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SehatSarmaya

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What you need to know

Extensive Coverage

Credit-based hospitalisation coverage is provided to you and your family members (including parents) at a network of pre-approved hospitals across the country1. Key features of coverage include:

  • 24 hours/52 weeks/365 days round-the-clock medical coverage
  • Accessible in all major hospitals across Pakistan
  • Use of non-network hospitals on re-imbursement basis

Coverage is provided in case of:

  • Inpatient Hospitalisation
  • Day Care Treatment
  • Emergency Accidental Out-patient Treatment
  • Specialised Investigations
  • Pre-Hospitalisation Benefit
  • Post-Hospitalisation Benefit
  • Miscellaneous Expenses
JS SehatSarmaya Coverage of Family Members

Add family members to the plan including children (above 90 days old), spouse (up to age 60) and parents (up to age 64) in the policy. Each family member is entitled to an independent coverage at the same benefit level as the main applicant. Once enrolled, the coverage can be continued up to the age of 65 years. This plan is issued for 1 year and can be renewed on an annual basis.

No Claim Bonus

Earn a bonus if there is no claim under the policy for 2 consecutive years. In addition, the basic annual limit will be enhanced by 100% with effect from the following policy year, free of charge. This limit enhancement, however, doesn't apply to individuals aged 55 years and above.

Coverage for pre-existing medical conditions

Coverage for pre-existing medical conditions is available after 4 policy years. Pre-existing conditions, if any, must be disclosed by the insured member at the time of enrollment.2

Get the policy at premium rates

Get the most affordable rates for the plan you choose and for the individuals you enroll in the plan

Benefit Limits:
The following chart gives you the Benefit Limits:

Description of Benefits Bronze Silver Gold Platinum
Basic Annual Limit Rs.100,000 Rs.200,000 Rs.350,000 Rs.500,000
Additional Annual Limit for Accidental Hospitalizationt Rs.25,000 Rs.50,000 Rs.100,000 Rs.100,000
Additional Annual Limit for Accidental Hospitalizationt Rs.25,000 Rs.50,000 Rs.100,000 Rs.100,000
Intensive Care Unit Actual Actual Actual Actual
Pre/ Post Hospitalisation Investigations 30 days 30 days 30 days 30 days
Pre/ Post Hospitalisation Consultations 30 days 30 days 30 days 30 days
Pre/ Post Hospitalisation Medicines 30 days 30 days 30 days 30 days
Emergency Evacuation Sub Limit Rs.25,000 Rs.35,000 Rs.50,000 Rs.50,000

FAQs for SehatSarmaya

What is SehatSarmaya?

SehatSarmaya is a comprehensive healthcare package that provides financial protection in case of an illness or accident that leads to hospitalization. The plan is underwritten by Allianz EFU, Pakistan’s first specialised health insurance company.

What Does SehatSarmaya Offer?

SehatSarmaya offers coverage in case of:

  • In-patient Hospitalisation
  • Day Care Treatment
  • Emergency Accidental Out-patient Treatment
  • Specialized Investigations
  • Pre-Hospitalisation Benefit
  • Post-Hospitalisation Benefit
  • Miscellaneous Expenses

What is meant by network hospitals and discount centers?

Allianz EFU has developed a network of over 160 carefully selected hospitals spread across the country. In case of hospitalisation, one can avail the credit facility arranged by Allianz EFU through a simple pre-authorization procedure and Allianz EFU will settle your bills directly with the hospital, as per your entitlement. Moreover, to add greater value to our services, Allianz EFU has chosen discount centers in major cities whereby the insured members can avail discounts on outpatient consultations and investigations just by presenting their Health Cards. In addition to this, credit shall be extended for specialized investigations like CT scan, MRI and thallium scan (where available) provided prior approval has been obtained from Allianz EFU.

What are the applicable premiums under different age bands?
The age bands and applicable premiums are given below:

Age (Next Birthday) Bronze Silver Gold Platinum
90 Days to 18 Years 3,950 6,100 8,600 10,050
19 to 29 Years 4,900 7,400 9,700 11,700
30 to 34 Years 6,250 8,850 11,350 14,200
35 to 39 Years 7,200 11,100 15,150 18,150
40 to 44 years 8,500 14,000 18,650 21,600
45 to 49 Years 9,800 16,000 20,900 24,500
50 to 54 Years 11,250 18,050 22,950 27,100
55 to 59 Years 13,850 20,650 25,050 31,300
Note:
  • The above rates are inclusive of Government Taxes.
  • Please add Rs.750 as Policy Admin Fee & Stamp Duty.
  • The above rates are subject to change without prior notice.

Disclaimer:

  • JS Bank Limited is acting as a distributor of the Insurance Policy on behalf of Allianz EFU Health Insurance Limited. This product is underwritten by Allianz EFU.
  • For exact Terms and Conditions, please refer to the Policy Document.