Sehat Zindagi
OBJECTIVE:
The objective of this product is to provide financial protection to an individual in case of unfortunate illness or accident that leads to hospitalization.
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Scope of Cover
State Life is pleased to offer a comprehensive in-patient health insurance product named ‘Sehat Zindagi Health Insurance’ Plan for consumer market.
The coverage will provide inpatient hospitalization, day care surgeries and benefits related to pre-and post hospitalization cost incurred by the policyholder through cashless mechanism from the network hospitals of State Life.
Who Can be Covered?
All Pakistani male/females aged 18-64 will be eligible for this product.
Coverage Period
Policy will be issued for a period of one year which may be renewed at the end of the policy year.
Premium rates subject to review by State Life each year
State Life Plans and Features
Benefits/Plans that can be chosen by the Individual
a) Following Benefits are covered under the Health Insurance Scheme of State Life:
| Package | Plan A | Plan B | Plan C | Plan D |
| Basic Hospitalization/ Room and Board Limits (Annual Limits Per Person) | 50,000 | 100,000 | 200,000 | 500,000 |
| Additional Limit for Accidental Emergencies (including ambulance charges) (Rs.) | 20,000 | 50,000 | 100,000 | 200,000 |
| Daily Room/Board | General Ward | General Ward | Semi-Private | Private |
| Pre/Post Hospitalization Investigations | 30 days | 30 days | 30 days | 30 days |
| Pre/Post Hospitalization Consultations | 30 days | 30 days | 30 days | 30 days |
| Pre/ Post Hospitalization Medicines | 30 days | 30 days | 30 days | 30 days |
| Medical Evacuation | – | 25,000 | 35,000 | 50,000 |
Specialized | In-patient lab and other tests carried out while being hospitalized. | |||
| OPD | Not Covered | |||
| Emergency Local Ambulance Charges | Covered | |||
| Coverage Applicable to: | All male and females aged 18 years to 64 years and their children from age 2 months to 17 years (if any). | |||
b) For Female Members (Optional Cover)
| Package | Plan A | Plan B | Plan C | Plan D |
| Basic Maternity Cover (Rs.) | 30,000 | 60,000 | 100,000 | 180,000 |
Note: C-Section or D&C are also covered where required under the maternity coverage. The maternity cover will be applicable after a waiting period of 6 months.
Benefits
1. Inpatient Care
Following medical expenses will be covered:
- Medical Practitioners’ fees
- Diagnostics Tests
- Medicines, drugs and consumables
- Intravenous fluids, blood transfusion, injection administration charges
- Operation theatre charges
- The cost of prosthetics and other devices or equipment if implanted internally during a Surgical Procedure.
- ICU / CCU / Stroke Unit costs
- In-patient lab and other tests carried out.
2. Hospital Accommodation
State Life will cover Reasonable and Customary Charges for Room Rent for Hospital accommodation.
3. Day Care Treatment
State Life will cover Medical Expenses for Day Care Treatment (including Chemotherapy, Radiotherapy, Hemodialysis, Dialysis or any procedure which needs a period of specialized observation or care after completion of the procedure) where such procedures/treatments are undertaken by an Insured Person as an Inpatient in a Hospital/Day Care Center for a continuous period of less than 24 hours.
Any OPD Treatment undertaken in a Hospital/Day Care Center will not be covered.
4. Emergency ambulance
State Life will cover Reasonable and Customary Charges for ambulance expenses incurred to transfer the Insured Person by surface transport following an Emergency to the nearest Hospital with adequate facilities if:
- The ambulance service is offered by a healthcare or ambulance service provider.
- State Life accepted an Inpatient Hospitalization claim.
Benefits/Plans that can be chosen by the Individual
a) Following Benefits are covered under the Health Insurance Scheme of State Life:
What happens when a policy is lost?
ln case the policy is lost, policyholder should get a duplicate policy issued. State Life issues it after completion of
certain formalilies and a nominal fee.