SBI Arogya Top up Policy: An Overview

As the name suggests, SBI Arogya Top up Policy works on a participative cost-sharing basis. Here, the medical expenses, up to a specific limit, are borne by the policyholder. The Insurer comes into the picture only if the medical expenses exceed the deductible limit. The additional costs incurred over and above that limit are then paid out of the top-up insurance policy. SBI Arogya Top up Policy is a known Top-up health insurance policy that offers unrivaled financial coverage in case the existing medical insurance crosses the threshold limit.

SBI Arogya Top up Policy: Key Highlights 

Coverage Offered

To buy SBI Arogya Top up Policy, an individual can opt for the Individual or Family Floater option with a Sum Insured in the range of Rs 1 lakh up to 5 lakh. The scope of coverage under this policy is:

In-patient treatment

The In-patient hospitalization expenses coverage would include the following:

1. All Room rent, boarding and nursing expenses
2. Medical Practitioner's Fees (including expenses incurred on Tele-consultation)
3. Expenses incurred on anesthesia, blood, oxygen, medicines & consumables, operation theatre charges, surgical appliances and any medicinal expenses incurred, which is an essential part of the surgery
4. Intensive Care Unit (ICU) charges
5. Diagnostic costs, X-ray, dialysis, radiotherapy, chemotherapy, pacemaker costs, prosthesis or internal implants
6. Physiotherapy, if it is an essential part of the inpatient care and ongoing treatment.

Pre-hospitalization Cover- Expenses incurred up to 60 days before admission in the hospital or in the case of domiciliary hospitalization would be covered.

Post- hospitalization Cover- Expenses incurred up to 90 days after discharge from the hospital or in the case of domiciliary hospitalization would be covered.

AYUSH treatment- Expenses incurred under the Ayurvedic, Homeopathy, Siddha and Unani treatment in a government recognized institute would be covered.

Inclusions of the Plan

The list of coverage under this policy includes:

1. Expenses incurred on Ambulance services up to Rs 5000 per hospitalization
2. Costs incurred on Maternity after the first 9 months are covered.
3. Treatment for HIV/AIDS up to Rs 1,00,000 would be covered except for the conditions which are permanently excluded.
4. Treatment for Genetic Disorders up to Rs 1,00,000 would be covered.
5. Under the Day Care benefit, 141 procedures that do not require 24 hours of hospitalization would be covered.
6. Expenses incurred on 12 developed treatments & procedures, up to 50% of the Sum Insured, would be covered.
7. Expenses incurred on Organ donors' treatment for the harvesting of donated organs would be covered.
8. Treatment for Mental Illness up to Rs 1,00,000 is offered.
9. Inherited internal ailments up to 10% of Sum Insured are included.

Exclusions of the Plan

The plan will not cover any treatment or expenses related to the following:

1. Diagnostic or evaluation
2. Rest cure, rehabilitation and respite care
3. Cosmetic surgery, sterility or infertility
4. Obesity treatment or surgery
5. Unproven treatment
6. Gender-Change
7. Any treatment taken abroad
8. Any error or breach of law on the part of the insured

Please refer to the Policy document for a complete list of exclusions.

Features & Benefits of the SBI Arogya Top up Policy

Given below are the main features and benefits of the SBI Arogya Top up Policy:

1. Comprehensive insurance coverage from Rs 1,00,000 up to Rs 50,00,000
2. No medical check-up required if the life insured don't have any medical history up to 55 years of age
3. Comprehensive insurance coverage of Pre and post-hospitalization.
4. Treatment under the AYUSH method
5. Income Tax exemption would be provided under Section 80D of the Income Tax Act.

Eligibility Criteria

The minimum eligibility conditions to buy this policy are:

Cancellation of the SBI Arogya Top up Policy

To surrender the SBI Arogya Top up Policy, the policyholder or life insured must visit the nearest branch of SBI General Health Insurance Company and submit the properly filled surrender request form, policy details, canceled cheque and rationale for cancellation.