarat
Zone 2: Coimbatore, Indore City, Rest of Kerala.
Zone 3: All remaining places & Locations other than Zone 1 1A & Zone 2
PRE-ACCEPTANCE MEDICAL
SCREENING
All persons above 50 years of age and those who declare adverse medical history in the
proposal form are required to undergo pre-acceptance medical screening at the
Company designated Centers The cost of such screening will be borne by the Company.
The age for screening and the cost sharing are subject to change.

2. IRDA Registration No : 129; Corporate Identity Number : U66010TN2005PLC056649
CORPORATE OFFICE: No.1, New Tank Street, Valluvar Kottam High Road, Nungambakkam, Chennai - 600034. Ph: 044-28288800
Help Line. 99946 12916, 93628 54443 E-mail.: dhanasekaran.p@starhealth.in
ROOM RENT/ NURSING &
BOARDING
ZONE 1 Zone 1A, Zone 2, Zone 3
SI 5,10,15,20 and 25 lacs : Single Std A/C room
SI 3 and 4 lacs : max of Rs.5000 per day
PRE & POST
HOSPITALIZATION EXPENSES
Pre & Post Hospitalization benefits extended to 60 & 90 days respectively with no caps
THER CHARGES INCLUDED A) Surgeon, Anesthetist, Medical Practitioner, Consultants & Specialist Fees.
C) Anesthesia, Blood, Oxygen, Operation Theatre charges, cost of Pacemaker etc.
E) Cost of Medicine and drugs
AMBULANCE CHARGES Rs 750/- per hospitalization up to max of 1500/- per policy period
AIR AMBULANCE COVER Up to 10% of the Basic sum insured per policy period. Available for Sum Insured of Rs. 5
Lakhs and above only.
DAY CARE PROCEDURES All day care procedures covered.
CAST OF HEALTH CHEK UP SI - 3,00,000/- Limit Per Policy Period Upto Rs. 750/-
SI - 4,00,000/- Limit Per Policy Period Upto Rs. 1,000/-
SI - 5,00,000/- Limit Per Policy Period Upto Rs. 1,500/-
SI - 10,00,000/-Limit Per Policy Period Upto Rs. 2,000/-
SI - 15,00,000/-Limit Per Policy Period Upto Rs. 2,500/-
SI - 20,00,000/-Limit Per Policy Period Upto Rs. 3,000/-
SI - 25,00,000/-Limit Per Policy Period Upto Rs. 3,500/-
AYUSH Treatment Expenses incurred on treatment under Ayurveda, Unani, Sidha and Homeopathy systems
of medicines in a Government Hospital or in any institute recognized by the government
and/or accredited by the Quality Council of India/National Accreditation Board on Health
is payable up to the limits given
SI 3,00,000/- to 4,00,000/- Limit per policy period Upto Rs. 10,000/-
SI 5,00,000/- to 15,00,000/- Limit per policy period Upto Rs. 15,000/-
SI 20,00,000/- and 25,00,000/- Limit per policy period Upto Rs. 20,000/-
BONUS ADDITIONS In respect of a claim free year of Insurance, for the Basic Sum Insured options
Rs.3,00,000/- and above, the insured would be entitled to benefit of bonus of 25% of the
expiring Basic Sum Insured in the second year and additional 10% of the expiring Basic
sum Insured for the subsequent years. The maximum allowable bonus shall not exceed
100%
ADDITIONAL SUM INSURED
FOR ROAD TRAFFIC
ACCIDENTA [RTA]
If the insured person meets with a Road Traffic Accident resulting in in-patient
hospitalization, then the Basic sum insured shall be increased by 25% subject to a
maximum of Rs. 5,00,000/- The additional sum insured shall be available only once
during the policy period and should be used for the particular hospitalization.
AUTOMATIC RESTORATION Such Automatic Restoration is available 3 times at 100% each time, during the policy
period. Each restoration will operate only after the exhaustion of the earlier one.
TAX BENEFITS Under sec 80 D
WAITING PERIOD A) 30 days waiting period.
B) 24 months waiting period for specified illness/diseases/treatments
C) 36 months waiting period for Assisted Reproduction Treatment.
For Accidental Injury - covered from DAY 1
INSTANT RECHARGE BENEFIT FREE OF COST extra coverage for all types of claims if and when the original SI becomes
insufficient, Upto 30% of SI ( Recharge SI filled only once in policy period & Facility for 3L
/ 4L / 5L only
AUTO COVER FOR NEW
BORN BABY
The coverage for New Born Baby starts from the 16th day after its birth till the expiry
date of the policy and is subject to a limit of 10% of the Sum Insured or Rupees Fifty

