SBI Retail Health Insurance

According to insurance experts, it is not a good idea to depend just on a group health insurance that your employer offers. It is always advised to have an individual health insurance plan. One major reason for this is individual or retail health insurance plans are lifelong renewable. Even if the insurer discontinues an individual health plan, it is ported to another insurer. But this does not happen with group health insurance because the coverage ends as soon as the relationship ends. For instance, if you change your job, you will not have group coverage.

To address this need, SBI General Insurance introduced an SBI retail health insurance policy to provide financial protection in case of a medical emergency.

Anyone above the age of 18 years can buy SBI retail health insurance plan. The entry age for this plan is between 18 to 65 years. And children from 3 months can be covered only if one of the parents is covered under the retail health insurance policy by SBI. The plan can be purchased for individuals as well as families. Note that the family floater option does not cover dependent parents and covers self, spouse, and dependent children.

Let’s look at the key features of the policy.

• The policy offers coverage from ₹ 50,000 to ₹ 5,00,000.

• The policy is available for a tenure of 1 year.

• For people upto the age of 45 years with no medical history, no pre-policy medical check-up is required.

• Covers pre-hospitalization expenses for 30 days and post-hospitalization expenses for 60 days upto 10 % of the hospitalisation expenses.

• Provides free medical check-ups upto ₹ 2500 after 4 claim-free years.

• The plan is available in three flexible options depending on your location. These are plan A ( Delhi and Mumbai), Plan B ( Kolkata, Chennai, Ahmedabad, Bangalore, and Hyderabad), and Plan C (the Rest of India).

• Add-on covers are available for enhanced coverage at an extra cost, like removal.

• The policy has a waiting period of 48 months for pre-existing diseases. No disease or treatment is covered in the first 30 days of the policy except for accidents. Certain illnesses are also not covered for 90 days, 1 year, 2 years, and 3 years as per the policy terms.

Given below are the medical expenses covered in the SBI health insurance retail policy:

Hospitalisation expenses

The policy covers hospitalisation expenses for hospitalisation of more than 24 hours. These expenses include:

• Room rent, boarding charges, and nursing expenses upto 1 % of the sum insured.
• ICU charges covered upto 2% of the sum insured per day.
• All admissible expenses under the above points during the policy term upto 25% of the sum insured per claim/injury/illness.
• Fees for the surgeon, anaesthetist, consultant doctor, and specialist are upto 40% of the sum insured per illness/claim.
• Medical supplies and equipment related to the treatment covered upto 40% of the sum insured per illness/claim.

Ambulance charges

• It is covered upto 1 % of the sum insured for a maximum limit of ₹ 1500.

Parental care

• It covers persons above the age of 60 years and includes nursing charges after hospital discharge upto ₹ 500/day or the actual charges, whichever is less, for a period of 10 days for every hospitalisation.

Child care

• This facility is available for children below 10 years of age and includes escort charges of ₹ 500/day of hospitalisation to a maximum of 30 days in a policy term.

Cataract

• Treatment for cataracts is covered upto 15% of the sum insured to a maximum limit of ₹ 25,000 per eye after a waiting period of 2 years.

Alternative Treatments

• AYUSH treatments are covered if treatment is taken in a government hospital or government-recognized institute.

Domiciliary hospitalisation

• It is covered if domiciliary hospitalisation is for more than 3 days up to 20% of the sum insured to a maximum limit of ₹ 20,000.

Accidental hospitalisation

• It is covered up to 125% of the sum insured limit after deducting the claims paid and outstanding from the sum insured and to a maximum of ₹ 1,00,000.

Convalescence benefit

• Available for the age group between 10 to 60 years up to ₹ 5000/insured for 10 days or more only once in the insurance period.

Daycare expenses

• Covered for less than 24 hours of hospitalisation.

HIV/AIDS Cover, mental illness, and genetic disorders

• Covered upto ₹ 50,000.

Internal congenital diseases

• Out of the sum insured, the disease is covered up to 10%.

Advanced treatments</h3>

• 12 advanced procedures are covered upto 50% of the sum insured.

Here are the expenses that are not covered under the policy.

• Any treatment that is taken outside India
• Injury or disease resulting from a nuclear weapon or material.
• Admission for diagnostic, rest, or rehabilitation purposes.
• Treatments relating to weight loss or obesity
• Gender-change procedures
• Cosmetic surgery
• Unlawful acts or unproven treatments
• Sterility and infertility procedures

SBI general insurance is one of the leading insurance providers in India with a network of 6400+ rural banks, 24000+ SBI branches, 114 locations, 10000+agents, and 350+ brokers. With such a strong presence, the company undoubtedly has a better insurance penetration. SBI retail health insurance plan is a popular insurance plan. When compared to other plans, it is better priced, offers better benefits and better service with a wide network and a large number of branches all over the country. It also offers flexible options to choose pricing according to your location. For more details about the plan, feel free to contact Coverfox customer care at 02248971018.