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SBI Arogya Top up Policy

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The Arogya Top Up Policy of SBI General allows you to add extra protection at low premium, so that you can easily overcome the rising medical costs in excess of your pre - decided medical costs. it provides coverage for both Individual and Family.

SBI General SBI Arogya Top up Policy - eligibility

  • Minimum Entry age is 3 months
  • Maximum Entry Age is 65 years
  • If the insured wishes to opt for an INR 5,00,000 deductible or more, the maximum age of entry will be extended to 70 years.

SBI General Health Insurance Review

SBI General Health Insurance
SBI General Health Insurance sum insured
1 lac − 30 lacs options available
Incurred Claims Ratio *
77.00%
SBI General Health Insurance tenure options
1 and 3 years options available
Claims Settlement Ratio **
75.20%
List of network hospitals
6,000+ hospitals
Number of policies issued *
637,615
Maximum family floater coverage
Self, Spouse + 2 dependent children (upto age of 23 yrs)
Number of lives covered *
4,654,150
* As per IRDAI report for 2020-21   |   ** As per NL25 data published on the Insurance Company website

SBI General insurance of Arogya Top up Policy overview

  • Key Features
  • Benefits
  • Exclusions

Key Features of SBI Arogya Top up Policy

  • Room Rent :Payable at Actuals upto Sum Insured
  • Co-pay :NIL co-pay for all treatment
  • Restoration Benefit:NIL Restoration Benefit
Sum Insured The plan provides a wide coverage of Rs. 1 lac to Rs. 50 lacs.
Policy Term 1, 2 and 3 years.
In-patient hospitalisation The plan covers hospitalization: Room rent & boarding expenses, Medical practitioners fees, Intensive care unit, Nursing expenses, Anesthesia, blood, oxygen, operation theatre expenses, surgical appliances, medicines & consumables, diagnostic expenses and x-ray, dialysis, chemotherapy, radiotherapy, cost of pacemaker, prosthesis/internal implants and any medical expenses incurred which is integral part of the operation, Physiotherapy as inpatient care and being part of the treatment, Drugs, medicines and consumables consumed during hospitalization period, Diagnostic procedures, Dressing, ordinary splints and plaster casts
Pre-hospitalisation The plan provides 60 days coverage for pre-hospitalization
Post-hospitalization The plan provides 90 days coverage for post-hospitalization
Ambulance Cover This plan covers ambulance expenses up to Rs. 5000 per hospitalization.
Alternative treatment This plan covers Alternative treatment covered by AYUSH.
Organ Donor Cover This policy covers the costs for organ donor’s treatment.

Benefits of SBI Arogya Top up Policy

  • Wide coverage - From Rs. 1 lac to Rs. 50 lacs with Rs. 1 lac to Rs. 10 lacs deductible option
  • No pre-medical test for people without medical history up to the age of 55.
  • 142 day care expenses covered.
  • Expenditure on maternity after the first 9 months of waiting.
  • Save tax in accordance with Section 80D.

Exclusions of Sbi Arogya Top up Policy

  • Waiting Period: 30 days from first inception of the health insurance policy.
  • Time bound Exclusions: Pre-existing diseases covered after first 4 years of coverage, Specified diseases or conditions covered after one year of coverage. First 9 months exclusion for Maternity expenses.
  • Treatment taken outside India.
  • Injury/disease directly or indirectly caused or contributed due to nuclear weapons/materials.
  • War, invasion, acts of foreign enemy, hostilities, etc.
  • Epidemic disease recognized by WHO or Indian government.
  • Intentional self injury or violation of any law.
  • Cosmetic or aesthetic treatments of any description, lasik treatment for refractive error. Any form of plastic surgery (unless necessary for the treatment of illness or accidental bodily injury).
  • Treatment for de-addiction from drug or alcohol or other substance.
  • Any condition directly or indirectly caused by or associated with human immunodeficiency virus or variant/mutant viruses and or any syndrome or condition of a similar kind commonly referred to as AIDS.
  • Vaccination or inoculation except as part of post-bite treatment for animal bite.
  • Treatment for any mental illness or psychiatric or psychological ailment / condition.
  • Outpatient department treatment
  • Genetic disorders and stem cell implantation / surgery / storage.
  • Treatments in health hydro, spas, nature care clinics and the like.
  • Experimental and unproven treatment Disease / illness or injury whilst performing duties as a serving member of a military or police force.

SBI General Health Insurance FAQ’s

There is No maximum exit age for this policy.

The minimum age of entry for SBI General’s Health Insurance Policy - Retail is 18 years. However Children from the age of 3 months can be covered subject to both parents concurrently covered with SBI General’s Health Insurance Policy - Retail. The Maximum age of entry for the policy is 65 years.

In a floater option single policy under one Sum Insured covers all in the family for e.g. 2Adults, 2 A 1C, 2A 2C, 2A, 1A2C , 1A 1C. The Sum Insured can be used by anyone in the family or all covered in the policy for multiple number of times till the time the Sum Insured limit is exhausted.

Sub limit defines the capping of insurance amount, for specific surgeries and medical procedures, which reduces the premium of the plan. You can also opt for an add on cover by paying extra premium to remove the sub- limits under the policy.

Yes, waiting periods will be applicable afresh in relation to the amount by which the Sum Insured has been enhanced. For example, if the waiting period for pre- existing disease is 4 years, any expenses under this cover can be claimed only after 4 years from the date of policy inception.

Brochure

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Policy wordings

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
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