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SBI Arogya Plus Policy
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SBI Arogya Plus Policy

With rising medical costs and high inflation, it has become more important to make sure that you and your loved ones are medically protected and financially secure during times of crisis. SBI General Insurance is a trusted and well-reputed insurance company in India, offering a variety of health insurance plans to meet the medical and financial needs of you and your family. The SBI Arogya Plus Health Insurance Plan works as a savior in times of need, with more than 4000 hospitals in its network and comprehensive coverage. It also offers lifetime renewability, ensuring that your loved ones are protected for lifelong.

What is SBI Arogya Plus Policy?

The SBI Arogya Plus Policy is one of the health insurance plans offered by SBI General Insurance. It is a comprehensive health insurance plan that provides a wide range of features and benefits to ease any financial burden that may arise during medical emergencies. It helps to protect against rising hospitalization costs and OPD treatments, thereby allowing individuals to focus on recovery and treatment rather than be stressed about finances during tough times.

When choosing a health insurance plan, one should always look out for certain key features such as coverage, the premium to be paid versus coverage offered, features and benefits, claim settlement ratio, etc. SBI Arogya Plus Health Insurance Plan meets all the checkboxes when it comes to providing comprehensive coverage. Following are the reasons to choose this medical insurance plan: 

The SBI Arogya Plus Policy offers wide coverage options. The coverage options for the plan are as follows: 

  • Hospital room rent, boarding fees, and doctor's fees
  • Operation Theatre and ICU charges
  • Nursing expenses
  • Medicines consumed during a hospital stay
  • Pre and post hospitalization coverage up to 60 days and 90 days, respectively.
  • Alternative treatments such as homeopathy or Ayurveda taken in recognized hospitals
  • Domiciliary or home hospitalization in case treatment in a hospital is not an option.
  • Outpatient treatments
  • No medical check-up is required for people under 55 years of age
  • The plan offers pre and post hospitalization treatment coverage
  • One can benefit from tax exemption under Section 80D of the Income Tax Act
  • It offers multiple coverages
  • It is also a family floater plan where family members can be covered under a single sum insured 

Features and Benefits of SBI Arogya Plus Policy

As a comprehensive health insurance plan, the SBI Arogya Plus Plan has a large number of features and benefits, which has earned it a wonderful reputation among insurance companies in the country. The following are some of the key features and benefits of the plan:

Features of SBI Arogya Plus Policy

  • 142 days of daycare expenses are covered in the plan.
  • No pre-medical check-up is required for persons who are below the age of 55 years.
  • Individual, as well as family floater plans, are available and customizable.
  • Outpatient expenses are covered as per the terms of the policy schedule.
  • Maternity expenses are also covered as per the OPD limit.
  • Your health insurance plan from other insurers can easily be renewed with SBI General Insurance.
  • No co-payment is required.
  • Income Tax benefits are granted under Section 80D of the Income Tax Act.
  • Pre-hospitalization expenses up to 60 days before admission are covered.
  • Post hospitalization expenses up to 90 days after discharge are covered.
  • Domiciliary hospitalization is covered.
  • Alternative treatments with recognized hospitals are covered.
  • Choice of the sum insured between Rs 1,00,000 to Rs 3,00,000.

Benefits of SBI Arogya Plus Policy

SBI Arogya plus policy benefits are as mentioned below:

Hospitalization Expenses

Cover room, boarding, doctor and nursing feeds

OPD Treatment

Up to limit specified as per premium paid

Ambulance charges

Actual expenses or Rs 1,500 whichever is lower

Alternative Treatments

Only applicable for treatments in government hospitals or institutes recognized by the government

Domiciliary Treatment

Rational charges towards healing

Inclusions and Exclusions of SBI Arogya Plus Plan

Certain important things are included and excluded from the SBI Arogya Plus Policy. An individual must read the entire policy document to understand all the inclusions and exclusions carefully. Some of these inclusions and exclusions are mentioned below:

Inclusions of SBI Arogya Plus Policy

The following medical expenses are covered in the health insurance plan:

  • Pre-hospitalization treatment up to 60 days before admission and post-hospitalization expenses related to treatment up to 90 days after discharge.
  • Ambulance expenses up to Rs 1,500 or actual, whichever is lower.
  • Domiciliary hospitalization expenses that are reasonable.
  • Expenses incurred during hospitalization on anesthesia, oxygen, medicine, operation theatre, ICU, surgeon, surgical appliances, dialysis, radiotherapy, chemotherapy, x-ray, cost of a pacemaker, etc.
  • Physiotherapy if it is a part of overnight hospitalization costs.
  • Cost of any diagnostic procedures.
  • Room charge, doctor’s consultation fees, dressing charges, nursing charges.
  • Maternity expenses covered under OPD limit.
  • Dressing, plaster casts, splinters, etc.
  • 142 daycare procedures that do not require 24-hour hospitalization
  • Alternative treatments taken in a government recognized institution or hospital.

