SBI Health Insurance

SBI offers health insurance plans to suit the needs of various types of customers. Here’s everything you need to know about coverage, eligibility, policy term, add-on covers, cashless treatment, hospital networks, and several offers and benefits.

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The State Bank of India (SBI) Health Insurance is the health segment belonging to the SBI General Insurance Company that was launched as a collaboration between the State Bank of India (SBI) and the Insurance Australia Group (IAG) in 2009. These health insurance plans come with complete health coverage to individuals, senior citizens, and families.

Not only this, but it also offers customized health insurance plans for COVID-19, critical illness, and others. The SBI General Insurance Company has designed a fair, fast, and transparent process for proper management as well as faster claim settlement.

Health Insurance Plans Offered by SBI

Given below are all the health insurance plans offered by SBI Health Insurance:

  1. SBI Health Alpha 
  1. SBI Super Top-Up 
  1. SBI Health Edge 
  1. SBI Super Health 
  1. SBI Arogya Supreme Policy 
  1. SBI Arogya Sanjeevani Policy 
  1. SBI Arogya Top-Up Policy 

SBI Health Alpha

A comprehensive retail health insurance policy that provides coverage for Gen Z, millennials, and senior citizens. Under the Health Alpha policy, income saving option is also provided if you opt for long term. 

Features and Benefits 

Category 

Features 

Minimum Entry Age 

  1. Adult: 18 years
  2. Child: 91 days – 25 years 

Maximum Entry Age 

  1. Hospitilsation Cover: No limit
  2. Personal Accident: 65 years 

Tax Benefit 

  1. Under Section 80D 

Free Look Period

  1. 30 days 

Policy Term 

  1. 1 year – 5 years 

Renewability 

  1. Lifelong 

Premium

  1. Depends on variant, age, and sum insured 

Sum Insured

  1. Rs.5 lakh - Unlimited 

SBI Super Top-Up

Under this cover, an additional layer of protection is offered above the existing health insurance policy. A more comprehensive cover is provided. Features and Benefits 

The main features and benefits of the policy are mentioned in the table below:

Category

Features 

Tax Benefit 

Under Section 80D 

Deductible

Rs.2 lakh – Rs.2 crore

Eligibility 

  1. Minimum 18 years
  2. Maximum: No limit 

Premium

Depends on variant, age, and sum insured 

Sum Insured

Rs.5 lakh – Rs.4 crore 

Waiting Period

  1. General Illnesses:30 days
  2. Pre-Existing Conditions and Specific Diseases: 24 months 

SBI Health Edge

Cover is provided for health-related uncertainties at affordable prices under the SBI Health Edge plan.  

Features and Benefits

The main features and benefits of the SBI Health Edge plan are mentioned below: 

  1. You can claim discounts on the premium by availing the flexi benefit option of co-payment. 
  1. Several optional covers are provided. 
  1. You have an option to opt for a long-term policy of three years. 
  1. Sum insured can range between Rs.3 lakh and Rs.25 lakh.

SBI Super Health Insurance

Under the policy, cover is provided against medical expenses that are unexpected. Domiciliary hospitilisation and in-patient cover are offered.  

Features and Benefits 

The main features and benefits of the policy are mentioned in the table below: 

Category 

Features

Eligibility

  1. Adult: 18 yearsand above
  2. Child: 91 days and above 

Tax Benefit 

Under Section 80D 

Free Look Period

30 days

Health Check-Ups

Yearly

Waiting Period

  1. General Illnesses:30 days
  2. Pre-Existing Conditions and Specific Diseases: 12 months - 24 months 

Premium

Depends on variant, age, and sum insured 

Sum Insured

Rs.3 lakh – Rs.2 crore 

SBI Arogya Supreme Policy

The SBI Arogya Supreme policy is an all-encompassing health insurance plan which is supposed to provide cover for an extensive range of medical conditions and procedures. The policy offers a flexible sum insured ranging from Rs. 1 lakh to Rs. 5 crore and is available in three distinct variants: Pro, Plus, and Premium.  

Features & Benefits

The following are the features and benefits of SBI Arogya Supreme Policy Plan: 

  1. Comprehensive coverage for in-patient hospitalisation, domiciliary hospitalisation, and advanced medical procedures. 
  1. Special provisions for mental illness or psychiatric illness, HIV, and bariatric surgery coverage. 
  1. Inclusion of internal congenital anomalies, genetic disorders, and cataract surgery within the policy coverage. 
  1. Additional benefits include recovery benefits, compassionate visits, and domestic emergency assistance services. 
  1. Coverage for daycare procedures, alternative treatments, organ donor expenses, and e-opinion consultations. 
  1. Added advantages such as sum insured refill benefit, cumulative bonus, and annual health check-ups. 
  1. Comprehensive coverage for road ambulance services and pre-post hospitalisation expenses. 
  1. Optional benefits like major illness coverage, additional sum insured for accidental hospitalisation, and hospital cash benefits are available. 
  1. Enhanced options include cumulative bonus enhancement, a No Claim Bonus (NCB) protector, and the ability to upgrade to a higher room category.

SBI Arogya Sanjeevini

Comprehensive cover is provided for hospitilisation, including pre-hospitilisation and post-hospitilisation. Up to 50% of the sum insured is provided for modern treatments such as oral chemotherapy and robotic surgeries. 

