Overview
The Star Cardiac Care Platinum plan is a specialized health insurance policy designed for individuals with heart ailments, offering coverage up to ₹15 lakhs. It covers modern treatments, heart transplants, coronary angiograms, and heart devices, with no pre-policy medical tests required. It features optional lump sum coverage for recurrence or metastasis of cancer and offers flexible premium payment options. It also offers a no-claim bonus. Every year, you go without making a claim, your sum insured grows by 10% up to a maximum of 100% of the sum insured.
Experts Review
Written by Nikhil Nair
Senior Writer
The Star Cardiac Care Platinum plan is tailored for those with existing or high-risk heart conditions, offering extensive coverage up to ₹15 lakhs. Its key features include coverage for advanced treatments such as heart transplants, modern treatments, and coronary angiograms, which are often excluded or limited in other plans. The policy also covers heart devices like pacemakers and provides pre- and post-hospitalization expenses, along with ambulance charges and day care procedures, making it comprehensive for cardiac patients.
However, the plan’s credibility is questionable due to Star Health’s poor claim settlement record, with an average claim settlement ratio of around 83% from 2021 to 2024, and high rejection rates.
The insurer also faces significant grievances, with the highest complaint volume (average of 46 for every 10,000 claims over 3 years) among peers, indicating operational challenges. Premiums are relatively high, approximately 20-25% more than comparable plans, reflecting the extensive coverage but raising affordability concerns. The waiting period for coverage of heart ailments is 36 months, which may be lengthy for urgent needs.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
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.
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
Pre existing diseases waiting
STANDOUT
If you are already dealing with cardiac ailments, then the insurer will cover you from day 31. However, if you are dealing with other pre-existing diseases including thyroid, diabetes, etc, then you’ll have to wait 3 years before they start covering these complications.
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Disease sub-limit
Your insurance cover won’t be fully available in case you are treated for cardio vascular conditions, 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/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. This includes the cost of medication by the way.
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.
Cataract and diseases of the anterior and posterior chamber of the eye
Diseases of ENT (Ear, Nose, Throat)
Thyroid-related diseases
Prolapse of intervertebral disc (except when caused by accident)
Varicose veins and varicose ulcers
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.
Customer Reviews
R
Rohit S (new)
Tailored for existing heart conditions, covers advanced treatments like heart transplants.
R
Ruby V (new)
Covers robotic surgeries and coronary angiograms, often limited in other plans.
S
Sachin G.
Covers heart devices like pacemakers, which is crucial for cardiac patients.
S
Sunil J (new)
Premiums are 20-25% higher than comparable plans, and the 36-month waiting period for pre-existing ailments is long.
S
Shanti K (new)
Star Health’s poor claim settlement record (around 83%) and high rejection rates are very concerning.
S
Sarika P (new)
A comprehensive option if you have a history of heart ailments.
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Frequently Asked Questions
Does Cardiac Care Platinum 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.
- Cardiac Ailment Waiting Period: For pre-existing cardiac ailments, the waiting period is 30 days.
Does Cardiac Care Platinum have room rent restrictions?
Does Cardiac Care Platinum offer a restoration benefit?
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