SBI Arogya Premier Policy
SBI Arogya Premier Policy is a far-reaching health policy that has both individuals as well as family floater plans. It is a significant plan covering a range of medical services, including some Ayurvedic and other treatment plans.
The sum insured ranges from around Rs 10 lakh to Rs 30 lakh of cover with no sub-limits, and tenure from annual to three years. The medical insurance policy covers most expected treatment, including diagnostics, hospitalization costs, intensive care unit costs, and several exclusions for specific diseases.
What is SBI Arogya Premier Policy?
A premier medical insurance policy, SBI Arogya Premier Plan is suitable for people from every walk of life. While it does not fit the needs of those who require coverage for critical illnesses, or require early coverage for pre-existing disease, it covers all of the natural needs of an individual or someone with a young family.
It even includes maternity cover, and cover for many day care procedures, and domiciliary hospitalization expenses.
When it comes to eligibility, the policy is for individuals or for families, which covers policyholder, spouse, and children who are under the age of 23.
Why Should You Choose SBI Arogya Premier Policy?
As a well-rounded policy, there are plenty of reasons to go for this policy plan, and allow it to be the primary medical insurance for one's self or family. Some of the best features of the plan and the provider are:
- It comes from a well-known company that can be trusted and has an excellent claim settlement ratio, along with the time taken to settle the claim.
- The medical screening requirements are generous, with a high age limit.
- There are no sub-limits for the claims, providing flexibility to the insured party.
- The coverage is also excellent, covering numerous treatments and with a wide range of inclusions.
- Bonuses such as accumulations and health check-ups offered from not claiming under the plan can all be very useful in the long run.
- The SBI Arogya Premier Plan also offers tax exemption on premiums paid under Section 80D of the Income Tax Act, 1961
- There is a family floater policy plan that provides benefits for the immediate family, including dependent children.
Benefits and Features of SBI Arogya Premier Policy
The SBI Arogya Premier policy is popular due to the following features and the benefits it offers:
Key Features of the SBI Arogya Premier Policy
- The policy has individual and family plans and covers extensive medical expenses.
- Medical screening is limited to those who are over 55 years old or have otherwise had a medical history that might be of concern.
- Along with pre and post hospitalization expenses of 60 and 90 days, respectively, the policy covers daycare expenses for around 142 procedures for all the policyholders.
- Maternity Expenses will also be covered. This will be for 9 months after the policy coming into effect.
- Organ donor expenses can also be covered under this plan.
- The policy offers coverage of Rs 10 Lakh to Rs 30 Lakh
- The policy covers ambulance charges. This also accounts for air ambulance costs up to Rs 1 Lakh, which is relatively rare.
Key Benefits of the SBI Arogya Premier Policy
Amongst the primary benefits of the plan, along with its medical coverage, are:
- There is a no-claim bonus. This is up to 10% of the Sum Insured and is a Cumulative amount, accumulated per year without claim to a maximum of 50%.
- Automatic reinstatement of Insured Sum that is available as part of the policy
- There are tax benefits of the policy, particularly deductions for the premium paid under the Income Tax Act, 1961.
- Alternative treatments from allopathic medicine are also covered under this plan with some necessary caveats.
Inclusions of SBI Arogya Premier Policy
The inclusions under the policy are:
- All hospitalization expenses including medical practitioner's fees, room rent, boarding expenses, nursing expenses, physiotherapy (as an inpatient and part of the treatment plan), medication, drugs, and other such necessities are covered.
- Other additional expenses that would be covered include diagnostic expenses and x-rays, Intensive care unit costs, blood, oxygen, anesthesia, operation theatre expenses, chemotherapy, surgical appliances, radiotherapy, dialysis, supporting equipment costs like that of a pacemaker, internal implants/ prosthesis and medical expenses caused as a part of the operation, organ donor expenses etc. are included.
- Ambulance expense, along with an air ambulance with a limit of Rs 1 Lakh is offered.
- Minor procedures, such as dressings, splints, and casts, etc. are covered.
- This also includes pre-hospitalization expenses for up to 60 days for medical claims that are allowable under the policy.
- Similarly, any post-hospitalization expenses for allowable medical claims will be covered for 90 days under the policy.
- Health Check-up reimbursement up to Rs 5,000 insured after 4 claim-free years.
- Day Care expenses for up to 142-day care procedures and domiciliary hospitalization if the hospital cannot offer a bed or for other reasons.
- Multiple alternative treatments are available, like Homeopathy, Ayurvedic, or Unani in an institute accredited by the National Accreditation Board on Health or the Quality Council of India, or the treatment must happen in a government hospital or any institute recognized by the government. The coverage is up to the sum insured.
- Maternity expenses are covered after 9 months of waiting period from the start of the policy.
- There is also the possibility of reinstatement of the 100% Sum Insured in the case that the sum insured is decreased due to a claim.
