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.
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.
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.
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:
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.
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:
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