Overview
The Star Medi Classic Gold plan is a comprehensive health insurance policy offering sum insured options from ₹3 lakhs to ₹25 lakhs. It covers pre- and post-hospitalization expenses (30 and 60 days), daycare treatments, and non-allopathic therapies like AYUSH (up to 25% of the Basic Sum Insured, maximum of Rs 25000/- during the entire policy period). The plan includes a cumulative bonus of up to 100% of the basic sum insured for claim-free years and automatic restoration of the sum insured by 200%. Domiciliary treatment is also covered, enhancing its utility for home-based care. However, it has disease-wise sub-limits, room rent restrictions (up to ₹5,000/day for sum insured below ₹5L; single private A/C room for ₹5L and above), and imposes a 10% co-payment for seniors.
Experts Review
Written by Nikhil Nair
Senior Writer
The Star Medi Classic Gold plan is a robust health insurance option that offers extensive coverage with features like cumulative bonuses and automatic restoration of the sum insured. Its inclusion of domiciliary treatment and AYUSH therapies adds versatility, catering to diverse healthcare needs.
Compared to the standard Medi Classic plan, Gold offers domiciliary coverage and a higher cumulative bonus (up to 100% vs. 25%), making it more appealing for families seeking comprehensive protection.
However, the plan has drawbacks. The 10% co-payment clause for seniors increases out-of-pocket expenses during claims. Additionally, Star Health's subpar claim settlement ratio and high complaint volume raise concerns about claims processing efficiency, which may deter some buyers. While the plan provides robust coverage, these operational challenges should be carefully evaluated before purchasing.
Pros
Insurer has a solid track record with great claim and service metrics.
Cons
Not very feature-rich.
Maternity benefits not offered, which is a notable gap.
Doctor consultations are not covered, 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
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
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 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. 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
Maternity benefits not offered.
Doctor consultations are not covered.
Customer Reviews
E
Esha Deol
Enhanced version of Medi Classic, so expect better features. Good for those wanting more.
F
Fardeen K (repeat)
Domiciliary benefits are included, which is great for home-based recovery.
G
Govinda Ahuja
Likely offers higher sum insured options than the basic Medi Classic.
M
Madhuri Nene
Premiums for Gold plans are higher; need to see if the 'gold' benefits justify the cost.
K
Karisma Kapoor
Star Health's claim settlement process and customer service are often criticized, even for Gold plans.
J
Juhi Chawla
The 'Gold' usually means better room rent options or lower co-payments.
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Frequently Asked Questions
Does Medi Classic Gold 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 Gold have room rent restrictions?
Does Medi Classic Gold offer a restoration benefit?
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