5 Lakh Health Insurance 

Your health is the foundation of your life's quality. Health issues can overshadow your achievements no matter how hard you work towards your goals. In today's world, where health problems and healthcare costs are rising, having a health insurance plan is not just a luxury but a necessity.
A 5-lakh medical insurance policy is a prudent step towards securing your finances and preparingRead More..
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Sum Insured 5 Lakh Health Insurance

  • Icon health maternity Happy Customer:
    20.46Cr
  • Icon health maternityClaims Handled:
    24000Cr
  • Icon health maternity Network Hospital:
    16625+

What Exactly Is A 5 Lakh Mediclaim Policy?

A 5-lakh health insurance provides coverage of up to ₹5 lakh to the beneficiaries. The sum insured of ₹5 lakh can be used to claim expenses for diagnostic tests, surgeries, and treatment for pre-existing according to the terms and conditions of the policy.
You can protect yourself and your family (in the case of a family floater plan) by investing in 5-lakh health insurance offered by a trustworthy insurance provider like SBI General. You may also be able to enhance your coverage by opting for optional covers.

5 Sublime Perks of Having a 5 lakh Medical Insurance Policy

With a 5-lakh health insurance, you can enjoy the following benefits:  

1. Satisfactory Coverage

This policy offers a sum insured of ₹5 lakhs, decent coverage for a small family. Such a plan can be extremely beneficial in case of sudden illness or accidents, providing significant financial relief. A 5-lakh health insurance can help you combat the ever-increasing healthcare costs, relieving you from the anxiety of managing unexpected medical expenses.

2. Cashless Treatment

If you get a health insurance plan from a leading insurer, like SBI General, you can avail of cashless hospitalisation at the network hospitals in India. All you have to do to avail yourself of this benefit is share your policy details with the network hospital of your choice and ask for cashless treatment.

4. Peace of Mind

A health insurance plan may not solve all your problems, but it can provide adequate financial coverage under challenging times when you or your family members fall ill. Without worrying about managing the finances, you can focus on the recovery journey and recover faster.

5. Tax Deductions

All Indian taxpayers can avail of a tax deduction of a maximum ₹1 lakh for the health insurance premium they pay for their family, including their parents over 60.

Top 5 Reasons to Go For 5 Lakh Health Insurance in India

If you have been thinking of investing in a health insurance plan, here are the top 5 reasons to help you make an informed decision:

1. Rising Healthcare Costs

The cost of healthcare in India is increasing at an alarming rate. Although you can’t stop the inflation, you can invest in a 5-lakh health insurance scheme to secure your finances. If you fall ill, the treatment costs can quickly add up and become a massive burden on you and your family, especially if you are hospitalised for a few days. To avoid such situations, you are advised to invest in health insurance.

2. Well-Rounded Coverage

With a 5-lakh health insurance plan, you can enjoy well-rounded coverage for your medical expenses, including diagnostic procedures, ambulance charges, and surgical fees.

3. Optional Add-on Covers

With a 5-lakh health insurance plan, you can select add-on covers to enhance your coverage. This unique feature allows you to customise your plan according to your requirements and pay strictly for what you want, allowing you to tailor your policy to your needs and budget.

4. Financial Security

Medical emergencies don’t usually announce themselves before impacting your family. A decent coverage plan can help you navigate such problems and secure your financial future.

5. Coverage for Pre-existing Diseases

You can get coverage for pre-existing conditions, such as diabetes, with a 5-lakh health insurance plan after the waiting period (if applicable).

General Inclusions and Exclusions In 5 Lakh Mediclaim Policy

Here is a list of common inclusions in 5-lakh health insurance:

  • In-patient hospitalisation expenses for when you stay in the hospital for a minimum of 24 hours
  • Pre- and post-hospitalisation expenses for about 30- 90 days
  • Treatment for congenital disabilities
  • Consultation charges
  • Surgeon’s fee
  • Diagnostic tests
  • Certain outpatient procedure expenses
  • Charges for ambulance services
  • Organ donor expenses (offered by some insurance providers)
  • Alternative AYUSH treatment expenses

Common exclusions in a 5-lakh health insurance plan are as follows:

Some health insurance plans offer add-on covers, like hospital cash benefits, no claim bonus protector, and major illness benefits, that you can utilise per your policy's terms and conditions.

  • Expenses for cosmetic surgeries and other non-essential medical procedures
  • Expenses for experimental treatment
  • Disposables
  • Medical expenses incurred outside the geographical boundaries defined in the policy
  • Rehabilitation expenses for substance abuse
  • Maternity and childbirth expenses (unless specified otherwise)
  • Weight management treatment
  • Expenses incurred due to treatments based on assisted reproductive technology

Who Needs a 5 Lakh Health Insurance Plan?

You can consider investing in 5-lakh health insurance if you fall under any of the following categories:

1. Young Adults and Individuals

Individuals who are just starting out in their careers or are relatively young and healthy can consider 5-lakh health insurance to secure their future and enjoy well-rounded coverage for low premium rates.

