SBI Retail Health Insurance Policy: An Overview

SBI Retail Health Insurance policy from SBI Health Insurance offers financial comfort in case of medical emergencies and financially empowers one to tackle all the costs of medical procedures. The policy covers the insured for in-patient medical expenses including pre and post hospitalisation expenses. 

SBI Retail Health Insurance Policy: Key Highlights

Coverage Offered

Based on their requirements, one can either opt for an Individual Plan or a Family Floater plan under the SBI Health Retail Health Insurance Policy. The sum insured can be chosen from Rs 50,000 to Rs 5 lakh. To buy online SBI Health Retail Insurance, one can fill in the required information on the SBI Health Insurance website and get the desired plan.

Everything that the SBI Retail Health Insurance Policy covers is detailed below:

• Hospitalization Expenses- Any in-patient hospitalization charges such as room rent, ICU charges are covered up to the sum insured.
• Pre-hospitalization Expenses Cover -Any medical expenses that are incurred 30 days before hospitalization are covered up to 10% of the SI.
• Post-hospitalization Expenses Cover- Up to 10% of the eligible hospitalization expenses incurred within 60 days post hospitalization are covered.
• Ambulance Charges- Ambulance expenses can be reimbursed up to Rs 1500.
• Free Medical Check-up- For every four claim-free years, free health check-up is offered up to a maximum of Rs 2500.
• Parental Care- Available for persons above 60 years with nursing charges up to Rs 500 per day, for a maximum of 10 days per hospitalization with a 15-days limit per policy period.
• Child Care- For a child below 10 years of age, Child Care benefit is covered up to Rs 500 per hospitalization with a 30-day limit per policy period.

Inclusions of the Policy

Anyone planning to buy SBI Retail Health Insurance Policy should be aware of the benefits offered by the policy. The SBI Retail Health Insurance Policy has the following benefits included:

• Accidental Hospitalization- For accidental hospitalization SI limit available for the insured will be 125% of the amount arrived after the deductions of the claims paid, subject to a maximum of Rs 1, 00,000.
• Alternative Treatment- Ayurvedic treatments are covered up to Rs 20,000 as per the sum insured. Other alternative treatments like Homeopathy and Unani are covered up to Rs 15,000 per policy period.
• Domiciliary Hospitalization- Treatment expenses exceeding 3 days towards domiciliary hospitalization can be claimed up to Rs 20000.
• Convalescence Benefit – Covered members who are above 10 years old and below 60 years of age, convalescence benefit is provided up to Rs 5000 per person for 10 days once a policy year.
• Day Surgery- Medical expenses incurred on procedures that require less than 24 hours of hospitalization are covered.
• Co-Pay- For any hospital admission not covered under the policy, 10% co-pay will be applicable along with the deductible.
• HIV/AIDS Cover- Medical expenses related to HIV/AIDS can be claimed up to Rs 50,000.
• Mental Illness & Genetic Disorders- Medical Expenses related to any mental illness or genetic disorders is covered up to Rs 50,000.
• Internal Congenital Diseases- Treatment expenses for Internal Congenital Diseases are covered up to 10% of the sum insured.
• 12 Advanced treatments procedures- Medical Procedures that require advanced treatment are covered up to 50% of the SI.

Exclusions of the Policy

The SBI Retail Health Insurance Policy does not cover the treatments listed below:

• Treatments outside India
• Injuries caused by nuclear weapons
• Evaluation Treatments
• Rehabilitation Treatments
• Obesity-related treatments
• Gender change treatments
• Cosmetic surgery expenses
• Refractive Error Treatment
• Treatments due to any sports injury
• Breach of Law
• Infertility and Sterility
• Unproven Treatments

Please refer to the policy document for a detailed list of exclusions.

Benefits and Features of the SBI Retail Health Insurance Plan

The SBI Retail Health Insurance plan offers the following benefits and features:

• Pre-policy medical test is not required up to 45 years
• 30 day waiting period, except for accidents, and 90 days to 3 years of the waiting period for specifically listed illnesses
• Add-on covers with policy
• Free medical check-up
• Wider coverage
• Flexible Plan options are available
• Premium payment is exempt from Income Tax under Sec 80 D of Income Tax Act

Cancellation of the Policy

Guidelines on cancellation of the SBI Health Insurance policy are mentioned below:

• One may cancel the policy after giving a 15-days written notice.
• For a period up to 1, 3, and 6 months, 75%, 50%, and 25% of the annual rate are refunded, respectively.
• The insurer may also cancel the policy on the ground of fraud and misrepresentation of medical facts by the policyholder.

Eligibility Criteria

One has to fulfill the following eligibility conditions to buy this policy: