SBI Arogya Top-up Policy

What is SBI Arogya Top-Up Policy?

Life is too uncertain. With medical inflation reaching sky high, the expenses can literally wreck you down in case of some serious illness or accident. There might be times, when the medical expenses can be even higher than the total sum insured amount of your regular health insurance policy. But, with SBI General’s Arogya Top-Up Policy in place, it can help you add an extra shield of protection at a very low premium for you to easily overcome the medical inflation over and above your pre- decided health insurance amount.

Feature & Benefits of SBI Arogya Top-Up Policy

Cashless treatment

Every health insurer has a tie-up with certain hospitals, wherein you can avail cashless services. Here, you do not have to spend money for squaring-up the hospital bill. The insurance company directly pays the hospital on your behalf. The SBI health insurance offers you a facility of cashless treatment with the presence of 3000 plus network hospitals.

Pre and Post Hospitalization

Pre-hospitalization expenses are covered by the SBI Arogya Top-up Policy 60 days before you get hospitalized. Post-hospitalization expenses are covered 90 days after you get discharge from the hospital.

Ambulance charges

During an emergency, the ambulance charges up to Rs.5000/- per hospitalization are covered by SBI Arogya Top-up Policy.

Tax Benefits

The SBI Arogya Top-up plan offers tax benefits under Section 80D of the Income Tax Act, 1961 for the premiums that you pay towards your health insurance policy. Maximum tax exemption - Rs. 25,000/- for self, spouse and dependent children Maximum tax exemption - Rs. 25,000/- for Parent(s) and Rs. 50,000/- for resident senior citizen parents.

Co-Payment

Co-payment means your share of the hospitalization bill that you need to pay for medical services covered by the health insurance plan. The SBI Arogya Top-up policy does not have any co-pay clause. However, this policy does have a deductible that is required to be exhausted before you make a claim under this health plan.

Reimbursement

You can either opt for cashless claim or reimbursement claim settlement process. Here, you need to settle the hospital bills directly with the hospital and then claim the reimbursement amount from the insurer by submitting all the original medical bills and other required documents.

Pre-Existing Disease

Pre-existing diseases are not covered for the first 4 years of continuous policy coverage.

Flexibility

Flexibility to opt for premium tenure of either 1 year/2 year/3 year.

Sum Insured

Sum insured is nothing but the total amount of cover offered by your health insurer. The SBI Arogya Top-up plan offers coverage ranging from Rs. 1 lakh to Rs. 50 lakhs.

Coverage

The SBI Arogya Top-Up Health Insurance policy offers coverage for the below:

  • Eligible hospitalisation expenses as under:

    • Intensive care unit
    • Nursing expenses
    • Medical practitioners fees
    • Diagnostic procedures
    • Room rent, boarding expenses
    • Anesthesia, blood, radiotherapy, surgical appliances, cost of pacemaker, medicines & consumables, oxygen, operation theatre expenses, prosthesis/internal implants, diagnostic expenses and x-ray, dialysis, chemotherapy,
    • Dressing, plaster casts and dressing.
    • Physiotherapy as inpatient care and being part of the treatment.
    • Medicines, Drugs and consumables consumed during hospitalization period.
    • Domiciliary hospitalisation.
    • Organ Donor Expenses.
    • Maternity Expenses.

Premium Charges

Depending upon the age of the insured, deductible opted as well as the sum insured amount, the amount of the premium would change from one person to another. The option for deductible ranges from Rs. 1 lakh to Rs. 10 lakhs.

Day care procedures covered

Not all the medical treatments require hospitalization of 24 hours and therefore these can be conducted either in a day-care center or in a hospital. Certain treatments that doesn’t require 24-hour hospitalization such as Radio therapy, Chemotherapy, Tonsillectomy, Dialysis, etc. are covered under this plan. Around 142 day-care procedures are covered under the SBI Arogya Top-up policy.

Organ Donor Benefits

The SBI Arogya Top-up policy offers coverage for the medical costs for the organ donor’s treatment up to the sum insured amount.

Avail AYUSH benefits

The SBI Arogya Top-up Plan offers coverage for alternative treatments such as Ayurvedic, Homeopathy or Unani, undertaken in a government hospital or institute is covered up to Sum Insured.

Waiting Period

The waiting period is 30 days from the date of the policy issuance date.

Value Added Benefits of SBI Arogya Top-Up Policy

Restoration of Sum Insured

In case the insured person exhausts the total amount of the sum insured including the no-claim bonus, the SBI Arogya Top-Up Policy offers 100% restoration of the sum insured during the policy period on payment of additional premium.

Alternative treatment - AYUSH

AYUSH comes under the alternative treatment that SBI Arogya Top-up Policy covers. If you get treated for AYUSH in any government hospital or any institute that is accredited by Quality Council of India or the National Accreditation Board on Health or any other hospital that is mentioned under the policy, the amount would be reimbursed. This policy also reimburses the Ambulance charges.

Tax benefit

The premiums that you pay for the SBI Arogya Top-up policy, offers you a tax benefit under Section 80D of the Income Tax Act, 1961.

