SBI General Health Insurance Policy

What is the Plan all About?

SBI General’s Health Insurance Policy – Retail covers medical treatment expenses and ensures hassle-free quality health care to you & your family. To take care of all your health related expenses, you can opt for this health policy.

3 Plan Variants can be opted under this plan:

Metro Plan
Semi Metro Plan
Rest of India Plan

Key Features

Get Wider health coverage
Flexible plan options
No pre-policy medical test up to the age of 45 years having
Avail add-on covers
Assured lifetime renewability
Fair, transparent, & quick claims settlement procedure
Avail cashless facility across wide range of network hospitals

Policy Benefits

In-patient hospitalization expenses are covered including Room Rent, Boarding, Nursing Expenses, and other related expenses are covered.
ICU charges are covered up to 2% of the sum insured per day, subject to a maximum of 25% of the SI per injury/illness per claim in a policy period.
Pre hospitalization expenses are covered for 30 days before hospitalization and post hospitalization expenses are covered for 60 days after hospitalization, subject to a maximum of 10% of applicable hospitalization expenses.
Convalescence benefit is covered up to a maximum of Rs 5,000 per insured, in case of hospitalization due to any illness/injury.
Domiciliary hospitalization expenses are covered up to 20% of the sum insured or Rs 20,000 whichever is less.
Day Care Procedures are covered, for which the insured person requires hospitalization for less than 24 hours.
Parental Care is available for persons above 60 years. Under this benefit, attendant nursing charge when discharged from the hospital for Rs 500 or actual whichever is less, is paid per day up to a maximum of 10 days per hospitalization, not applicable for more than 15 days in a policy period.
Child care benefit is applicable for child below 10 years. Rs 500 for each completed day of hospitalization is paid, up to a maximum of 30 days in a policy period.

Value Added Benefits

In case of accidental hospitalization, Sum Insured is increased by 25% of the balance sum insured available, subject to a maximum of Rs 1 lac. It is applicable only once under the policy per person.
Free health check-up is applicable on completion of 4 claim-free policy years.
Alternative/ Ayurvedic treatment expenses and Homeopathy & Unani treatment expenses are reimbursed.
Consultants & Specialists Fees, Anaesthesia, Operation Theater Charges, Blood, Oxygen, and other related medical expenses are covered up to 40% of .
Ambulance charges are covered.
Tax Benefit under section 80D of Income Tax Act, 1961.

Sub Limits

Room Rent Limit is capped up to 1% of sum insured per day.
ICU charges are capped up to 2% of the sum insured per day.
10% co-pay applies for all eligible admissible claims in non-network hospitals.
Operation and consultancy charges are covered up to 40% of sum insured
Free health check-up is covered up to 1% of sum insured up to a maximum of Rs 2500.
Treatment of cataract is covered up to 15% of sum insured, up to a maximum of Rs 25,000 per eye.
Ambulance charges are covered up to 1% of Sum Insured up to a maximum of Rs 1500.
Ayurvedic treatment expenses are reimbursed up to 15% of sum insured in a policy period, subject to a maximum of Rs 20,000. Homeopathy & Unani treatment expenses are reimbursed up to 10% of sum insured in a policy period, subject to a maximum of Rs 15,000.
Plan A (Metro plan) pays 100% of the admissible claim amount for treatment at any location in India, Plan B (Semi Metro Plan) pays 100% of the admissible claim amount for treatment at semi metro and rest of India locations & 80% for metro locations, Plan C (Rest of India) pays 100% of the admissible claim amount for treatment at rest of India locations and 80% & 70% for treatment at semi-metro and metro locations respectively.

Waiting Period Clause

Initial Waiting Period: Claims arising during first 30 days of the policy start date, except accidental claims.
Specific Waiting Period: Some treatments such as Hydrocele, Hernia, etc. are covered after 1 year from the inception date of the policy. Other treatments such as Cataract, Hysterectomy, etc. are covered after 2 years from the inception date of the policy. Joint replacement surgery (done due to an accident) is covered after 3 years from the inception date of the policy.
Pre existing Disease Waiting Period: Any pre-existing disease until 48 months of continuous policy coverage. All specified pre-existing diseases are covered after completion of such waiting period.
Cataract Waiting Period: Medical expenses incurred in the treatment of cataract is covered after the first two years of continuous policy coverage.

Who can Buy the Plan?

Factor	Minimum	Maximum
Age (as on last birthday)	Adult: 18 Years, Children: 3 Months	65 Years
Sum Assured	Rs 50,000	5 Lacs
Cover Type	Individual/Family Floater	-
Policy Tenure	1 Year	1 Year
Grace Period	30 Days	-
Free Look Period	15 Days	-
Riders	Removal Of Room & ICU Rent Sub-limits, Removal Of Sub-limits On Operation And Consultancy Charges, Removal Of Ayurvedic And Homeopathic Cover	-