SBI Health Insurance

SBI Insurance Company Overview

  • SBI Health Insurance Plans are best for providing complete and all-around protection to you and your loved ones. SBI Health Insurance Plans protects your hard-earned savings from ever-rising medical costs by paying a small premium amount.

  • SBI Health Insurance Plans comes in various forms like Arogya Sanjeevani, Arogya Premier, Arogya Plus, Arogya Top-up, Corona Kavach, Retail Health Insurance, Critical Illness, Hospital Daily Cash, Group Health Insurance and more. SBI Health Insurance Plans offers comprehensive protection through coverage for hospitalization, daycare procedures, medical care at home (domiciliary hospitalization), ambulance charges, pre and post-hospitalization, and more.

  • SBI General Insurance has a massive network of 6000+ Network Hospitals, 125 Locations across India, 22000+ branches, Satellite Presence in 350+ locations for helping its customers in all possible ways. With a customer base of Over 6.8 Crore Customers to date and successfully handled claims worth over₹ 11000 Crore, it has proven its popularity among the masses.

Some Important Facts

Incurred Claim Ratio 52%
Network Hospitals 6000+
Renewability Lifelong
Insurance Agent 8000
Branches 21000+

GIC Achievement of SBI Health Insurance

SBI General Insurance Company or SBI GIC has been in operation since 2010 and has established itself as a profitable insurance company with a broad customer base spread across India. SBI GIC has been awarded and recognised several times by prestigious groups like Indian insurance awards group for its excellent performance in the insurance industry. The company has received special acknowledgement for reaching out to the underserved segment of the country. SBI GIC has made its products widely available without compromise on quality and services.

All About SBI Health Insurance Plans

SBI GIC offers a range of insurance products among which SBI Health Insurance is a complete health insurance solution that covers a broad range of health insurance needs of individuals. Apart from health cover, SBI health insurance also offers tax benefits against premiums paid towards the policy. With SBI health insurance, you can avail cashless emergency and planned treatments in any of the 3000+ network hospitals of the company. It offers health insurance to individuals, families and corporate segment.

The company offers a cooling period of 15 days within which the policyholder can return the health insurance, and the policy is deemed cancelled.

Besides cover for basic medical illness, SBI health insurance also offers protection against critical illness, ambulance expenses, pre and post hospitalisation expenses, several other expenses and policy renewal benefits.

Features and Benefits of SBI General Health Insurance Policies

  • Good Coverage Options: SBI offers a range of health insurance plans where the policyholder can choose the sum insured amount as per his requirements and financial limitations.
  • A Wide Range of Add-ons To The Plan: The SBI Health insurance offers a wide range of add-ons to complement your basic health insurance. Some of the riders provided remove the sub-limits on room rent, ICU charges, consultancy charges, operation theatre fee etc.
  • Excellent Customer Support: The company provides 24x7 customer support to resolve issues, answer claim related queries and other queries related to insurance.
  • Free Medical Check-up: The policyholders are liable to get free health checkups upon the completion of at least four claim-free years.
  • Easy Purchase and Renewal of The Plan: It is possible to purchase and renew the plans online without any hassle by just following a few simple steps.

Checklist before Buying SBI Health Insurance

Before making a health insurance purchase, it is advisable to analyse personal and family needs related to health insurance. One should look at all the critical factors such as coverage, benefits, premium amount, policy term and so on. Comparing health insurance online can help you make an informed decision.

Following are the documents that you should keep ready while purchasing SBI General Health Insurance.

  • Identity Proof and Address Proof
  • Medical Certificate, If Required

SBI Health Insurance Plans List

SBI Health Insurance Plan

Let’s take a detailed look at each health insurance policy offered by SBI Health insurance.

Features of SBI health Insurance Plan

  • SBI Health Insurance is a comprehensive health insurance policy with a wide coverage from Rs. 50,000 to Rs. 5,00,000.
  • The policy doesn’t insist on a medical test up to the age of 45 years for people without any medical history.
  • The policy offers flexible plans under one roof – Metro plan, semi-metro plan and rest of India.
  • Pre and post hospitalisation expenses.
  • Free medical checkups for every four claim-free years up to Rs. 2500.
  • The policy covers ambulance charges, daycare expenses, ICU charges, specialist fees and other expenses as mentioned in the policy document.
  • The premiums paid towards this policy are tax exempted.

