The new Group Medical Insurance Scheme for in-service bank employees and retirees for 2026-27 will be active from 1st November 2026. The existing policy, covering employees and retirees other than SBI, is due to end on 31 October 2026 and will be renewed for 2026-27. The renewed policy will continue as a combined policy for in-service and retired employees. It currently covers around 5.70 lakh in-service employees and 1.53 lakh retired employees.
New Group Medical Insurance Scheme Policy 2026-27 for Bank Employees
#1) Under the renewed policy, the room rent limit in six metro cities and their urban agglomerations—Delhi, Mumbai, Chennai, Kolkata, Bangalore and Hyderabad has been increased from ₹5,000 to ₹7,000 per day. The ICU rent limit will increase from ₹7,500 to ₹9,500 per day.
#2) The maternity coverage has also been increased. For normal delivery, the limit is increased from ₹50,000 to ₹1 lakh, while for a Cesarean section, limit has been increased from ₹75,000 to ₹1.50 lakh. The maternity limit will include eligible baby-care expenses from delivery until discharge. Vaccination expenses for children up to one year of age, as per the National Immunisation Schedule, will also be covered within the overall maternity limit.
#3) The ex-gratia amount for employees suffering from critical illness has been increased from ₹1 lakh to ₹2 lakh. The cataract treatment limit has been increased from ₹40,000 to ₹50,000 per eye, including the cost of the lens and associated pre- and post-hospitalisation expenses.
#4) The dependent income eligibility limit has been increased from ₹18,000 to ₹24,000 per month.
#5) Another major change is related to infertility treatment. It was not included in the 2025-26 base policy and employees had to pay an additional premium for top-up coverage. For 2026-27, infertility treatment will be included in the base policy for all employees, with a separate standalone limit of ₹2 lakh for eligible needy employees.
Other Treatments Covered
#6) For all insured persons, albumin infusion will be included in the daycare list of procedures. Peritoneal dialysis will be covered under the base policy, with or without hospitalisation. Expenses related to oral chemotherapy, including medicines, professional consultation fees and medically necessary investigations prescribed by the consulting physician, will also be covered.
#7) Under domiciliary treatment, vector-borne diseases such as Dengue and Chikungunya will be covered. Certain rare diseases listed by the Ministry of Health and Family Welfare under Group 2 and Group 3 will also be included.
Medical Insurance Premium for Bank Employees
#8) For 2026-27, the medical insurance premium for employees will be paid by the respective Bank. The coverage and premium mentioned are:
| Employee Category | Medical Insurance Coverage | Premium |
|---|---|---|
| Substaff & Clerical Staff | ₹4 lakh | ₹36,200 |
| Scale I to V | ₹5.25 lakh | ₹46,467 |
| Scale VI & VII | ₹7 lakh | ₹68,454 |
Medical Insurance Premium for Retired Bank Employees
#9) The Medical Insurance Premium for Retired Bank Employees is as follows:
| Category | Coverage | Retiree with Spouse | Retiree – Single Person |
|---|---|---|---|
| Substaff & Clerical | ₹3 lakh | ₹27,996 | ₹25,197 |
| Substaff & Clerical | ₹4 lakh | ₹32,144 | ₹30,329 |
| Scale I to V | ₹5.25 lakh | ₹41,714 | ₹38,552 |
| Scale VI & VII | ₹5.25 lakh | ₹41,714 | ₹38,552 |
| Scale VI & VII | ₹7 lakh | ₹62,213 | ₹49,770 |
Medical Insurance Add-on and Top-up Options for Bank Retirees
#10) For adding a physically or mentally challenged dependent family member, the add-on premium is ₹10,001 for ₹3 lakh coverage, ₹12,501 for ₹4 lakh coverage, ₹15,001 for ₹5.25 lakh coverage and ₹35,001 for ₹7 lakh coverage.
#11) Retirees can also opt for a top-up policy of ₹1 lakh, ₹2 lakh, ₹3 lakh or ₹4 lakh. The premium for a retiree with spouse is ₹13,126, ₹21,001, ₹30,801 and ₹41,001, respectively. For a single retiree, the corresponding premiums are ₹11,152, ₹17,851, ₹26,176 and ₹32,801.
#12) For a physically or mentally challenged dependent family member of a retiree, with or without spouse, the add-on top-up premium is ₹5,001 for ₹1 lakh, ₹10,001 for ₹2 lakh, ₹20,001 for ₹3 lakh and ₹30,001 for ₹4 lakh coverage per dependent.
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