3. IRDA Registration No : 129; Corporate Identity Number : U66010TN2005PLC056649
CORPORATE OFFICE: No.1, New Tank Street, Valluvar Kottam High Road, Nungambakkam, Chennai - 600034. Ph: 044-28288800
Help Line. 99946 12916, 93628 54443 E-mail.: dhanasekaran.p@starhealth.in
thousand, whichever is less, subject to the availability of the sum insured, provided the
mother is insured under the policy for a continuous period of 12 months without break.
DONOR EXPENSES FOR
TRANSPLANT OF ORGANS
Payable where the insured is the recipient. Maximum payable under this head is 10% of
the sum insured or Rupees one lakh whichever is less, subject to availability of the sum
insured and provided the claim for transplantation is payable. Donor screening expenses
are not payable.
SHARRED
ACCOMMODATION
Insured person occupies, a shared accommodation during in-patient hospitalization,
then amount as per table given below will be payable for each continuous and
completed period of 24 hours of stay in such shared accommodation.
ASSISTED REPRODUCTION
TREATMENT
Reimburse medical expenses incurred on Assisted Reproduction Treatment.
SECOND MEDICAL OPINION Insured Person is given the facility of obtaining a Medical Second Opinion from a Doctor
in the Company's network of Medical Practitioners.
FIRST 2 YEAR EXCLUSION Cataract, diseases of the vitreous and retina, Diseases of the ENT, mastoidectomy/
tympanoplasty/stapedectomy, Diseases of the thyroid gland, Varicose veins and varicose
ulcers, Diseases of the prostate, Urethral stricture/obstructive uropathies, All types of
Hernia, Varicocele/ Hydrocele, Fistula/ fissure in ano, hemorrhoids/ Pilonidal sinus and
fistula, Congenital internal defect /disease, Gall bladder diseases and Stones (Calculii) in
any internal organ and its management/treatment, All and any treatment related to
female reproductive system /benign breast diseases, Any treatment related to
tendon/ligament/ fascia/bone and joints, Diseases of disc and vertebra including IVDP
(PIVD), Lumps/cysts of any type on any part of the body, Transplant of organs and
surgery
GENERAL EXCLUSION Maternity, Circumcision, Preputioplasty, Frenuloplasty, Preputial Dilatation and Removal
of SMEGMA, Inoculation or Vaccination, Congenital External Condition / Defects /
Anomalies, Dental treatment or surgery unless necessitated due to accidental injuries
and requiring hospitalization. (Dental implants are not payable), Intentional self-injury,
Psychiatric, mental and behavioral disorders, Treatment for Sub-Fertility, Treatment
arising from or traceable to pregnancy, childbirth, family planning, miscarriage, abortion
and complications of any of these (other than ectopic pregnancy), HIV / AIDS, Expenses
incurred on weight control services including surgical procedures, such as Bariatric
Surgery, Surgical treatment of Sleep apnea, treatment for genetic and endocrine
disorders, Expenses incurred on High Intensity Focused Ultra Sound, Uterine Fibroid,
Embolisation, Balloon Sinoplasty, Enhanced External Counter Pulsation Therapy and
related therapies, Chelation therapy, Deep Brain Stimulation, Hyperbaric Oxygen
Therapy, Rotational Field Quantum Magnetic Resonance Therapy, VAX-D, Low level laser
therapy, Photodynamic therapy, Expenses incurred on Lasik Laser or other procedures
Refractive Error Correction and its complications, Oral Chemotherapy, Immuno therapy
and Biologicals, except when administered as an in-patient, when clinically indicated and
hospitalization warranted. All types of Cosmetic, Aesthetic treatment of any description,
all treatment for erectile dysfunctions, Change of Sex. Plastic surgery (other than as
necessitated due to an accident or as a part of any illness), Cost of spectacles and
contact lens, hearing aids, walkers and crutches, wheel chairs, Nutritional Supplements,
CPAP, BIPAP, Continuous Ambulatory Peritoneal Dialysis [CAPD], infusion pump and such
other similar aids, Cochlear implants and procedure related hospitalization expenses.
Hospital registration charges, admission charges, record charges, telephone charges and
such other charges.

4. IRDA Registration No : 129; Corporate Identity Number : U66010TN2005PLC056649
CORPORATE OFFICE: No.1, New Tank Street, Valluvar Kottam High Road, Nungambakkam, Chennai - 600034. Ph: 044-28288800
Help Line. 99946 12916, 93628 54443 E-mail.: dhanasekaran.p@starhealth.in
How much to pay?
Attached Addition Premium Chart - Including GST 18%
.
Comparison of benefits between old FHO and revised FHO
Old FHO Revised FHO
5 SI options from 3 L to 15 L 7 SI options from 3 L to 25 L
Room rent based on SI, Class and Zone
Room rent based on SI only, 5000 for 3L & 5 L, single
standard AC room for SI 10 L and above
Only 405 day care procedures covered
Any and all day care procedure covered - Cataract
alone has sub limits
no air ambulance cover
Air ambulance available upto 10% of SI, for SIof 5 L
and above
Health check up in a block of 3 years Annually for every claim free year
New born baby cover available and 30 days waiting
period applicable
New born baby cover available, provided mother is
covered under the policy for a minimum of 12
months and 30 days waiting period does not apply
Emergency medical evacuation not available Emergency medical evacuation available
Compassionate travel not available Compassionate travel available
Repatriation of mortal remains not available Repatriation of mortal remains available
Lumpsum payout in treatment of company suggested
network hospital - not available
Lumpsum payout in treatment of company
suggested network hospital - availablefor SI 3 L and
above
2nd medical opinion not available 2nd medical opinion available online
Assisted Reproduction(infertility) treatment not
available
Assisted Reproduction(infertility) treatment available
for SI 5 L and above after a waiting period of 36
months
AYUSH treatment not covered AYUSH treatment covered for all SI with sublimit
Shared accommodation cash benefit not available
Shared accommodation cash benefit available for
each completed period of 24 hourof stay for SI 3 L
and above
Recharge benefit available for SI 3 L to 5 L Recharge benefit available for SI 3 L to 25 L
Automatic restoration of SI for 100% only
Automatic restoration in 3 instalments of 100% of SI
each (value up to 300%)
Additional SI for two wheeler road accident not
available
Additional SI of 25% for two wheeler road accident is
available upto a maximum of 5 lacs, Helmet wearing
essential
No claim bonus up to 35% of SI No claim bonus can be accumulated up to 100% of SI
Portability:
 This policy is portable. For details please contact SSM 99946 12916, 93628 54443.