Exclusion of SBI Arogya Top-Up Policy

  • Pre-existing health conditions for the first 4 years of the policy period
  • Injuries that are take place due to war or warlike activities
  • Any illness or disease that arise within the first 30 days of commencement of the policy except the accidental injuries
  • Health Conditions such as gall bladder stone, diabetes, calculus diseases, hernia, hydrocele, tonsillectomy, benign prostatic hypertrophy, surgery of varicose veins, sinusitis, gastric or duodenal ulcers, chronic renal failure, non-infective arthritis, medical expenses for treatments that are taken outside India
  • Cosmetic or aesthetic treatment of all kinds
  • Any sexually transmitted diseases or venereal diseases
  • Any kind of convalescence or comfort expenses related to hospital stay
  • Any treatments that take place in nature care clinics, hydro, spas, etc.
  • Injuries sustained by exposure to nuclear weapons or radioactivity
  • Maternity expenses for the first 9 months of the policy
  • Medical treatments that are undertaken due to obesity, weight loss, and weight management
  • Injuries occurred due to influence of alcohol or drugs
  • Intentional self-injuries, suicide, or attempt to suicide
  • Injuries sustained during service under military or police

Eligibility Criteria & Documents Requirement

Eligibility Criteria Apply to SBI Arogya Top-up Policy

  • Minimum Entry Age 3 months for children and 18 years for adults
  • Maximum Entry Age 65 years of age
  • 70 years (in case Rs.5 lakh deductible chosen)
  • Policy term 1, 2 or 3 years

    Documents Required to Buy SBI Arogya Top-up Policy

Here is a list of documents required to buy the SBI Arogya Top-up Policy:

  • KYC - Proof of ID and Proof of Address.
  • Proof of Date of Birth.
  • Medical check-up report, if required.

    Easy Procedure to Renew SBI Arogya Top-up Policy

The SBI Arogya Top-up Policy is an online health insurance plan. You can renew this plan online by visiting the official website of SBI. Then click on the ‘renew your policy’ tab and then enter the name of the policy- ‘SBI Arogya Top-up Policy;’ Select the tab, ‘renew’. Then make the payment using your debit/credit card or netbanking. On successful payment, you will receive the SBI Arogya Top-up policy document in your inbox.

What is the Claim Procedure for SBI Arogya Top-up Policy?

SBI Arogya Top-up plan has a claim process which is similar to any other health insurance policies offered by SBI General. In case of a cashless treatment facility, it is important that you inform the third-party administrator regarding the claim and also get a pre-authorisation. The authorization letter along with the ID card issued by SBI General should also be produced at the hospital. All the original bills as well as other proofs of treatment undertaken from the network hospital should be submitted to the insurance company.

In case of other hospitalisation claims, all you need to do is submit certain documents at the time of claim filing. Mentioned below are the documents required for this purpose:

  • Duly filled Claim form
  • Proof of Photo identity
  • 2 recent passport size photographs
  • Original discharge card
  • Death certificate, in case applicable
  • Copies of all medical tests and proof of treatment taken
  • Any other documents required by the insurance company

On submission of these documents to the insurer, the process for claim settlement will commence. The insurance company will inform you with regards to the acceptance or rejection of the claim. If case the insurer rejects your claim, you will be notified in writing with a valid reason for the same. In case the insurer accepts your claim, the insurance company will compensate you within 7 days.

Documents Required to Claim SBI Arogya Top-up Policy

Here is a list of documents required to claim the SBI Arogya Top-up Policy:

  • Duly filled claim form
  • Photo id and 2 recent passport size photographs
  • Hospital discharge card in original
  • All the copies of the evidence of treatment followed and medical bills
  • Death certificate, if required
  • Any documents apart from the above, as required by the insurer

Conclusion & Reviews

Conclusion

We all know that accidents or any serious illnesses occur uninvited and may drain your pockets off. The SBI Arogya Top-up policy, offered by SBI General Insurance, offers you additional protection that may arise due to inflated medical costs. This policy is in demand due to the host of benefits it offers. The claim settlement process is smooth, fast, fair and transparent.

Reviews of SBI Arogya Top-Up Policy

1.) Mr.Kiran Pawar : This policy helped me in a very critical phase of my life. My father suffered an emergency hospitalization and SBI Arogya Top-up policy offered us seamless and quick claim settlement process. Ambulance charges were also covered under this plan.

2.) Mrs. Madhavi Raut : SBI Arogya Top-up Policy proved as a saviour for our family. The hassle-free claim settlement services offered great relief and a stress-free environment back home. The drugs and medicines that were consumed by my mother during the hospitalization period were all reimbursed. Above all, it also helped to save tax under Section 80D of the Income Tax Act, 1961.

FAQ's On SBI Arogya Top-up Policy

Is this policy available for long term?

No, the SBI Arogya Top-up policy is not available for long term. It can be availed only for a duration of 1 year, 2 years or 3 years.

Who can be covered under Arogya Top-up Policy?

Any individual whose age ranges from 3 months to 65 years can be covered under SBI Arogya Top-up Policy. Also, your family consisting of self, spouse and dependent children can also be covered under this policy on a family floater basis.

Is portability allowed under this policy?

Yes, portability is allowed under the SBI Arogya Top-up Policy.

Does this policy cover treatment by Ayurvedic method?

The SBI Arogya Top-up Plan offers coverage for alternative treatments such as Ayurvedic, Homeopathy or Unani, undertaken in a government hospital or institute is covered up to Sum Insured.

Is health check-up compulsory under this policy?

Pre-medical check-up is not compulsory up to the age of 55 years

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