SBI Arogya Top-Up Policy

SBI has always been featured as one of India’s most reliable insurance providers that offers a huge variety of policies, comprehensive, if not exhaustive, for every possible scenario. SBI Arogya top-up plan is an example in this context, offering that extra shield of financial protection for times when your medical expenses far outweigh your sum insured.

The SBI Arogya top-up plan is a low premium additional cover that takes care of arbitrary costs like pre and post-hospitalization costs, ambulance costs, and daycare procedures like radiotherapy, chemotherapy, and dialysis, going the extra mile to make sure no stone is left unturned.

What’s Arogya Top-up Policy?

In this age of unpredictability, it is only logical that you have a backup plan in place to ease financial troubles. More so, there have been situations where costs of treatments, thanks to the steep rise in medical costs, exceed the sum insured, unleashing a heavy financial burden upon you and your family. It is at times like these when SBI Arogya top-up plan comes to the rescue and provides much-needed coverage for costs that one might overlook in the face of unexpected events.

This is a comprehensive top-up cover, which can be availed at an additional premium. The policy comes into action when the basic policy cover exhausts. The policy provides coverage for emergency hospitalisation expenses including pre and post-hospitalisation expense cover.

Key Features and Benefits of SBI Arogya top-up plan

The SBI Arogya Top-up plan comes with an arsenal of benefits that work under most situations. The key features and benefits are as follows:

• Cashless treatments allow for seamless pre to post-hospitalization coverage without costing much.
• SBI’s reputation as one of India’s most successful insurances companies boasting of an even more impressive claim settlement ratio makes this a painless process
• Pre and Post-hospitalization coverage allow for expenses incurred 60 days before hospitalization and 90 days after hospitalization.
• One of the very few policies that allow for alternative medicinal treatment under AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy).
• No co-pay clause means you are covered in entirety without having to pay anything out of your own pockets.
• Tenure flexibility allows you to choose to be covered for up to 3 years at a stretch.
• 142 Daycare procedures that do not require hospitalization are also covered.
• Low premiums ensure your budget is on point. 

Inclusions of SBI ArogyaTop-up Plan

This top-up plan covers the following expenses:

• Intensive Care Unit charges
• Nursing fees
• Medical practitioner charges
• Diagnosis and diagnostic procedures
• Room rent and boarding charges
• Anaesthesia, blood transfusion, radiotherapy, medicines, and other consumables
• Operation theatre charges
• Prosthesis, internal implant expenses
• X-ray and dialysis, chemotherapy
• Dressing, plastering, and cast expenses
• Organ donor expenses
• Maternity expenses 

Exclusions of SBI Arogya Top-Up plan

SBI Arogya's top-up policy comes with its own set of exclusions. It would be wise to go through the list of exclusions to understand what the policy does not include. Some of these exclusions are:

• Pre-existing health conditions that might be covered by another policy, or is claimable under another policy. SBI Arogya top-up allows for pre-existing health conditions only after 4 years into the policy
• Cosmetic procedures
• Sexually transmitted diseases including HIV/AIDS
• Injuries arising from war or terrorist activities
• Involvement in military activities
• Expenses incurred at salons, spas, or nature care clinics
• Incidents occurring due to alcohol or drug abuse
• Intentional self-harm including suicide attempts
• Expenses arising from medical procedures involving weight loss including liposuction
• Maternity expenses for the first 9 months of the policy

*This list is not exhaustive. For a complete list of exclusions, please log on to the insurer’s website.

Eligibility Criteria to Buy SBI Arogya Top-up Plan

For one to be eligible to buy a top-up plan, they need to be:

• Between 3 months of age to a maximum of 65 years of age
• There is no lifetime renewal option for this plan. Policy term can be chosen from one of the three options viz 1, 2 or 3 years
• If a 5 lakh deductible is chosen, the maximum entry age is 70

Medical Examination

Although there is no mandatory medical examination for an applicant up to the age of 55 years, any applicant wishing to buy the SBI Arogya top-up plan is subject to a pre-acceptance medical examination, based on which underwriters will decide on the applicant's eligibility. The medical reports are to be undertaken by the applicant, and these reports are valid for one month.

The most common medical tests asked for are listed below:

The costs incurred by the applicant are reimbursed once the underwriters determine the risk factors involved, and if the policy can be issued.

Sum Insured

The sum insured, depending on the deductible (an agreed-upon amount that the policyholder will bear before the insurance company rolls out a claim), the sum insured ranges between Rs 1 lakh to Rs 10 lakh depending on your need.

Increase in Sum Insured

Unlike life insurance, SBI Arogya Top-up plans do not allow for revisions in the basic sum assured midterm. However, this can be done while renewing the policy, which will be treated as a new application and is subject to underwriting to determine risk factors before deciding upon the approval or rejection of the said application. In either case, the information is conveyed to the applicant. 

In closing, it is advisable to go for a plan that provides that extra shield of financial protection, hence easing life for everyone involved.

Deductibles

Although this plan does not offer a co-payment option, a deductible clause is built into it. A deductible is any amount that a policyholder pays out of his/her own pockets before the insurer rolls out a pay-out towards a claim. The higher the deductible, the lower is the premium. SBI offers a sum insured of a minimum of Rs 1 lakh to Rs 10 lakh subject to deductibles ranging from a minimum of Rs 1 lakh to a maximum of Rs 10 lakh.  

How to Buy the SBI Arogya Top-Up plan?

The policy can be bought online, and the process is straightforward. The online procedure to help you successfully buy a plan is explained below:

• Log on to Paisawiki.com
• Once on the website, you can select the Arogya top-up policy.
• The page will ask you for your registered mobile number and email ID.
• There are three policy types to choose from. You can go for Individual, Family Floater, or Family Individual types.
• The premium calculator will ask for your preferred sum assured and a deductible amount of your choice. This will return a quote that will carry your potential policy details like the tenure, premium amount, the sum insured, and the deductible.
• Simple payment methods like a debit card or payment gateways like Google Pay allow you to pay the premium, after which the policy will be activated. 

Documents Required to Buy the SBI Arogya Top-up Plan

Because SBI Arogya top-up plans do not require medical tests unless specifically asked for, the policy can be bought online with an age proof, address proof, and valid ID proof.

Claim Process of SBI Arogya Top-Up Plan

Like any other product offered by SBI General, the claim process is straightforward. SBI Top-up plan can be claimed as cashless and reimbursement claim. A claim form, which is available on the SBI insurance website, is to be produced along with the following documents:

• Filled claim form
• Proof of identity
• Passport-size photographs
• Discharge card
• Death certificate, if applicable
• Medical reports along with all medical tests taken

Upon submission of these documents, the insurance company will usually compensate you within 7 working days.

Renewal Process of SBI Arogya Top-Up plan

Renewal, in this context, is only plausible if the policy lapses. Some scenarios can be listed as below:

• Once a claim is made, the policy effectively ceases to exist. The only way to go about it is to buy a new policy.
• SBI offers 30 days as a "grace period." If the policyholder does not pay the premiums, the policy effectively lapses. It is up to the insurance company to keep it rolling till the premiums are paid, or to void it.

Loading and Renewal Premium Rate

Premiums, at the time of fresh issuance, are based on the age of the applicant. However, this is subject to change depending on loading. Loading, in insurance terms, is an additional cost levied by the insurer when the actual risk is higher than the anticipated risk.

FAQs About SBI Arogya Top-Up plan