Policy explained · Star Health
Star Health Comprehensive: what your policy covers
Star Health Comprehensive limits the room to a private single AC room on every sum insured. It has a 10% co-pay if you joined at 61 or older and a 24-month wait for knee & hip replacement. A room category has no rupee figure, so this page shows the limits in words and no rupee example.
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At a glance
- 🛏️Room rentA private single AC room; conditions apply, see the termsPolicy wordings, page 9, read 27 Sep 2026
- 🧾10%Co-payIf you joined at 61 or olderNot in the worked examplePolicy wordings, page 39, read 27 Sep 2026
- ⏳24 monthsKnee & hip replacement waitOver by month 30Policy wordings, page 32, read 27 Sep 2026
- ⏳36 monthsPre-existing conditions waitNot over at month 30Policy wordings, page 31, read 27 Sep 2026
- 🩹Not coveredConsumablesThese are yours to payPolicy wordings, page 35, read 27 Sep 2026
Waiting periods, month by month
- Pre-existing conditions36 monthsNot over at month 30
- Knee & hip replacement24 monthsOver by month 30
- Spine surgery24 monthsOver by month 30
- Prostate surgery24 monthsOver by month 30
- Hysterectomy24 monthsOver by month 30
- Bariatric surgery36 monthsNot over at month 30Conditions apply, see the terms
Worked example: a knee & hip replacement bill
A room category, not a rupee limit. We do not show a rupee example for this policy, because:
- The limit is a room category (a single AC room), not a rupee amount.
The limits as the policy states them:
- Room rent limit: A private single AC room. Condition: The hospital's most economical single-occupancy AC room with an attached washroom, not a deluxe room or suite. The same on every sum insured. (Policy wordings, page 9, read 27 Sep 2026)
- Co-pay: 10% of the claim is yours if you joined at 61 or older (Policy wordings, page 39, read 27 Sep 2026)
- A limit of ₹2,50,000 applies if you have robotic surgery (policy wordings).
Every room rent limit in the documents we read:
Room (Private Single A/C room), Boarding and Nursing Expenses as provided by the Hospital / Nursing Home.
Policy wordings, page 9
1. Room category: Private Single A/C room
Customer information sheet (CIS), page 10
Ask what you would pay for knee & hip replacement on your plan
The terms, with the policy text
15 terms read from the Star Health Comprehensive documents (UIN SHAHLIP26044V092526). Open a source to read the policy text, its conditions and the page.
| Term | What it means | Policy text and source |
|---|---|---|
| Room rent limit | A private single AC roomLimit applies | Policy wordings, page 9Condition: The hospital's most economical single-occupancy AC room with an attached washroom, not a deluxe room or suite. The same on every sum insured. Room (Private Single A/C room), Boarding and Nursing Expenses as provided by the Hospital / Nursing Home. |
| Co-pay | 10% of the claim is yours if you joined at 61 or olderOnly in some cases | Policy wordings, page 39Co-payment: This policy is subject to co-payment of 10% of each and every claim amount for fresh as well as renewal policies for Insured Persons whose age at the time of entry is 61 years and above. This co-payment will not apply for those insured persons who have entered the policy before attaining 61 years of age and renew the policy continuously without any break. |
| Proportionate deduction | Applies: if your room costs more than the limit, the insurer cuts the charges linked to the room in the same ratioCan cut your bill | Policy wordings, page 9Associated Medical Expenses means expenses that shall include the applicable nursing charges, Operation theatre charges, Professional fees of Medical Practitioner including Surgeon/ anesthetist / Physician/Specialist of the Hospital where the Insured Person has been admitted and treated and hence Proportionate deduction will be applicable on these items. “Associated Medical Expenses” does not include cost of pharmacy and consumables, cost of implants and medical devices and cost of diagnostics, ICU charges and hence proportionate deduction will not be applicable on these items. / Any hospitalization expenses arising under this Policy, which vary based on the room rent occupied by the Insured Person will be considered in proportion to the room rent limit / room category stated in the Policy or actuals whichever is less. |
