Overview
Star Special Care is a specialized health insurance plan designed for children aged 3 to 25 diagnosed with Autism Spectrum Disorder (ASD). It offers a sum insured of ₹3 lakhs and covers room, boarding, and nursing expenses, surgeon fees, anesthesia, and ambulance charges. Above all, the plan provides decent care for children with ASD.
Experts Review
Written by Nikhil Nair
Senior Writer
The Star Special Care plan is tailored specifically for children with Autism Spectrum Disorder, which is a great niche to address. With a sum insured of ₹3 lakhs, it provides a decent financial safety net for medical expenses related to ASD. I appreciate that it covers room, boarding, and nursing expenses, as well as surgeon fees and anesthesia costs.
On the downside, the plan comes with a 20% co-payment on each claim. Also, Star Special Care has room restrictions and limited pre- and post-hospitalization coverage. More specifically, it has sub-limits for certain ailments such as adenotonsillectomy and hospitalization for treatment of seizures.
Pros
Insurer has a solid track record with great claim and service metrics.
Offers Autism Spectrum Support, which makes this policy stand out.
Cons
Not very feature-rich.
No Restoration Benefit, which is a notable gap.
No Bonus for being healthy and not claiming insurance, which could be a drawback for some.
Your insurer doesn’t provide free health check-ups, 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
Autism Spectrum Support
STANDOUT
This is a specially designed policy for children diagnosed with Autism Spectrum Disorder.
Co-payment
The policy will only cover 80% of the final bill. The rest is on you. They call this a co-payment.
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 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. But there is a 90 days waiting period for HIV/AIDS and 2 years for Pre-Existing Disability.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Convalescence, general debility, run-down condition, Nutritional deficiency states
Venereal disease, Sexually transmitted diseases, other than HIV
Cerebral palsy, Mental retardation, Chromosomal and Genetic abnormalities
Chondrocyte Implantation, Bone marrow transplantation
Naturopathy Treatment
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.
Diseases of the anterior and posterior chamber of the eye (e.g., cataract, glaucoma, retinal issues)
Diseases of ENT (e.g., sinusitis, tonsillitis, adenoidectomy, mastoidectomy, tympanoplasty, septoplasty)
All types of hernia
All obstructive uropathies (e.g., BPH, urethral strictures)
Hydrocele
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 Restoration Benefit.
No Bonus for being healthy and not claiming insurance.
Your insurer doesn’t provide free health check-ups.
No coverage if you are forced to hospitalize at home.
Maternity benefits not offered.
Doctor consultations are not covered.
Customer Reviews
R
Rajesh Khanna
This plan for children with ASD is a blessing. Finally, something specific for our needs.
M
Meera Malhotra
Covers room, boarding, and nursing expenses, which are major costs. Thank you Star Health.
A
Alok Mehra
Surgeon fees and anesthesia costs being included gives a lot of financial relief.
V
Vandana Tandon
Sub-limits for adeno tonsillectomy and seizures can be problematic. Wish it was full cover.
S
Simran Saini
The 20% co-payment on each claim is quite high, especially for recurring expenses.
P
Priya Puri
The focus on comprehensive care for children with ASD is evident in the coverage details.
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Frequently Asked Questions
Does Special Care 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 Special Care have room rent restrictions?
Does Special Care offer a restoration benefit?
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