SBI Arogya Plus Health Insurance Plan

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Amid the medical inflation and exorbitant hospitalization charges, SBI Arogya Plus Health Insurance Plan will work as a saviour. With this plan, you have the option to avail treatment close to 4400 network hospitals. There is no exit age for the plan, hence you can easily renew your policy throughout your lifetime.

Key Features of SBI Arogya Plus Health Insurance Plan

  • Daycare expenses covered up to 142 days
  • No pre-medical test required for people with no medical history up to the age of 55 years
  • Individual health insurance & Family Floater plans available
  • OPD expenses as per the policy schedule
  • No pre-medical test for applicants below the age of 55 years
  • Coverage of Maternity Expenses up to the OPD limit
  • You can easily renew your existing health insurance plan from other insurers with SBI health insurance
  • No co-payment required
  • Tax saving under Sec 80 D of Income Tax Act

Inclusions of SBI Arogya Plus Health Insurance Plan

This policy covers the following medical expenses:

  • 60 days of coverage for Pre-hospitalization expenses and 90 days after the hospitalization.
  • Ambulance expenses up to Rs. 1500
  • Domiciliary hospitalization expenses
  • Integral expenses incurred on anesthesia, oxygen, medicines, operation theatre, surgical appliances, chemotherapy, dialysis, radiotherapy, x-ray, pacemaker cost, and similar
  • Physiotherapy as part of in-patient care
  • The cost incurred on diagnostic procedures
  • Room charges, medical consultation fees, dressing charges, ICU, and nursing expenses
  • Domiciliary hospitalization cover
  • Maternity expenses are only covered under the OPD benefits
  • Dressing, plaster casts, and ordinary splints
  • Ambulance cover up to Rs. 1500
  • OPD treatment and consultation costs ( up to a specified limit)
  • 142 daycare procedures are also covered
  • Pre-hospitalization charges are covered for 60 days for each claim under the plan
  • Post-hospitalization charges are covered for 90 days for each claim under the plan
  • An alternative treatment that is taken in a government recognized institute or hospital

Plan Details

Sum Assured Options (Rs.): Sum Insured options of Rs. 1 lakh, 2 lakhs and 3 lakhs. OPD sum assured depends on the age of the insured person, medical history and the premium cost

Eligibility Criteria: The minimum entry age is 3 months and the maximum entry age is 65 years.

Policy Term: You can buy a 1 year, 2 years and 3-year plan

Premium: The premium for a 1 lakh policy is Rs. 8,900. The premium for a 2 lakh and 3 lakh plan is Rs. 13,350 and Rs. 17,800 per annum respectively.

Grace Period: 30 days of grace period for policy renewal

Exclusions of SBI Arogya Plus Health Insurance Plan

This plan won’t cover the following medical expenses:

  • Pre-existing disease before the completion of 4 years of the policy term
  • Som specified diseases to be covered after a waiting period of one year
  • Expenses incurred on overseas medical treatment
  • Treatment that is taken within 30 days of the policy purchase date
  • Epidemic diseases declared by the World Health Organization
  • Congenital diseases are not covered
  • Any alternative treatment such as aromatherapy, naturopathy, acupuncture, osteopath, homeopathic, reflexology and Ayurveda.
  • Treatment for sexually transmitted diseases, AIDS and HIV
  • Self-inflicted injuries and suicidal attempts
  • Medical treatment related to depression and mental disorders
  • Health treatment for an overdose of alcohol consumption and drug abuse

Claim Procedure for SBI Arogya Plus Health Insurance Plan

The company follows a simple and hassle-free claim process. Here’s how your claim will be processed:  

  • Lodge your claim request by calling SBI health insurance toll-free number
  • Original medical documents and claim-form needs to be submitted to initiate the claim process
  • After assessing the documents your  claim request will be approved or rejected
  • The claims are usually settled within 30 days of submitting the documents
  • For cashless hospitalization, a pre-authorization form needs to be submitted to the TPA desk at the hospital or to the insurance provider
  • In case of planned hospitalization, you need to intimate the insurer well in advance
  • In case of emergency hospitalization you need to immediately inform the insurer to initiate the claim process
Written By: PolicyBazaar - Updated: 01 April 2019
Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.
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