SBI Health Insurance Policy

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.

Particulars

Minimum

Maximum

Entry Age (in years)

18

65

Sum Coverage (in Rs.)

50,000

5,00,000