Three Plans Are Available Under This Policy, These Are:

Benefit Plan Treatment in location A (Mumbai & Delhi) Treatment in location B (Chennai, Kolkata, Bangalore, Ahmedabad & Hyderabad) Treatment in location C (The rest of India)
Plan A (Mumbai & Delhi) 100% 100% 100%
Plan B (Chennai, Kolkata, Bangalore, Ahmedabad & Hyderabad) 80% 100% 100%
Plan C (The rest of India) 70% 80% 80%

The percentage of the amount mentioned in the table above is with respect to the applicable insurance claim amount. The company will make payment only after scrutinising the necessary bills and documents.

Plan Details

Entry Age From 3 months to 65 years
Plan Basis Individual and family
Sum Assured Minimum: 50,000, Maximum: 5,00,000
Medical Screening Only for the customers above 45 years
Co-Payment 10%
Waiting Period 1 year

Arogya Premier Plan

SBI GIC has designed a special plan for high net worth individuals which offers excellent coverage and comes with a number of benefits and add-ons.

Features of Arogya Premium Policy

  • The policy has the most comprehensive coverage starting from Rs. 10 lakhs and going up to Rs. 30 lakhs.
  • The policy comes with individual and family floater options
  • The premiums paid towards this policy are eligible to receive tax benefits.
  • No medical tests are required for the customers aged below 55 years and ones who do not have a medical history.
  • The pre and post hospitalisation expenses are covered for 60 and 90 days, respectively.
  • The company gives reimbursement of health check-up benefits up to Rs. 5000 if no claims are made for four consecutive years.
  • The company provides a cumulative bonus of 10% on the sum assured for each claim-free year, (subject to a maximum bonus of 50% of the sum assured).
  • The maternity expenses are covered for an initial 9 months after taking the policy.

Plan Details

Policy Term 1,2, and 3 years
Entry Age From 3 months to 65 years
Plan Basis Individual and Family
Sum Assured Minimum: Rs. 10,00,000, Maximum: Rs. 30,00,000
Premium Payable in Advance
Medical examination Only for those above 55 years
No Claim Bonus 10%
Discounts Cumulative Bonus

Arogya Plus Plan

The SBI Arogya Plus plan is designed to enhance a policyholder’s health insurance with multiple coverage options. The plan ensures that the policyholders do not spend too much on hospital bills.

Features of Arogya Plus Plan

  • The policy offers two plan options: Individual and family plan with an equal sum assured for dependents or less than the sum assured for the primary party.
  • The plan has flat premium rates that are the same for all the age groups.
  • Maternity Expenses covered up to the OPD limit..
  • The plan does not cover pre-existing illness for the first four years of the policy and certain specified illness for the first year of the plan.
  • No medical tests are required for people aged below 55 years and ones who do not have a medical history.
  • The policy safeguards against 142 day care procedures and reimburses the ambulance expenses up to Rs. 1500.
  • The insured can claim tax benefits under Section 80D of the Income Tax Act, 1961.

Plan Details

Policy Term 1,2, and 3 years
Entry Age From 3 months to 65 years
Plan Basis Individual and Family
Sum Assured Minimum: Rs. 1 lakh, maximum: Rs. 3 lakhs
Premium For 1 lakh SA: Rs. 8,900
For 2 lakh SA: Rs. 13,350
For 3 lakh SA: Rs. 17,800

Arogya Topup Plan

The SBI Arogya Topup plan is the ideal health insurance to meet unexpected critical events such as accidents or illness, over and above the basic health insurance plan.