2. Individuals with a Restricting Finances

With a 5-lakh health insurance plan, you can enjoy well-rounded coverage for your medical expenses, including diagnostic procedures, ambulance charges, and surgical fees.

3.Individuals Who Don’t Have to Take Care of Dependents

If you don’t have the responsibility of taking care of your family, investing in 5-lakh health insurance for your family makes financial sense.

4.Individuals Who Don’t Have a History of Major Illnesses

A relatively healthy individual can enjoy the benefits of a 5-lakh medical insurance plan at a lower cost. If such an individual gets affected by any major illness after the waiting period, they can easily claim the incurred medical expenses after that.

5. A Small Family

If you are a part of a small family with relatively healthy people and no dependent parents to take care of, you may opt for 5-lakh health insurance for now. Enhancing your overall coverage is recommended as your children grow up, and your financial position improves.

Please note that these are general recommendations; you are advised to choose a health insurance plan only after carefully considering the pros and cons of the policy and analysing your requirements.

How to Pick the Best 5 Lakh Medical Insurance Policy?

Here are some tips to help you choose the right 5 lakh insurance plan for yourself:

  1. Look for an insurance provider with your preferred hospital as a part of their network.
  2. Read the policy documents to understand the inclusions and exclusions of the policy.
  3. Check for any co-payment, room rent, or similar clauses that may restrict your coverage.
  4. The claim settlement process of the insurer shouldn’t be unnecessarily complex.
  5. Look for add-on covers to enhance your coverage if your finances allow you to get comprehensive coverage.
  6. Choose an insurance provider with a high claim-settlement ratio to increase the likelihood of approval of your claim.
  7. Check the waiting period for pre-existing conditions in the policy documents. Some policies waive the waiting period for pre-existing conditions or decrease the period at additional costs.

Documents required for buying a 5 Lakhs Health Insurance Policy Online

Purchasing a 5 Lakhs Health Insurance Policy online is seamless and straightforward. To ensure a smooth experience, having the right documents ready is crucial. Here’s a simple guide to what you’ll need.

Essential Documents

  • Proof of Identity: Valid ID proofs such as Aadhaar Card, Passport, Voter ID, or PAN Card are required. These documents confirm your identity and are necessary for the policy issuance.
  • Proof of Address: Documents like a Utility Bill, Passport, Aadhaar Card, or Driving License serve as proof of residence. This helps in verifying your current address.
  • Age Proof: Your age can be verified with documents like a Birth Certificate, School Leaving Certificate, Passport, or Aadhaar Card. Age proof is important for accurately calculating premiums.
  • Medical History: While not always mandatory, having your medical history handy can be helpful. It includes any previous medical reports, prescriptions, and details of past treatments if required.
  • Income Proof: Sometimes, income proof such as a Salary Slip, IT Returns, or Bank Statement may be required. This helps in assessing your financial capacity for premium payments.

Steps to Upload Documents Online

  • Gather Documents: Ensure all required documents are scanned and saved on your device.
  • Fill in the Application: Complete the online application form with accurate personal and medical details.
  • Upload Documents: Follow the prompts to securely upload scanned copies of your documents.
  • Review and Submit: Double-check all information and documents before submitting your application.

Why Choose Online?

Buying a health insurance policy online is not only convenient but also secure. It saves time, reduces paperwork, and allows you to complete the process from the comfort of your home. With everything done digitally, you can get your policy issued instantly without hassle.

Get Started Today

Protect your health and secure your future by purchasing a 5 Lakhs Health Insurance Policy online. Have your documents ready and experience a quick, easy, and efficient process. Your health is your wealth—make the smart choice today.

Eligibility for 5 lakhs health sum insured plan

Ensuring your health and well-being is paramount, and our 5 Lakhs Health Sum Insured Plan is designed to provide comprehensive coverage when needed. To be eligible for this plan, here are the simple criteria:

1. Age Criteria:

  • Minimum Age: 18 years
  • Maximum Age: 65 years

2. Medical Examination:

  • For individuals below 45 years: No medical examination required
  • For individuals above 45 years: Medical examination may be necessary, subject to the insurer's discretion

3. Medical History:

Individuals with pre-existing conditions may still be eligible, but coverage for those conditions may have specific terms and waiting periods.

4. Policy Renewal:

The policy can be renewed annually, ensuring continuous coverage for your health needs.

5. Citizenship:

Indian citizens, as well as NRIs (Non-Resident Indians) residing in India, are eligible for this plan.

6. Premium Payment:

Premiums are based on factors such as age, sum insured, and medical history.

How to Apply?

  • Check Eligibility: Ensure you meet the criteria mentioned above.
  • Research Plans: Explore various insurance providers and their offerings.
  • Fill Application: Complete the application form accurately.
  • Submit Documents: Provide the necessary documents to support your application.
  • Payment: Pay the premium through the preferred mode of payment.
  • Policy Issuance: Upon approval, your policy will be issued, providing coverage.