- Cumulative Bonus at the rate of 10% of the Sum Insured for every claim-free renewal which can be accumulated maximum of 50%.
Exclusions of SBI Arogya Premier Policy
The exclusions under the policy are typical, and as follows:
- Only accidental injuries are allowable within the first month after the policy comes into effect. Otherwise, there is a strict waiting period to follow.
- Several medical conditions have a waiting period of a year of the policy, including tonsillectomy, diabetes, and complications from diabetes, duodenal ulcers, sinusitis, hernia, cataract, hydrocele/gastric, chronic renal failure, benign prostatic hypertrophy, etc., and maternity expenses have a waiting period for the first 9 months of the policy.
- Pre-existing conditions have a waiting period of a full 4 years.
- Any diseases or injuries from war or similar hazardous situations, such as any form of radioactivity or nuclear weapons, are not allowable, along with injuries from being part of the military or police force.
- Cosmetic treatments, such as cosmetic dental treatments or cosmetic surgery, are not allowable.
- Expenses related to treatments from abroad are not allowed.
- Another common exclusion is from injuries that come from a suicide attempt or any injuries caused to the self deliberately, as well as any injuries due to drugs or alcohol or expenses from attempting to rehabilitate from drugs or alcohol.
- Treatment-related to genetic disorders are not allowable, as well as congenital diseases.
- Sexually transmitted diseases, and particularly HIV, AIDS, are not covered under this policy, obesity, weight loss and similar problems are also not covered.
- Management for psychiatric disorders or any mental health issues is not allowable.
Eligibility Criteria of SBI Arogya Premier Policy
The policy comes with the following eligibility criteria:
Minimum Entry Age
Maximum Entry Age
Dependent children- 23 years
Rs 10 lakh -30 lakh
Self, Spouse, children
Not required up to the age 55 years
Claim Process of SBI Arogya Premier Policy
To claim from SBI Arogya Premier, there are multiple methods:
- The can be registered using their toll-free number at 1800 22 1111
- One can also log on to the official website of the insurer and click on 'Intimate Claim' and then submit details such as your name, mobile number, policy number, and any relevant remarks to reach the claim form.
Along with this, it is necessary to keep all of the detailed documents such as the prescriptions, the diagnostic reports, the expense receipts, and so on:
- Medical discharge certificate from the hospital
- Original report for diagnosis or treatment
- Bills and receipts for drugs
- Proof of any diagnostic tests (such as x-rays, or ECG) and treatment
- Original policy documents
For cashless treatment, the administrator would have to be notified before hospitalization or within 24 hours of hospitalization in case of an emergency. Documents related to this will also be required.
Renewal Process of SBI Arogya Premier Policy
The SBI Arogya Premier Plan can be renewed by paying the annual premium to any office of SBI General Insurance before the policy expires or paying within the 30 days of the grace period, which begins the day after the due date of the premium. However, no claims would be processed during the grace period, and it would be considered as a lapsed policy.
All the associated benefits shall continue and stay active to the insured once the company has received the premium.
The policy renewal quote can quickly be reviewed online, by visiting the website of Paisawiki and clicking on ‘Renew Policy’ then filling in the relevant details. The most important detail is the policy number.
How to Buy SBI Arogya Premier Policy?
The policy can be bought online, and payment can be made in several ways. The policy documents, including the proposal form, should be filled in accurately and kept ready for the buying process to go smoothly.
Documents Required to Buy SBI Arogya Premier Policy
- The proposer will require several documents to apply to the policy. For a family floater policy, the whole family may be required to furnish some documents.
- Address proof documents and ID proof documents: These documents will usually be any government documents, including utility bills, in case of address proof.
- Along with this, other documents that may be required are the application form and medical reports.
- Photos may also be required.
FAQs About SBI Arogya Premier Policy
Ans: Multiple alternative treatments are available, like Homeopathy, Ayurvedic, or Unani. Provided such treatment must be taken in an institute accredited by the Quality Council of India/ National Accreditation Board on Health, or the treatment must happen in an institute recognized by the government or government hospital. The coverage is up to the sum insured.
In case of such habits, for each habit, an increase of 5 percent of the premium is to be expected, due to the higher medical risks associated with such habits.
Ans: There is a free look period of 15 days, in which time the policyholder must decide whether they are satisfied with the SBI Arogya Premier Plan and whether they will cancel it or continue with it.
Ans: The policy plan is available up to three years' tenure.
Ans: The plan is indeed portable, and your existing Health indemnity policy can be ported into SBI Arogya Premier.
Ans: Pre-existing illnesses are only covered four years after the commencement of this policy. All pre-existing illnesses are not covered, as many diseases are excluded under the plan.
Ans: Medical screening is not required for those without a history of illness, and under the age of 55.
Written By: Paisawiki - Updated: 09 April 2021