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SBI Health Insurance Policy

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SBI Health Insurance Plan

SBI Health Insurance Plan is a comprehensive health insurance policy which covers medical treatment expenses. The plan helps insured to bear the high cost of medical treatment expenses & stay financially stable.

 

Key Features of SBI Health Insurance Plan

  • Worldwide Coverage
  • No Medical Test up to age 45 
  • Maximum Entry Age up to 65 years
  • Family Floater option
  • Tax Exemption under Section 80D

 

What is covered in SBI Health Insurance Plan?

The policy offers the following 19 expenses:- 

Sr. No

Type of expense

Expense limit (in Rs.)

1.

Medical Treatment with Room, Up to 1% of the Board & Nursing Expenses & Sum Insured per day Service Charges etc.

Up to 1% of the sum assured (SI) per day

2.

Medical Treatment in Intensive Care Unit (ICU)

Up to 2% of the SI per day

3.

All admissible claims under 1 & 2 during the policy period

Up to 25% of the SI per illness/injury per claim

4.

Consultants & Specialists Fees

Up to 40% of the SI per illness/injury per claim

5.

Anaesthesia, Blood, Oxygen, OT Charges, Surgical Appliances

Up to 40% of the SI per illness/injury per claim

6.

Pre-hospitalisation

Up to 10% of the eligible hospitalisation expenses incurred 30 days prior to date of

admission into the hospital

7.

Post-hospitalisation

Up to 10% of the eligible hospitalisation expenses incurred 60 days after the date of

discharge from the hospital

8.

Ambulance charges

1% of SI up to a max of Rs. 1500

9.

Free Medical Check-up

Free medical check-up - 1% of SI up to a max of Rs. 2500 for every 4 claim free year

10.

Parental Care: Attendant nursing charge to take care of you parents who are above 60 years of age

Available for persons above 60 years old. Attendant nursing charges after discharge from the hospital for Rs. 500 or actual whichever is less per day up to a maximum 10 days per hospitalisation. The charges can be reimbursed for a period of 15 days during the entire Policy period.

11.

Child Care: Attendant escort charges to take care of child below 10 years of age

Available for child below 10 years. Attendant escort charges of Rs 500 for each completed day of hospitalisation subject to maximum of 30 days during the Policy Period.

12.

Limit of Cataract

15% of sum insured subject to maximum of 25000 per eye subject to first two years exclusion.

13.

Accidental Hospitalization

SI under the policy shall increase by 25% of the balance sum insured available subject to max of Rs.1 Lac.in case of accidental hospitalisation. Payable only once under the Policy per person

14.

Alternative Treatment

Reimbursement of Ayurvedic Treatment up to a maximum of15% of Sum Insured per Policy period up to a maximum of Rs. 20000 & Homeopathy and Unani Treatment up to a maximum 10% of Sum Insured per Policy period up to a maximum of Rs. 15000.

15.

Domiciliary Reasonable

Reasonable and Customary Charges towards Domiciliary Hospitalisation as defined in Policy definition subject to 20% of the Sum Insured maximum up to Rs. 20000 whichever less is

16

Convalescence Benefit (Benefit available for Insured above Insured 10 years & below 60 years

Covers the convalescence expense up to an amount not exceeding Rs. 5,000/- per Insured, if the insured is hospitalised for any bodily injury or illness as covered under the Policy, for a period of 10 consecutive days or more. Admissible only once during the Period of Insurance.

17.

Co-Payment on all eligible admissible in non-network hospitals

10% on all eligible admissible claims

18.

Cash Less facility

Across SBI General Network hospitals

19.

Coverage for selected day care surgeries within 24 hours of hospitalization

Covers select Day Surgery where less than 24 hours hospitalisation for specified procedures like Dialysis, Chemotherapy, Radio therapy, Eye Surgery, Dental Surgery (Due to accident), Tonsillectomy, etc are covered.



 

Eligibility Criteria and other conditions in SBI Health Insurance Plan

Particulars

Minimum

Maximum

Entry Age (in years)

18

65

Sum Coverage (in Rs.)

50,000

5,00,000



 

Additional Features of SBI Health Insurance Plan

Free look period – If the policy holder is not convinced with the terms and conditions of the policy, s/he can cancel the same within 15 days of the receipt of policy document.

Long time Renewability – The policy can be renewed for a life time.

Add-on Covers - available including removal of sub-limits on Room & ICU rent, Operation and Consultancy charge\

 

Exclusions - What is not covered in SBI Health Insurance Plan?

  • Pre-existing illnesses within first 48 months from the policy inception date
  • Disease contracted during the first 30 days from the policy inception date
  • Certain diseases/surgeries like Hernia, Hydrocele etc shall be covered after a waiting period of 1 year.
  • Certain diseases like Cataract, Hysterectomy shall be covered after a waiting period of 2 years from commencement of Policy. 
  • Joint replacement surgery shall be covered after a waiting period of 3 years from commencement of Policy except done due to an accident. 
  • Treatment with alternative medicines like acupuncture, acupressure, osteopath, naturopathy, chiropractic, reflexology and aromatherapy 
  • Treatment arising from or traceable to pregnancy (whether uterine or extra uterine) and childbirth including caesarean section, and/or any treatment related to prenatal and postnatal care.
  • Congenital Illness/Conditions
  • Expenses arising from HIV or AIDS and related diseases.
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.

 
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