SBI General - Arogya Plus Policy

Financial planning can go for a toss when serious illness/ accident adds up to routine health problems. Managing medical expenses becomes more challenging with rising medical costs. SBI General s Arogya Plus Policy is a financial protection against rising OPD medical expenses and hospitalisation expenses. It allows you to focus on your treatment by taking care of medical expenses better.

* No pre-policy medical test up to the age of 55 years for people with no medical history.
* Multiple coverage options - Individual & Family Floater options.
* OPD expenses as specified in the policy schedule.
* 142 Day Care expenses covered.
* Coverage of Pre and Post Hospitalisation Expenses - 60 days before and 90 days after the hospitalisation.
* Maternity Expenses covered up to the OPD limit.
* Sum Insured option of INR 1,00,000, INR 2,00,000 & INR 3,00,000.
* Save tax under Sec 80 D (Tax benefits are subject to change in tax laws).

This Health Insurance policy covers the following subject to the terms and conditions:
Eligible hospitalisation expenses as under:
* 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.
* OPD treatment: - expenses for OPD consultation and treatment up to limit specified.
* Pre-hospitalisation expenses up to 60 days for each of the admitted hospitalisation claim under the Policy.
* Post-hospitalisation expenses up to 90 days for each of the admitted hospitalisation claim under the Policy.
* Day Care expenses for 142 Day Care Procedures.
* Ambulance expenses up to INR 1500.
* Alternative treatment taken in a government hospital or in any institute recognized by government and/or accredited by quality council of India/national accreditation board on health.
* Domiciliary hospitalisation.
* Maternity Expenses covered under the OPD Benefit only.

Minimum entry age is 3 months and maximum entry age is 65 years. There is no exit age.

Individual/ Family {For Family Insurance Policy - Family means the spouse, dependent children, parents and parents in law. For Family Floater Insurance Policy - Family means the spouse and dependent children.
Hospitalisation sum insured options are 1, 2 and 3 Lakhs. OPD sum insured will depend on the age, premium and family type. Sum Insured of dependents will either be less than or equal to Proposer/ Primary Insured s Sum Insured.

* 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.
* 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.