Features of SBI Arogya Topup Plan

  • The plan comes with individual and family floater option, where the family plan also includes the parents and parent-in-law in addition to the policyholder, spouse, and dependents.
  • No medical tests are required for the customers aged below 55 years and who do not have a medical history.
  • The pre and post hospitalisation expenses are covered for 60 and 90 days respectively.
  • The plan offers reimbursement of up to Rs. 5000 for ambulance charges.
  • The plan covers alternative recovery treatments such as Ayurveda, Yoga, Siddha, Unani, and Homeopathy (AYUSH).
  • The plan offers a grace period of 30 days from the policy renewal date.
  • The insured can claim tax benefits under Section 80D of the Income Tax Act, 1961.

Plan Details

Policy Term 1,2, and 3 years
Entry Age From 3 months to 65 years
Plan Basis Individual and family, family floater
Sum Assured Minimum: Rs. 1 lakh, maximum: Rs. 50 lakhs
Premium Discounts 5% discount for 2 years policy
7.5% discount for 3 years policy

Critical Illness Plan

The SBI Critical Illness policy covers the policyholder against at least 13 critical diseases. The plan provides a fixed sum if the policyholder is diagnosed with a critical illness, irrespective of the actual medical expenses. Health insurance helps you bear the high cost of critical illness treatment, thereby keeping you financially stable.

Features of SBI Critical Illness Plan

  • This policy provides coverage to the policyholder against 13 serious illnesses such as paralysis, coma, blindness, first heart attack, heart valve surgery, stroke, aorta graft surgery, major organ transplant, coronary artery bypass grafts, multiple sclerosis, primary pulmonary arterial hypertension, kidney failure and cancer.
  • As per the policy terms, only one critical illness shall be covered in one lifetime.
  • The insured can claim tax benefits under Section 80D of the Income Tax Act, 1961.

Plan Details

Policy Term 1 and 3 years
Entry Age Minimum: 18 years, Maximum: 65 years
Plan Basis Individual
Sum Assured Rs. 2 Lakh to Rs. 50 lakhs.

Hospital Daily Cash Plan

The SBI Hospital daily cash plan is specially designed to take care of the day to day medical expenses at the time of hospitalization of the insured. The plan generally covers miscellaneous expenses which are usually not covered by traditional health insurance plans.

Features of Hospital Daily Cash Plan

  • The policyholder receives daily cash benefit up to Rs. 2000 per day of hospitalisation.
  • The policyholder receives daily cash benefit up to Rs. 4000 per day of ICU hospitalisation.
  • The policyholder receives daily cash benefit up to Rs. 4000 per day of accidental hospitalisation.
  • The pre and post hospitalisation expenses are covered for 30 and 60 days, respectively.

Plan Details

Policy Term For individuals: 1,2 and 3 years
For the family: 1 year
Entry Age Minimum: 18 years, maximum: 65 years
Children from the age of 3 months

What is Not Covered Under SBI Health Insurance?

  • Diseases occurred within 30 days from the policy inception.
  • Certain surgeries like Hernia and Hydrocele will be covered after 1 year of waiting period from the policy inception.
  • Cataract, Hysterectomy etc. will be covered after 2 years of the waiting period.
  • Surgery of joint replacement will be covered after three years from the date of policy commencement.
  • HIV AIDS and other sexually transmitted diseases are not covered under SBI General health Insurance.
  • Treatments with alternative medication like acupressure, acupuncture, naturopathy, osteopath, etc. are not covered under SBI Health insurance.
  • Treatment arising from pregnancy are not covered.
  • Congenital diseases are not covered.

SBI Health Insurance Renewal Process

SBI General provides a comfortable and secure online policy renewal facility to its customers. The process is quick and user-friendly. It is possible to renew your SBI Health Insurance plan in a few simple clicks. Follow the below-mentioned steps to complete the online health insurance renewal process.

Step 1: As a registered user, log on to the official company website.

Step 2: Go to the “Renew your Policy” tab and enter the policy details which you want to renew.

Step 3: Click on “Renew” for instant SBI Health insurance online renewal.

Step 4: Pay the policy premium digitally by using any of the payment options given on the website and complete the policy renewal process.

Step 5: You will receive an authentication email on your registered email address. You can download the acknowledgement receipt of your SBI General health Insurance online renewal for the future reference.