Exclusions of SBI Arogya Plus Policy

Although it is a comprehensive policy, SBI Arogya Plus policy does not cover the following related expenses, and the insurer is not liable to pay the policyholder if he incurs expenses related to the following treatments:

  • Pre-existing illnesses and diseases (This is only covered after a waiting period of 48 months.)
  • Any illness or injury except accidental injury during the first month of the policy coverage.
  • Maternity expenses for the first 9 months of the policy
  • For the first year of the policy, the following conditions are not deductible:
    • Tonsillectomy
    • External tumor
    • Cataract
    • Hydrocele
    • Hernia
    • Benign prostatic hypertrophy
    • Hysterectomy
    • Hypertension
    • Diabetes
    • Non-infective arthritis
    • Calculus disease
    • Sinusitis
    • Nasal disorder
    • Chronic renal failure or kidney failure
    • Varicose veins
  • Expenses incurred on overseas treatment
  • Epidemic diseases which are recognized by the WHO or Government of India
  • Intentional self-injury attempted suicide or injury that results due to a violation of the law
  • Injuries incurred due to war or war-like activities
  • Cosmetic or aesthetic treatments or surgeries
  • Any illnesses or condition due to AIDS, HIV or other venereal diseases
  • Injury or hospitalization due to the influence of alcohol or drugs
  • Treatment or rehabilitation expenses related to alcohol or drugs
  • Genetic disorders and internal or external congenital diseases
  • Injuries or treatment while serving under the military or police
  • Medical treatment related to depression or other mental disorders

Eligibility Criteria to Buy the SBI Arogya Plus Policy 

The SBI Arogya Plus Health Insurance Policy has a minimum entry age of 3 months and a maximum entry age of 65 years. It does, however, have a lifetime renewability option. The plan is both an individual and a family floater plan meaning additional members of your family, such as spouse, parents, and children, can also be covered under a single sum assured. There is no medical check-up required for a person below 55 years of age.  Let’s check the plan information in detail here:

Eligibility Requirement

Minimum age of entry:3 months

Maximum age: 65 years with the option of lifetime renewability

Options for Sum Insured

Options range from Rs 1,00,000 to Rs 3,00,000

OPD sum insured depends on the age of the person and previous medical check-ups as well as premium costs

Policy Term

Policy terms can be 1, 2 or 3 years

Premium

The premiums per annum are as follows depending on the sum insured:

 

·      If the sum insured is Rs 1,00,000 then the premium is Rs 8,900

·      If the sum insured is Rs 2,00,000 then the premium is Rs 13,350

·      If the sum insured is Rs 3,00,000 then the premium is Rs 17,800

Grace Period

There is a 30 day grace period for payment of premiums

Claim Process of SBI Arogya Plus Plan

SBI Arogya Plus Plan offers its policyholder the benefits of cashless services and paperless claim settlements across its network of hospitals. To avail cashless treatment, one must call the insurance company and request a pre-authorization in writing. Once all the information is verified, the insurance company will send the authorization directly to the hospital. The policyholder must provide the insurance ID card to the hospital to avail of this facility. Once the treatment is complete, the policyholder must send the insurance company all the required documents such as medical bills, reports, etc.  

For other types of hospitalization claim settlements, the policyholder must notify the insurance company immediately after the accident or event or injury has occurred. The documents that are required for the claim process have to be then be submitted to the insurance company after discharge. The following documents may be required when making a claim. 

  • Claim form with all the information duly signed
  • Photo ID and address proof of the policyholder
  • 2 stamp size photographs
  • Original Discharge certificate
  • If applicable, the death certificate
  • Copies of all medical treatments, diagnostic reports such as blood tests, x-rays, etc.
  • Investigation reports
  • Original Medical bills and receipts

Once all the required documents are submitted, the insurance company takes forward the claim process. It needs to verify all the documents and will inform the policyholder accordingly if their claim has been accepted or rejected. Once the claim is accepted, the insurance company will reimburse the policyholder within 7 days. If the claim is rejected, the insurance company will explain as to the cause of rejection of the claim.

Renewal Process of SBI Arogya Plus Policy 

The procedure to renew your SBI Arogya Plus Policy is very simple and hassle-free. The health insurance plan can efficiently be renewed through the Paisawiki.com or at your nearest branch office. While doing it online, the individual is required to provide certain details like Name, date of birth, policy number, etc. for the company to draw up their details. Once this is done, you can click on "Continue to get a quote" and choose the ‘renew health insurance cover’ option. The amount for renewal has to be paid much before the expiry date. In case one fails to make the payment by the expiry date, a grace period of 30 days is given. These grace periods protect the policy and provide the insured with the coverage without losing benefits such as the waiting period, and coverage of pre-existing illnesses, etc.

How to Buy SBI Arogya Plus Policy?

On the Paisawiki.com, you can enter details such as Name, Date of Birth, etc. and fill in your options to receive a quote. Compare and buy the plan of your choice . The plan can then be bought online or through a representative at your nearest SBI branch after submitting all the required documents and completing medical checkups if required.

Documents Required to Buy the SBI Arogya Plus Policy

Before deciding to apply for the SBI Arogya Plus Health Insurance Policy, one must do thorough and comparative research of all existing plans in the market. It is important to compare features such as premium in terms of coverage, claim settlement ration, range of network hospitals, value-added services, etc.

To get the right quote for your SBI Health Insurance Plan, you can visit a branch office or the official website and fill in the details required to receive a quote for your sum insured and premium to be paid. If you are ready to go ahead and apply for the SBI Arogya Plus Policy, then the following documents will be required when submitting your application:

  1. ID proof of all members in the plan such as PAN Card, Aadhar Card, Passport, Voting ID, Driving License, etc.
  2. Address Proof such as telephone bill, electricity bill, Aadhar Card, Passport, etc.
  3. 2 passport-sized photographs of all members that are going to be covered under the plan
  4. Proposal form duly filled and signed by the policyholder. Make sure to reveal everything correctly. Do not falsify any information as this may lead to the cancellation of your policy, or your claim may not be settled efficiently.

FAQs About SBI Arogya Plus Policy

Written By: Paisawiki - Updated: 22 September 2020

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