Arogya Top-up Policy
SBI Health Insurance
  • Cashless Treatment
  • Flexible Plan
  • Tax Benefits u/s 80D
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SBI Arogya Top-up Policy

SBI Arogya Top-up Policy is a health top-up plan that offers the additional cover along with the basic health insurance plan. It is designed to overcome the inflation over and above your existing basic health insurance plan. The plan allows the insured to continue the treatment even when the basic health insurance limit gets exhausted.

SBI Arogya Top-up Policy: Eligibility

Entry age30 months to 65 years
Sum assured1 lac to 50 lacs
Policy tenure1, 2 or 3 years
DeductibleApplicable
RestorationAvailable

Key Features

SBI Arogya Top-up is a suitable tool to enhance the basic health insurance policy. The plan carries great features which are given below for your reference.

  • Cashless Treatment: SBI Arogya Top-up Policy allows you to grab the cashless facility at SBI partnered network hospitals (3000+). Under the same, you don’t have to spend any amount on the hospital bills; the plan will take care of the same on your behalf.
  • Pre and Post Hospitalization: The plan offers coverage against pre-hospitalization expenses up to 60 days and post-hospitalization 90 days after you get discharged from the hospital.
  • Ambulance Charges: In case of an emergency, the ambulance charges might cost around Rs.5000 per hospitalization. Such expenses are also liable to get covered under SBI Arogya Top-up Policy.
  • Tax Benefits: The plan also comes out with tax benefits under section 80D of the Income Tax Act, 1961 for the premiums that you pay towards keeping your policy active. Maximum tax exemption- Rs.25,000 for self, dependent children & spouse, Rs.25,000 for parents and Rs.50,000 for old-age parents.
  • Co-Payment & Deductible: Co-payment is a process under which you have to pay a part of the hospital bill while filing the claim. Under the SBI Arogya Top-up policy, there is no co-pay clause. However, there is a clause related to the deductible which needs to be exhausted before you file any claim.
  • Pre-Existing Disease: The plan will be able to cover your pre-existing diseases after 4 years of continuous policy coverage.
  • Flexibility: The plan offers the flexibility to choose the premium tenure from 1 year/2 years/3 years.
  • No-medical Check Up: It does not ask for any pre-acceptance medical checkup to get insured until the age of 55 years.
  • Daycare Procedures: The plan offers the required cover against 144-day care procedures that do not require 24 hours hospitalization.
  • Organ Donor Benefits: The SBI Arogya Top-up Policy provides coverage against medical expenses for the organ donor’s treatment up to the sum insured limit.
  • AYUSH Benefits: The plan also covers against alternative treatment which includes ayurvedic, unani or homoeopathy, taken in a government hospital up to sum insured limit.
  • Domiciliary Hospitalization: SBI Arogya Top-up Policy is there to cover all expenses related to domiciliary hospitalisation (treatment at home) that takes place due to any genuine reason.
  • Maternity Expenses: Maternity expenses is something which is also liable to get the cover under this plan.
  • Restoration of The Sum Insured: It is an exclusive feature that allows the 100% restoration of the sum insured. You might have to pay an additional premium to avail of this benefit.
  • Discounts: The plan offers a discount on choosing a family floater option or insuring for a long tenure.

Is It Worthy To Invest in SBI Arogya Top-up Policy?

SBI Arogya Top-up Policy by SBI General Insurance Company is in demand because of the host of benefits that it offers. The plan is dedicated to offering additional protection that may arise because of inflated medical costs. It is an affordable yet effective option when it comes to having additional health protection. It might cost less as compared to investing in a new health insurance plan but the coverage is beyond your expectations. So, you never have to think about the insufficiency of basic health insurance and can get additional assistance whenever you need it.

Exclusions

  1. Injuries that take place because of war or warlike activities.
  2. Any disease or illnesses that come out within the initial 30 days of commencement of the plan except the accidental ones.
  3. Aesthetic and cosmetic treatment.
  4. Health conditions which include stone, gallbladder, diabetes, hernia, calculus diseases, hydrocele, benign prostatic hypertrophy, tonsillectomy, sinusitis, surgery of varicose veins, gastric or duodenal ulcers, chronic renal failure, non-infective arthritis and medical expenses for treatments which are taken outside India.
  5. Any venereal diseases or sexually transmitted diseases.
  6. Convalescence expenses.
  7. Injuries occur because of nuclear weapons or radioactivity.
  8. Maternity expenses within 9 months of the policy.
  9. Medical treatments associated with weight loss, obesity, and weight management.
  10. Injuries that took place under the influence of alcohol or drugs.
  11. Self-injuries and attempt to suicide.

Documents Required

Below is the list of required documents to buy SBI Arogya Top-up Policy:

  1. ID proof and address proof.
  2. Medical check-up report (if required).
  3. Proof of date of birth.

SBI Arogya Top-up Policy: Claim Procedure

The SBI Arogya Top-up Policy claim process is simple and quite similar to other health insurance plans by SBI General Insurance Company. In case you want to go for cashless hospitalization, you need to reach out the TPA along with the pre-authorisation form. You need to submit the same along with the ID proof to the TPA or the SBI General Insurance Company. The TPA will deal with the hospital bills directly. The TPA will collect all bills and proofs from the network hospital to process your case quicker.

In the case of reimbursement, the process is different. You have to pay for all the medical bills and can file a claim for reimbursement. To do that, you have to submit a few documents along with the claim form.

After submitting the required documents to the insured, the insurance company will start processing your claim settlement case. Once the company is done with the process, SBI executive will inform you about the acceptance or rejection of the claim. In case the claim gets rejected, you will receive the reason behind it. In case of the acceptance, the insurer will transfer the claim amount within 7 days.

Documents Required to Claim SBI Arogya Top-up Policy

Below is the list of required documents to claim the SBI Arogya Top-up Policy:

  1. Duly filled & signed claim form.
  2. ID proof with 2 passport size photographs (the recent one).
  3. Original hospital discharge card.
  4. All documents related to the treatment followed by medical bills.
  5. Death certificate (if required).
  6. Any documents requested by the insurer.

FAQs

Yes, there is a loading charge of 5% in the premium for smoking, tobacco and alcohol habits.

SBI Arogya Top-up Policy offers options of deductible ranging from Rs 1,00,000 to Rs 10,00,000.

It is very easy to check the status of the policy when you are a registered user of the same. You have to log in to the official website of the company along with the policy details. After logging in, you can easily check the status anytime.

You can pay the premium for SBI Arogya Top-up Policy through online and offline modes. You can pay in cash by visiting any branch or make the online payment with the help of your debit card, credit card or through net banking.

Yes, portability is allowed under the SBI Arogya Top-up policy. You are allowed to port the health policy into the SBI Arogya Top-up Policy.

Yes, the sum insured is allowed to be reinstated on payment of pro-rata additional premium. However, the policyholder has to choose for this benefit at the time of the inception only.

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Last updated on 24-02-2020