Invest in Your Health Today!

By meeting these straightforward eligibility criteria, you can avail yourself of the benefits of a 5 Lakhs Health Sum Insured Plan. Prioritise your health and secure your future with comprehensive coverage.

Factors Determining the 5 Lakh Health Insurance Premium

Here is a list of the most important factors affecting your policy premium:

1. Age

The first thing any insurance provider evaluates is your age when offering health insurance. The policy premium largely depends on your family's average age (in the case of a family floater plan) or your individual age. The higher the average age of the policyholder(s), the higher the policy premium.

2. Medical History

Since people with pre-existing conditions are likely to raise claims, their policy premiums are usually higher than those of individuals without pre-existing conditions.

3. Geographical Location

The policyholders’ geographical location makes a big difference in their claim requests. Someone who lives in a metro city will be charged more for treatment than someone who lives in a rural area.

4. Lifestyle Habits

Another factor which influences your policy premium is your lifestyle habits. People who have hazardous occupations, people who smoke, or people who consume alcohol are considered high-risk individuals; thus, their policy premiums are usually high.

How Does the 5 Lakh Health Insurance Plan Work?

The working of a 5-lakh health insurance plan is explained briefly below:

1. Premium Payment

After purchasing a health insurance policy, you must ensure timely payment of the policy premium to enjoy continued coverage. You can pay the policy premium monthly or quarterly, for example.

2. Claim Settlement

You can raise claims in two ways:

  • By visiting a network hospital, you can avail of cash claim services and get treatment.
  • By depositing a claim form with supporting documents, you can get a reimbursement for your medical expenses.

3. Policy Renewal

You can usually renew your insurance policy by paying the premium after the expiry date or talking to an expert from the insurance provider’s team to discuss your plan's coverage.

How to Purchase a 5 Lakh Health Insurance Plan via SBI General?

Today, you can purchase a 5-lakh health insurance plan from SBI General Insurance, such as the Arogya Sanjeevani Health Insurance, by visiting the official website or downloading our mobile app. You may also visit the nearest branch office to discuss the policy details with an expert and choose the right policy for yourself. Before purchasing a health insurance policy, you should carefully read the policy wording and clarify your doubts.

Once you have purchased a policy, you will receive the policy documents and other relevant information in your email. A physical copy of the documents will be shared via mail with you at your registered address.

Benefits of Obtaining a SBI General 5 Lakh Mediclaim Policy

Some of their key benefits are mentioned below:

  • Access to more than 6000 network hospitals
  • Coverage for in- and out-patient procedures
  • Coverage for 60 days pre- and 90 days post-hospitalisation
  • No claim bonus (NCB) for every claim-free year
  • An increment of 15% on NCB every claim-free year
  • Opinion from an expert panel of doctors
  • Option to refill the sum insured
  • Coverage for organ donor expenses

How to Make a Claim for Your 5 Lakhs Health Insurance Policy Online

Claiming your 5 Lakhs Health Insurance Policy is quick and hassle-free with our online platform.

Steps to Follow:

  • Notify Us: Inform us about your claim by filling out our online claim form or contacting our customer support team.
  • Submit Documents: Upload the necessary documents, including medical bills, discharge summary, and other relevant paperwork.
  • Review Process: Our claims team will review your submission and assess the validity of your claim.
  • Approval: Once your claim is approved, the settlement process begins.
  • Receive Payment: Receive your claim amount directly into your bank account or through other preferred methods.

Why Choose Online Claim Processing?

  • Convenience: Submit your claim anytime, anywhere, without visiting our office.
  • Faster Processing: Online claims are processed quicker, ensuring you receive your benefits promptly.
  • Transparency: Track the status of your claim in real time through our online portal.

FAQs About 5 Lakh Health Insurance

According to the law, health insurance premiums invite 18% GST.

It depends on your requirements. If you are relatively young and healthy and don’t have any dependents to take care of, a 5-lakh health insurance may be sufficient for you.

Generally, yes. However, a pre-defined waiting period exists to claim medical expenses for pre-existing conditions.


Summary Up

Now that you know the benefits of a 5-lakh health insurance plan, consider investing in securing your future. Health insurance plans that offer ₹5 lakh sum insured can provide adequate coverage for you or your family, especially if you don’t have any pre-existing medical conditions.

Some people don’t understand what is health insurance, which can often stop them from investing in their future. However, you can start by selecting suitable options since you understand health insurance's benefits, policy features, and more. Once you have shortlisted a policy worth considering, use the online health insurance calculator to calculate the tentative premium amount.

Disclaimer: The coverages/benefits and the extent of coverage may vary between plans. Please read the policy wordings carefully before making a purchase. SBI General Insurance and SBI are separate legal entities and SBI is working as Corporate Agent of the company for sourcing of insurance products. Tax benefits are subject to changes in tax laws.

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