Mediclaim policy of SBI

Value Added Benefits of Mediclaim Policy of SBI

On payment of additional premiums, the below add-ons can be availed with this policy. Any one or both the add-ons can be opted by the primary policyholder and will be applicable to all the members in the family

  • Removal of room & ICU rent sub-limits
  • Removal of sub-limits on operation and consultancy charges

Inclusion of Mediclaim Policy of SBI

Expense Heads Expense Limit (Rs.)
Medical Treatment with Room, Board & Nursing Expenses & Service Charges etc. Up to 1% of the coverage amount per day
Medical Treatment in Intensive Care Unit Up to 2% of the coverage amount per day
Admissible claims under 1 & 2 during the policy term Up to 25% of the sum insured per ailment/injury per claim
Consultants & Specialists Fees Up to 40% of the sum insured per ailment/injury per claim.
Anaesthesia, Blood, Oxygen, OT Charges, Surgical Appliances Up to 40% of the sum insured per ailment/injury per claim.
Appliances -
Pre-hospitalisation Up to 10% of the eligible hospitalisation expenses incurred 30 days prior to the date of admission into the hospital
Post-hospitalisation Up to 10% of the eligible hospitalisation expenses incurred 60 days after the date of discharge from the hospital.
Ambulance charges 1% of the coverage amount up to a maximum of Rs. 1,500.
Free Medical Check up Free medical check-up - 1% of the coverage amount up to a maximum of Rs. 2,500 for every four claim-free years.
Parental Care: Attendant nursing expense to look after f parents over 60 years of age. Available for individuals above 60 years. Attendant nursing expense post discharge from the hospital for Rs. 500 or actual, whichever is less per day, up to a maximum of 10 days per hospitalization. The cost can be reimbursed for a duration not surpassing 15 days during the entire policy term.
Child Care: Attendant escort charges to take care of child less than 10 years of age. Available for child less than 10 years. Attendant escort charges of Rs. 500 for every completed day of hospitalisation, subject to a maximum of 30 days during the policy term.
Limit of Cataract 15% of the coverage amount, subject to a maximum of Rs. 25,000 per eye, subject to first two years exclusion.
Accidental Hospitalisation Sum Insured Limit shall increase by 25% of the balance sum insured available subject to max of Rs.1 lakh. in case of accidental hospitalisation. Payable only once under the Policy per person.
Alternative Treatment (Subject to treatment availed at an Ayurvedic hospital confirming with the company’s definition of hospital and which is registered with any local government bodies) Reimbursement of Ayurvedic Treatment, up to a maximum of 15% of coverage amount per Policy term, up to a maximum of Rs. 20,000 & Homeopathy and Unani Treatment up to a maximum of 10% of coverage amount per policy term, up to a maximum of Rs. 15000.
Domiciliary Hospitalisation Reasonable and Customary Charges towards Domiciliary Hospitalisation as stated in the policy definition, subject to 20% of the coverage amount maximum up to Rs. 20,000, whichever less is.
Convalescence Benefit- Benefit available for policyholder over10 years & below 60 years. Covers the convalescence cost up to a sum not greater than Rs. 5,000 per policyholder, if the policyholder is hospitalised for any bodily injury or illness as covered under the Policy, for a period of 10 consecutive days or more. Admissible only once during the policy term.
Co-Payment on all eligible admissible claims in non-network hospitals 10% on all eligible admissible claims
Cashless facility Across SBI General's Network Hospitals
Coverage for select Day Surgery procedures where less than 24 hours hospitalisation is needed. Covers select Day Surgery where less than 24 hours hospitalisation for specified procedures

Source: SBI General Insurance

Exclusion of Mediclaim Policy of SBI

  • Any ailment, condition or injury for which the individual has been diagnosed, received medical treatment, had signs and/or symptoms, prior to the first policy’s inception, until 48 consecutive months have elapsed, following the inception date of the first policy with the insurer.
  • Any disease contracted in the first thirty days of the policy’s commencement.
  • Hernia and Hydrocele shall be covered after a 1-year waiting period
  • Hysterectomy and Cataract will be covered after a 2-year waiting period
  • Joint replacement surgery shall be covered after a 3-year waiting period, except undertaken due to an accident.
  • Treatment with alternative medicines
  • Treatment with regards to pregnancy and childbirth
  • Congenital diseases.
  • All costs related to AIDS and related diseases.
  • Use/Abuse of intoxicating drugs or alcohol.

