• SBI General Retail Health Insurance Policy

    Health Insurance
    • Enjoy options to cover yourself, your spouse, kids and even your parents
    • Enjoy access to 10,000+ hospitals for cashless treatment
    • Reduce your taxable income by up to Rs. 50,000 deduction under section 80D**

    The SBI General Retail Health Insurance Policy is a scheme developed to provide comprehensive health insurance for an individual or a whole family. With flexible plans and multiple coverage options, this policy aims to provide better security in times of rising healthcare costs. By subscribing to this cover, policyholders can financially protect themselves from unexpected illnesses and injuries.

    Eligibility For SBI General Retail Health Insurance Policy

    This policy cover can be taken by anyone living in India irrespective of the region. The minimum entry age for the primary insured person must be at least 18 years. This policy covers people of all ages ranging from infants (at least 3 months old) to the elderly. The maximum entry age for SBI General Health Insurance Policy - Retail is 65 years. For people above 45 years of age, a pre-insurance medical test is required when they take this policy for the first time.

    Plan Options

    SBI General Retail Health Insurance Policy comes with three different plans that allow policyholders to choose their preferred treatment location. Specific plans are available for specific locations, but policyholders can choose other treatment locations by co-paying a part of the sum insured. The premium charges vary based on the treatment location opted by the user. The admissible claim amount is based on the plan and the treatment location chosen, as shown in the table below:

    Plan Type Treatment Location A (Mumbai & Delhi) Treatment Location B (Chennai, Kolkata, Bangalore, Ahmedabad, and Hyderabad) Treatment Location C (Rest of India)
    Plan A (Mumbai & Delhi) 100% 100% 100%
    Plan B (Chennai, Kolkata, Bangalore, Ahmedabad, and Hyderabad) 80% 100% 100%
    Plan C (Rest of India) 70% 80% 100%

    The percentages displayed here represent the admissible claim amount. The company will verify the claim before providing compensation to the insured.

    Features Of SBI General Retail Health Insurance Policy

    The Retail Health Insurance Policy by SBI General aims to satisfy the needs of people with differing insurance requirements. Some of the key features of this policy are as follows:

    • It is possible tNo choose a wide range of sum insured from Rs.50,000 to Rs.5 lakh.
    • If the entry age of the insured person is above 60 years, the maximum sum insured would be restricted to Rs.2 lakh.
    • People above 70 years of age can renew this policy subject to the payment of additional loading charges applicable for the specific age band.
    • Individual policy can be taken separately for all family members including the insured, his/her legal spouse, legal & dependent children, and dependent parents.
    • Different plans and co-pay options are available in different locations across India.
    • Family floater option is available to provide a comprehensive insurance cover for all members of a family under a single policy.
    • All family members including the primary insured, his/her legal spouse, and legal & dependent children can be covered under the same floater policy.
    • The maximum sum insured for family floater cover is Rs.2 lakh.
    • The premium charges paid for this policy is exempt from income tax under Section 80D of the Income Tax Act.
    • Insurance policy taken from any insurer in India can be renewed with SBI General.
    • If there are 4 claim-free years, a free medical checkup with a maximum limit of Rs.2,500 is offered to the insured.
    • The policy offers coverage for pre-hospitalisation expenses for up to 30 days before hospitalisation. However, these expenses must be related to the primary reason for hospitalisation.
    • Post-hospitalisation expenses are also covered for up to 60 days after discharge from the hospital. However, these expenses must be related to the primary reason for which the insured was hospitalised.
    • Two different add-on covers can be chosen by paying a little extra premium. These two add-on covers are ‘removal of room and ICU rent sub-limits’ and ‘removal of sub-limits on operation and consultancy charges’.

    Benefits Of SBI General Retail Health Insurance Policy

    SBI General Retail Health Insurance Policy focuses on covering all medical expenses associated with hospitalisation. Some of the benefits offered under this policy are as follows:

    Type of expenses Expense limit
    Room and boarding expenses associated with medical treatment 1% of the sum insured per day
    Expenses associated with stay in intensive care unit (ICU) 2% of the sum insured per day
    Ambulance charges 1% of the sum insured subject to a maximum of Rs.1,500 per illness or injury
    All medical expenses associated with nursing home stay or ICU stay Up to 25% of the sum insured per illness or injury
    Charges related to fees of consultants and specialists Up to 40% of the sum insured per illness or injury
    Charges related to anaesthesia, blood, oxygen, and surgical appliances Up to 40% of the sum insured per illness or injury
    Pre-hospitalisation expenses Up to 10% of the admissible hospitalisation expenses
    Post-hospitalisation expenses Up to 10% of the admissible hospitalisation expenses
    Attendant nursing charges for aged parents who are above 60 years old Rs.500 or the actual charges incurred per day (whichever is lesser) subject to a maximum of 10 days per illness or 15 days per policy period
    Attendant escort charges to care for children below 10 years of age Rs.500 per day subject to a maximum of 30 days per policy period
    Alternative treatment (The hospital must conform to the company’s definition of an ayurvedic hospital, and it must be registered with the government.) Ayurvedic treatment - 15% of the sum insured subject to a maximum of Rs.20,000 per policy period. Homeopathy & Unani treatment - 10% of the sum insured subject to a maximum of Rs.15,000 per policy period
    Domiciliary hospitalisation 20% of the sum insured or Rs.20,000 (whichever is less)
    Convalescence benefit (10 to 60 years of age) Up to Rs.5,000 (hospitalisation for injury or illness must be more than 10 consecutive days)

    Apart from the benefits mentioned in the table, this policy also provides cashless treatment facility throughout a select network of SBI General approved hospitals. For most benefits in the table, the hospitalisation period must be at least 24 hours. However, this cover can also be used for certain day care procedures like dialysis, chemotherapy, radiotherapy, tonsillectomy, dental surgery following an accident, and eye surgery.

    Exclusions From SBI General Retail Health Insurance Policy

    This insurance cover comes with a few exclusions for which the company is not liable to provide any compensation to the insured. The following list of exclusions apply to SBI General Retail Health Insurance Policy:

    • Any pre-existing injuries or illnesses
    • Diseases contracted during the first 30 days of the policy
    • Conditions like hernia and hydrocele during the first year of the policy
    • Conditions like cataract and hysterectomy during the first two years of the policy
    • Joint replacement surgery during the first three years of the policy unless caused by an accident
    • Treatment procedures like acupuncture, naturopathy, reflexology, aromatherapy, acupressure, osteopathy, and chiropractic therapy
    • Treatments related to childbirth and pregnancy
    • Injuries caused while under the influence of alcohol or drugs
    • Expenses related to AIDS and venereal diseases
    • Congenital diseases

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