| Consumables (gloves, masks and other non-medical items) | Not covered: these are yours to payNot covered | Policy wordings, page 3534. Other Excluded Expenses as detailed in the website www.starhealth.in - Code Excl 37 |
| Costs before and after the hospital stay | 60 days before admission, 90 days after dischargeCovered | Policy wordings, page 115. Pre-Hospitalization Expenses: Medical expenses incurred for a period not exceeding 60 days prior to the date of hospitalization are payable subject to an admissible hospitalization claim. 6. Post-Hospitalization Expenses: Medical expenses incurred for a period up to 90 days from the date of discharge from the hospital |
| Waiting period for pre-existing conditions | 36 months of continuous coverNot over at month 30 | Policy wordings, page 311. Pre-Existing Diseases - Code Excl 01 A. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer. |
| Waiting period for knee & hip replacement | 24 months of continuous coverOver by month 30 | Policy wordings, page 32iii. 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]. |
| Waiting period for spine surgery | 24 months of continuous coverOver by month 30 | Policy wordings, page 32iv. 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), |
| Waiting period for prostate surgery | 24 months of continuous coverOver by month 30 | Policy wordings, page 32ix. All Diseases of Prostate, Stricture Urethra, all Obstructive Uropathies, |
| Sub-limit for prostate surgery | No sub-limit on laser vaporisation of the prostateNo sub-limit | Customer information sheet (CIS), page 11Condition: The modern treatment table pays laser vaporisation of the prostate up to the sum insured. It states no limit for other prostate surgery. Vaporisation of the prostrate IONM Limits in Rs. 5,00,000/- Upto the Sum Insured |
| Waiting period for hysterectomy | 24 months of continuous coverOver by month 30 | Policy wordings, page 32related to all Diseases of Cervix, Uterus, Fallopian tubes, Ovaries, Uterine Bleeding, Pelvic Inflammatory Diseases |
| Waiting period for bariatric surgery | 36 months of continuous coverNot over at month 30 | Policy wordings, page 15Condition: You must be over 18, and a cashless claim needs prior approval. This benefit is subject to a waiting period of 36 months from the date of first commencement of this policy and continuous renewal thereof with the Company. |
| Sub-limit for bariatric surgery | ₹2,50,000Limit applies | Policy wordings, page 15Condition: For a sum insured of ₹5 lakh to ₹15 lakh. Above ₹15 lakh the limit is ₹5,00,000. 5,00,000/- to 15,00,000/- 2,50,000/- |
| Exclusion rule for bariatric surgery | Covered when the policy's conditions are metConditions apply | Policy wordings, page 336. Obesity/ Weight Control - Code Excl 06: Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions; |
| Robotic surgery sub-limit | ₹2,50,000Limit applies | Policy wordings, page 10Condition: The robotic-surgery limit for a ₹5 lakh sum insured. 5,00,000/- 2,50,000/- 2,00,000/- |
Questions
Does Star Health Comprehensive have a room rent limit?
At a ₹5 lakh sum insured: a private single AC room. The hospital's most economical single-occupancy AC room with an attached washroom, not a deluxe room or suite. The same on every sum insured. Source: Policy wordings, page 9, read 27 Sep 2026.
How is proportionate deduction calculated on Star Health Comprehensive?
If your room costs more than the room rent limit, the insurer divides the limit by your room's daily rent and pays that share of the charges linked to the room. Source: Policy wordings, page 9, read 27 Sep 2026.
Check your own policy
Send your policy on WhatsApp. A person reads it and works out what your stay would cost you before you are admitted.
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Sources
- Star Health Comprehensive: policy wordings (accessed 27 Sep 2026)
- Star Health Comprehensive: customer information sheet (cis) (accessed 28 Aug 2026)