Sahara Health Insurance in partnership with Shikhar Insurance Company is a financial arrangement where an insurer provides coverage for medical expenses in exchange for regular payments, known as premiums, which vary based on the chosen package.

Insurance Coverage

Coverage Topic — Coverage Amount

• Medical Expenses — Rs. 100,000 / Rs. 200,000 / Rs. 500,000

• Accidental Treatment — Rs. 100,000

• Accidental Death — Rs. 100,000

• Funeral and Transport Expenses — Rs. 20,000

Inclusions and Exclusions

What’s covered by Sahara Health Insurance?

In-Patient Hospitalization:

• This covers expenses when you’re admitted to a hospital for at least 24 hours.

• It includes room charges (single standard AC room/cabin), doctor and nurse fees, operation theater costs, and expenses for diagnostic tests, medicines, blood, and medical appliances.

Day Care Procedures:

• Recognizing advancements in medical technology, the policy covers approximately 150 specific treatments and procedures that may not require a full 24-hour hospitalization.

• This coverage applies even when the procedure is done with local anesthesia.

Pre- and Post-Hospitalisation Coverage:

• It includes medical expenses incurred in the 30 days before hospitalization (pre-hospitalization) and the 30 days after hospitalization (post-hospitalization).

What’s not covered by Sahara Health Insurance?

• Medical expenses incurred outside Nepal.

• Pre-existing Conditions for 4 years.

• Cosmetic Procedures.

• Dental and Vision Care.

• Alternative Therapies like Acupuncture, naturopathy, homoeopathy.

• Fertility Treatments.

• Mental Health and Substance Abuse.

• Experimental or Investigational Treatments.

• Self-inflicted Injuries or Illegal Activities, like Injuries from suicide attempts or illegal actions.

• War or Nuclear Risks.

• Non-prescription Drugs.

Also, this is a group insurance policy, so a separate payment receipt is not available. If an individual invoice is required, eSewa will reissue upon request.

Terms and Conditions

• Eligibility: For ages 5–65; health check-up required if over 45 (at user’s cost).

• Coverage: 1-year policy with a 30-day waiting period (except accidents).

• Claims: Submit within 30 days post-discharge.

• Premium: Varies by age and coverage; refund if application is rejected.

• Responsibility: Users must provide correct info.

To learn more about the terms & conditions, visit the source.

Insurance Partner: Shikhar Insurance

Note: This insurance package provides coverage only for people between 5 and 65 years.