Source: SBI General Insurance

Eligibility Criteria Apply to Mediclaim Policy of SBI

The minimum entry age for SBI General's Health Insurance Policy - Retail is 18 years. Children from the age of 3 months can be covered, provided that one parent is concurrently covered with SBI General's Health Insurance Policy - Retail. The maximum age of entry is 65 years.

Documents Required to Buy Mediclaim Policy of SBI

To avail a health insurance policy, an individual will be required to submit certain documents. Some of the documents include

  • Identity Proof - PAN card, Aadhaar card, Passport, etc.
  • Address Proof - Aadhaar card, Passport, Driving license, etc.
  • Medical certificate, if required

Documents Required to Claim Mediclaim Policy of SBI

Following is a list of documents that have to be submitted in order to file a claim:

  • Filled-up claim form,
  • Valid photo identity card
  • Original discharge card/certificate/death summary
  • Copies of prescription for diagnostic tests, treatment advise and medical references
  • Original investigation reports
  • Itemized original hospital bill and receipts
  • Hospital and related original medical expense receipt
  • Original pharmacy bills with prescriptions

SBI Health Insurance for Account Holders

SBI has an extensive presence with about 23,000 branches. The health insurance policies provided by SBI GIC are available for SBI account holders.

Adults aged between 18 to 65 years, and children between 3 months to 18 years of age are eligible to opt for the health plan. The policy has a one year waiting period for specified diseases. The policyholder can make cashless and reimbursement claims. Pre-policy medical test is not required up to 65 years of age for people with no medical history. The insurance coverage varies from Rs. 50,000 to Rs. 5,00,000. Cashless treatment is available at 3000+ network hospitals across the country. Pre and post hospitalisation expenses are covered under this plan. The premiums paid towards the health insurance policy are eligible to receive tax benefits under Section 80D of the Income Tax Act, 1961.

Document required to Buy SBI Health Insurance Policy

The following documents are required to buy SBI Health Insurance Policy:

  • Identity proof and residential proof
  • Medical certificate, if required

Claim Process with SBI Health Insurance

Cashless Claim Procedure:

Step 1: Take the approval from the company and contact the TPA.

Step 2: Keep the health insurance card with you during hospitalisation.

Step 3: The company will contact the network hospital and clear the bills.

Reimbursement Claim Procedure:

Step 1: Fill out the duly signed claim form issued by the company.

Step 2: Submit hospital bills, invoices and discharge summary along with the claim form.

Step 3: The company will reimburse the claim amount within seven working days from the date of claim.

Documents to Claim SBI Health Insurance Policy

Following is the list of documents required to file a claim against SBI General health insurance policy.

  • Hospital Details: The details of the hospital should be provided where the insured was undergoing the treatment. The details may include treatment name, duration of the treatment, number of doctors, nurses and available beds.
  • Hospital Bills: All the original bills issued by the hospital authorities must be produced at the time of making a claim towards the policy.
  • Discharge Report: Submit the original discharge report.
  • Other Reports: Original reports regarding the treatments, lab reports, other investigation reports, and medical bills have to be submitted.
  • Follow-up Details: The insured needs to send details regarding follow up and future line of treatment along with original bills.
  • Claims Form: The correctly filled and signed claims form has to be submitted along with all the documents mentioned in the list.

SBI General Health Insurance Network Hospitals for Cashless Treatment

SBI General Health Insurance company has an extensive network of 3000+ cashless hospitals through which the policyholders can get quality services with cashless facilities. To locate the nearest network hospital, log on to the official website of the SBI General Health Insurance and visit the “Hospital Network” section.

