General Insurance

SBI General Health Insurance Plan

Eligibility Criteria

Minimum Entry Age 3 months for children, 18 years for adults
Maximum Entry Age 65 years of age

Benefits

Wide Coverage from Rs. 50,000/- to Rs. 5,00,000/-

Free medical check up for every 4 claim free years up to a maximum limit of Rs. 2,500/-

Product Features

Key Features

Sum Insured

Sum Insured is the amount of cover provided by the insurance company.
The plan provides a wide coverage of Rs. 50,000 to Rs. 5,00,000/-.
In-patient hospitalisation

This covers hospitalization expenses due to an illness or accident.
The plan covers hospital accommodation, charges for stay in Intensive Care Unit, related hospitalization expenses such as surgeon’s fees, nursing, anesthesia, blood, oxygen, operation theater charges, surgical appliances, medicines, drugs and consumables up to the sum insured.
Pre-hospitalisation

It covers the medical expenses due to an illness before the insured is hospitalized.
The plan covers pre-hospitalization expenses up to 10% of eligible hospitalization expenses incurred 30 days prior to date of admission into the hospital.
Post-hospitalisation

It covers the medical expenses due to an illness after the insured is discharged from hospitalization.
The plan covers pre-hospitalization expenses up to 10% of eligible hospitalization expenses incurred 60 days after the date of discharge into the hospital.
Health check-up

A free medical check-up is provided by the insurance companies to its policyholders.
This plan provides free health check-up which is 1% of sum insured up to a maximum of Rs. 2500/- for every 4 claim free years.
Medical treatment with room boarding & nursing expenses

Room rent specifies the sub-limit on room rent charges you can avail in case of hospitalization which includes nursing expenses, service charges, etc.
In the event of hospitalization, the policyholder is entitled to get 1% of sum insured per day.
 

Other Features

Child Care

Attendant escort charges to take care of child below 10 years of age.
Available for below 10 years. Attendant escort charges of Rs. 500/- for each completed day of hospitalization subject to maximum of 30 days during the policy period.
Parental Care

Attendant nursing charge to take care of you parents who are above 60 years of age.
Available for persons above 60 years of age. Attendant nursing charges after discharge from the hospital for Rs. 500 or actual whichever is less per day up to a maximum 10 days per hospitalization. The charges can be reimbursed for a period not exceeding 15 days during the entire policy period.
Domiciliary Hospitalization

If a patient is in a condition that he cannot be moved to the hospital or there is lack of accommodation in the hospital, he is been treated at home and this process is known as domiciliary hospitalization.
Reasonable and customary charges towards domiciliary hospitalization as defined in policy definition subject to 20% of the sum insured maximum up to Rs. 20,000/- whichever is less.
Convalescence benefit

Benefit available for insured above 10 years and below 60 years.
Covers the convalescence expense up to an amount not exceeding Rs. 5,000/- per insured, if the insured is hospitalized for any bodily injury or illness as covered under the policy, for a period of 10 consecutive days or more. Admissible only once during the period of insurance.
Day Care Treatments

These are treatments that don’t require a 24-hr hospitalization and conducted in a hospital or day-care center.
Covers Select Day care surgery where less than 24 hours hospitalization for specified procedures like Dialysis, Chemotherapy, Radio therapy, Eye Surgery, Dental surgery (due to accident), Tonsillectomy, etc. Are covered.
 

Exclusions

  • Any disease contracted during the first 30 days commencement of the policy.
  • Certain diseases/surgeries like Hernia, Hydrocele etc shall be covered after a waiting period of 1 year.
  • Joint replacement surgery shall be covered after a waiting period of 3 years from commencement of policy except done due to an accident.
  • Treatment arising from or traceable to pregnancy (whether uterine or extra uterine) and childbirth including Cesarean section and/or any treatment related to prenatal and post natal care.
  • Congenital diseases
  • All expenses related to AIDS and related diseases.
  • Use/Abuse of intoxicating drugs or alcohol.