Today we are talking about SBI Health Insurance For Senior Citizens. State Bank of India(SBI) is one of the largest financial support providers in India in terms of its insurance scheme offerings. As old age brings several health issues that are expensive to treat and care for. The older a person gets, the more physical and mental stress starts to affect their health. Health insurance for Senior Citizens might become very helpful in these situations.
These insurance plans are designed to offer financial aid for medical treatments to individuals of 60 years of age or above in their hour of need. Senior citizen health insurance plans offer critical illness cover, cashless hospitalization, pre-existing disease cover, treatment of specified illness, disease, injury, or hospitalization within or outside the country.
All health insurance companies in India offer health plans to this particular segment to make them financially secure. So, do SBI has its health insurance policy for senior citizens known as SBI Arogya Plus Policy.
Factor to consider before choosing a suitable health plan for senior citizens
It is important not to just rely on your parent’s knowledge of their medical history at times of opting for a health insurance plan. Your parents might suffer from any certain health issue or medical conditions that they are not aware of.
Health insurance providers require information about the existing health condition that your parents bear in their current state. So, it is very important to provide thorough information regarding the medical history of your parents.
Several factors come while choosing the best-suited health insurance policy. It is very important to compare the various health insurance plans available in the market and consider factors such as cover, cost, and exclusions before zeroing in on the final right plan.
Form Fill up
Once chosen the right policy, you need to fill in the proposal form of the policy. It is necessary to provide correct and relevant information, as providing incorrect information will not just lead to complications but, also might cause rejection of the application.
After submitting the proposal form, the insurance company’s panel doctor will go through it and interview to verify the information on the form. Next, the doctor will conduct some tests depending on the health condition of the individual. Blood routine, lipid profile, sugar, urine routine, liver function test, kidney function test, serum creatinine, PSA(for men), sonography(for women) are some of them.
Senior Citizen’s Health Insurance Coverage
The insurance companies in India offer various types of senior citizen health insurance plans, so do the offered coverages differ from plan to plan.
Mentioned below are some of the coverages provided under the Senior Citizen Health Insurance Plan.
1. Health plans for senior citizens cover all kinds of medical and hospitalization expenses for the treatment of listed illnesses, diseases, injuries, or health conditions. These expenses also include room rent, fees of the doctors/specialists/physician, OT charges, costs of medicines and drugs, etc. These expenses are usually covered up to the limit of chosen insured sum amount.
2. Most of these health plans cover medical expenses made before and after hospitalization. Each plan has its own specific time and coverage limit, many plans cover 30 days of pre-hospitalization and 60 days of post-hospitalization expenses, while some cover, 60 and 90 days respectively.
3. After a specific waiting period, certain pre-existing medical conditions can be covered. So, you must thoroughly read the prospectus before buying a plan.
4. Many health plans for senior citizens cover daycare procedure expenses. The daycare procedures do not need 24 hours or more of hospitalization, such as in chemotherapy, dialysis, etc.
5. Some plans provide coverage for treatment at home to the insured, which makes it easier for old people to get the treatment without the hassle of traveling to the hospital at times when they are not in the condition to do so.
What is not covered in senior citizens’ health insurance
1. Any pre-existing injuries/diseases.
2. Any diseases contracted within 30 days of availing of the policy.
3. Any non-allopathic treatment.
4. Expenses related to self-inflicted injuries.
5. Expenses as a result of drug abuse.
6. Cost of spectacles/lenses and dental treatment (except arising out of accident).
7. Medical expenses incurred for treatment of Aids.
8. Certain health issues like joint replacement are covered only after 2 years of availing of the policy.
9. Cosmetic surgery.
10. Injury due to war, the act of foreign army, etc.
SBI Arogya Plus Policy (SBI health insurance policy for senior citizens)
1. Hospitalization cover includes medical bills and room charges.
2. Cashless Hospitalization.
3. Day Care expenses arising out of technological advancements.
4. Ambulance Charges are covered.
5. No medical test is required for up to 55 years of age.
6. Higher sum insured coverage.
7. Faster and hassle-free settlement.
8. Affordable comprehensive plan.
9. Multiple coverage options.
10. Policy period of 1, 2, or 3 years.
11. Sum insured ranges from Rs. 1 Lakh to Rs. 3 Lakhs.
12. Tax benefits under Sec 80D of the Income Tax Act, 1961.
13. Discount of 5% for 2-year term & 7.5% for 3 year term.
14. Access to over 10,000 hospitals for cashless treatment.
Scope of coverage
1. OPD expenses covered.
2. Inpatient hospitalization.
3. Domiciliary hospitalization.
4. Up to 142 daycare procedures covered.
5. 60 days pre & 90 days post-hospitalization expenses.
6. Reimbursement of alternative treatment under AYUSH.
7. Up to Rs. 1500 emergency ambulance expenses covered.
Premium chart (Excluding GST)
Premium before service tax Rs. 8,900
Premium before service tax Rs. 13,350
Premium before service tax Rs. 17,800
Premium after service tax Rs. 10,502
Premium after service tax Rs. 15,753
Premium after service tax Rs. 21,004
SBI General Arogya Plus Policy does cover Cashless hospitalization facilities. To avail of the cashless treatment, the insured must call the insurer and request pre-authorization in writing with the ID card issued along with the policy. If satisfied with the claim, the insurer will send an authorization letter to the insured or the hospital facility.
After the treatment, the insured must send all the original bills and receipts to the insurer for validation. For other hospitalization claims, the insurer must be notified immediately after an event that may give rise to a claim. The documents required for making the claim must be submitted to the insurer soon after discharge from the hospital.
Required documents for the claim
1. Duly filled claim form with all the necessary details.
2. Valid photo identity card and address proof of the insured.
3. 2 photos of the insured or the nominee.
4. Original discharge certificate.
5. Death certificate (if applicable).
6. Copies of medical treatments and diagnostic tests.
7. Original medical bills and receipts.
Once these documents are submitted to the insurer, the claim process will begin. The insurer will validate the claim by verifying all the submitted documents. The insured will get informed regarding the acceptance or rejection of the claim. After accepting, the insurer will settle the payment within 7 days from the date of acceptance. In case of rejection, the insurer will provide the reason for doing so.