A medical emergency can bring unexpected expenses beyond hospital bills. From transportation and food to income lost during recovery, hospitalization can create additional financial pressure. That’s where Sun Medicare can provide financial support through a fixed cash benefit for covered hospitalization cases.
And now, getting Sun Medicare is easier with eSewa. You can explore the plan, check its coverage and premium, and purchase the insurance directly through the eSewa app by scanning the QR code available at your nearest Sun Nepal Life branch.
What is Sun Medicare?
Sun Medicare is an add-on (rider) health benefit plan by Sun Nepal Life Insurance that provides financial support during emergency hospitalization. It covers 15 specified life-threatening conditions and incidents, with different benefits applicable to surgical and non-surgical cases.
The benefit can help you manage expenses such as transportation, food, daily household needs, or income loss during your recovery
Key Benefits of Sun Medicare
1. Coverage for 15 Specified Emergency Conditions
Sun Medicare provides coverage for 15 specified emergency conditions and incidents, including heart attack, stroke, kidney failure, fractures, and other covered emergencies.
2. Fixed Cash Benefit
The benefit is determined according to the applicable payout structure and hospitalization period, rather than the actual amount spent on medical treatment.
3. No Hospital Bills for Benefit Calculation
The payout is based on the policy’s defined terms and conditions, including the nature and duration of the covered hospitalization, rather than the actual hospital expenses.
4. Surgical and Non-Surgical Coverage
Different payout structures apply to covered surgical and non-surgical hospitalization cases.
5. Affordable Annual Premium
Get additional hospitalization protection with a premium starting from Rs. 1,000 per year, subject to the applicable plan and policy terms.
Coverage Details
Sum Assured
- Term Life Insurance: Rs. 50,000
- Medicare: Rs. 50,000
Policy Term
- 1 Year
Payout Structure
- Surgical Cases: 25% of the Sum Assured for the first 2 days and 10% of the Sum Assured for each of the remaining 5 days, as applicable under the policy.
- Non-Surgical Cases: 10% of the Sum Assured for each applicable day, up to 10 days
What Does Sun Medicare Cover?
Sun Medicare covers the following 15 specified diseases and incidents:
- Road traffic accident / acute injury at workplace or home
- Acute appendicitis
- Acute pancreatitis
- Myocardial infarction
- Moderate to severe stroke
- Gastrointestinal bleeding
- Traumatic brain injury
- Ectopic pregnancy
- Anaphylactic shock due to insect bite
- Hospitalization due to snake bite
- Pulmonary edema or organ dysfunction due to heat stroke
- Cardiopulmonary arrest (CPA) due to drowning
- Acute poisoning from pesticides, agricultural chemicals, household products, and specified chemicals
- Acute wound infections
- Second or higher-degree burn caused by electricity or fire
Coverage is subject to the definitions, conditions, and terms specified in the applicable insurance policy.
What is Not Covered?
Some key exclusions under Sun Medicare include:
- OPD treatment or hospitalization of less than 24 hours
- Pre-existing illnesses and related hospitalization, except where specifically covered
- Medical complications arising from chronic diseases, other than specifically covered conditions
- Treatment related to dengue, malaria, chikungunya, Japanese encephalitis, and kala-azar
- Chronic bacterial infections
- Injuries or hospitalization resulting from combat sports, riots, civil commotion, rebellion, or illegal activities
- Cosmetic, dental, elective, or pre-planned surgery, unless medically necessary due to an accident
- Injuries or illnesses arising from illegal acts or participation in hazardous or combat sports
- HIV/AIDS and related conditions
- Pandemics or epidemic conditions, unless specifically covered
- Hospitalization that is not medically required, including home-based treatment, outpatient consultation, and external or follow-up consultations
For complete details, exclusions, and conditions, please refer to the applicable insurance policy terms and conditions.
Why Consider Sun Medicare?
Hospitalization can affect your finances in ways that go beyond medical expenses.
Sun Medicare provides a fixed hospitalization benefit that can offer additional financial support when you need it most.
It may be suitable if you:
- Want additional financial protection against unexpected hospitalization
- Want a fixed cash benefit instead of expense-based reimbursement
- Want support for incidental expenses during hospitalization and recovery
- Want to complement your existing health or medical insurance
- Prefer a convenient way to purchase insurance digitally
How to Purchase Sun Medicare Through eSewa
Getting Sun Medicare is simple with the eSewa.
Step 1: Scan the QR code available at your nearest Sun Nepal Life branch using eSewa app.
Step 2: Explore the Sun Medicare plan and check its coverage and premium.
Step 3: Enter the required details.
Step 4: Complete the payment through eSewa.
Get in Touch with Sun Nepal Life
For more information about Sun Medicare, policy-related queries, claims, or further assistance, you can contact Sun Nepal Life Insurance Company Limited through the following channels:
Email: corporatesales@sunlife.com.np
Customer Support (WhatsApp/Viber): 9801234444
You can also visit your nearest Sun Nepal Life branch for personalized assistance and further information.
Find Your Nearest Branch: https://www.sunlife.com.np/en/about/network