Reviews of SBI Health Insurance Policy

SBI Health insurance has always focused on helping their customers to make better informed decisions that give them better healthcare and a sense of security. It offers health insurance plans ranging from Rs. 50,000 to Rs. 50 lakhs. No pre-policy medical tests are required if the customer doesn’t have any medical history. SBI General Health Insurance offers individual and family floater plans that cover self-spouse, children and dependent parents, under one health insurance plan.

The policyholder can choose flexible plan options according to the location of the treatment. The company also offers lifelong renewability option to its customers. It has a quick and simple process to purchase and renew health insurance policies. They can be availed in a few simple steps from the company portal.

The health plans offered by the company include pre and post hospitalisation expenses. The policyholders can get free health check-ups up to a certain amount and are also eligible to receive no claim bonus and discounts. The health insurance coverage under SBI GIC can be enhanced by attaching additional coverage. Most importantly, the company offers a vast network of more than 3000 hospitals across the nation where you can get cashless treatment.

The premiums paid towards these health insurance plans are tax eligible under Section 80D of the Income Tax Act, 1961.

FAQ's On SBI Health Insurance

Why SBI Health Insurance Plans?

It is important to cover yourself against a sudden illness or injury that might leave you financially devastated and highly stressed. SBI General's health insurance plans help you manage your medical expenses ensuring quality, health, and happiness of your family.

What are the covers offered under Pre and Post Hospitalization Expenses?

Pre-hospitalisation expenses refer to the expenses incurred before the patient is moved to the hospital for treatment purpose. These expenses include:

  • Medical tests
  • Medicines
  • Vaccinations
  • Doctor’s fees

Post hospitalisation expenses are similar in nature, but are incurred once the patient moves out of the hospital after treatment.

What are the covers offered under Daycare Surgeries/Treatments?

SBI health insurance covers treatment like chemotherapy, Tonsillectomy, Cataract, etc. under day care surgeries/treatments.

What is the age limit for buying SBI health insurance policies?

The minimum age to buy SBI health insurance policy is 18 years; however, children as young as 3 months can also be part of health coverage if both the parents are enrolled under the same health insurance plan.

What is the maximum tenure of SBI health insurance policies?

SBI health insurance policies come with a policy term of up to three years.

What are the family floater policies? How are premiums calculated on SBI Health Insurance Plan?

Family floaters are the policies where the entire family is covered under one insurance plan. The premiums are calculated on the basis of the oldest person covered under the plan.

What is the waiting period for clearing coverages in case of emergencies?

SBI Health insurance offers a grace period of 30 days wherein the policyholder is not entitled to pay for healthcare expenses, although the insurer accepts the hospitalisation due to accidents. There is no waiting period during the renewal of old policies.

Does SBI General Health Insurance cover alternative treatments?

Alternative medicine treatments such as reflexology, aromatherapy, chiropractic, osteopathy, naturopathy, acupuncture, and acupressure are not covered under health insurance policies from SBI General.

How can I check my policy status for SBI General Health Insurance Policy?

You can check your SBI Health insurance policy status by visiting the official website of SBI General health insurance. Log in with a correct login id and password, enter the policy number and check the status of your policy.

What is the policy cancellation process under SBI Health Insurance Policy?

The company offers a free look period of 15 days within which you can cancel the policy and return it to the company. The company will refund the policy premium after deducting the stamp duty charges. You need to submit a duly filled form along with the original policy documents at the nearest SBI branch.

How to fill the SBI Health Insurance form?

The policyholder needs to fill up the part A of the form that contains details such as personal details, policy number, insurance history, details of hospitalisation, details about the claim, and bank account details of the insured. The part B of the form has to be filled by the hospital authorities.

What is SBI health insurance premium?

SBI health insurance premium is a fee paid to the company against the health coverage provided. The company offers a few modes of payment namely:

  • Cash payment at the nearest branch
  • Online premium payment

For online payment method, you can pay via credit card, debit card or net banking facility.

Customer Reviews
Average Customer Rating:
SBI Health Insurance 3 / 5 ( 4 reviews )
Write a review