Features and Benefits 

 The main features and benefits of the policy are mentioned in the table below: 

Category 

Features

Entry Age 

18 years – 65 years

Tax Benefit

Under Section 80D

Renewability

Lifelong 

Health Check-Ups 

Not required for individuals up to the age of 45 years who have no medical history

Waiting Period

  1. Initial Waiting Period:30 days
  2. Pre-Existing Conditions:36 months
  3. Specific Diseases: 24 months - 24 months 

Sum Insured

Rs.50,000 – Rs.10 lakh 

SBI Arogya Top-Up Policy

The SBI Arogya Top Up policy offers enhanced coverage to both individuals and families, helping them manage substantial hospitalisation and recovery expenses without depleting their savings. This policy includes a mandatory deductible ranging from Rs. 1 lakh to Rs. 10 lakh and offers a sum insured from Rs. 1 lakh to Rs. 50 lakh.  

Features and Benefits

The following are the features and benefits of SBI Arogya Top Up Policy Plan: 

  1. There is no requirement for pre-acceptance medical tests for individuals up to the age of 55 years. 
  1. Comprehensive coverage, encompassing in-patient hospitalisation, ambulance charges, and daycare expenses. 
  1. Coverage for pre-post hospitalisation and domiciliary hospitalisation. 
  1. Inclusion of maternity expenses and internal congenital diseases. 
  1. Provision for mental illness coverage and HIV or AIDS coverage. 
  1. Comprehensive coverage for alternative treatments, organ donor expenses, and advanced medical treatments. 

What is Covered in SBI Health Insurance Plans?

SBI General Health Insurance has lots of health insurance product. These plans come with lots of features and touch each and every domains of health insurance so that the policyholders can get all the benefits provided by the plans. Now, we will have a look at what all are covered in SBI Health Insurance Plans

SBI Health Insurance Coverage

  1. Individuals and Families: SBI Health Insurance provides health plans designed to offer coverage to individuals and their families. These plans are available for individuals aged 18 to 65 years and encompass coverage for pre-hospitalisation and post-hospitalisation, over 500 daycare procedures, e-opinion cover, domestic air ambulance, and more.
  1. Critical Illnesses: SBI Health Insurance extends coverage for 13 critical illnesses through its dedicated critical illness policy. This policy offers multiple plan options, a 15-day free look period, tax benefits, and sums insured of up to Rs. 50 lakh.
  2. Your Liabilities: SBI Health Insurance also addresses your financial liabilities through its loan insurance policy. This policy provides coverage for 13 critical illnesses, permanent disablement or accidental death, and loss of employment.
  3. All-in-one Plan: SBI Health Insurance presents a comprehensive super health insurance policy that encompasses a wide range of coverage needs. This policy combines 27 base covers and seven optional covers, covering daycare procedures, medical treatment abroad, maternity expenses, OPD expenses, wellness coverage, and road and air ambulance coverage, all under a single umbrella.
  4. Hospital Daily Cash: SBI Health Insurance offers a single policy to address your daily hospital cash needs. It provides daily cash benefits ranging from Rs. 2000 to Rs. 4000, convalescence expenses, and more.

Exclusions in SBI Health Insurance Plans

The following things are not covered under the SBI Health Insurance Plan:

  1. Treatments with alternative medicines such as acupuncture, acupressure, naturopathy, and osteopath are not covered.
  2. Treatments related to maternity are also not covered.
  1. Coverage associated to congenital diseases are excluded.
  2. HIV/ AIDS and other sexually transmitted diseases will not be covered.

Why Choose SBI Health Insurance Plans?

Here are some of the key advantages of opting for SBI health insurance plans:

  1. No Pre-policy Medical Tests: Many SBI health insurance plans waive the requirement for pre-policy medical tests for individuals up to the age of 45 years.
  2. Coverage for NRI Medical Expenses: SBI Health Insurance for NRIs extends coverage for the medical expenses incurred by non-resident Indians during their visits or stays in India.
  3. Round-the-clock Customer Support: SBI General Insurance Company boasts a well-coordinated customer support team that provides timely assistance to policyholders 24/7.
  4. Efficient Claims Handling: The claims team at SBI General Insurance Company is well-prepared to offer efficient and prompt assistance for all claim-related matters to policyholders.
  1. Tax Benefits: Policyholders can avail of tax-saving benefits on SBI Health insurance premiums under Section 80D of the Income Tax Act, 1961.

SBI Health Insurance Premium Calculation

The premium calculation for SBI health insurance plans is influenced by several key factors. These factors assess the level of risk associated with your health and the potential claims that may be required to address those risks. Let's delve into the factors that impact your SBI health insurance premiums in detail

  1. Age: Age is a primary factor considered by insurers when issuing an insurance policy. Older applicants are more susceptible to illnesses, so premiums tend to be more affordable when purchased at a younger age.
  2. Medical History: Your medical history plays a crucial part in determining the likelihood and frequency of future claims. If you have pre-existing medical conditions, your premiums are likely to be higher.
  3. Smoking Habits: Smoking is a hazardous habit that poses various health risks, including cardiovascular issues and other health problems. Smokers are more susceptible to diseases compared to non-smokers, leading to higher premiums.
  1. Profession: Your profession can significantly impact your health insurance premiums. Certain occupations come with inherent health risks, and individuals in such professions may face higher premium costs due to the increased likelihood of health issues.

How to Apply for SBI Health Insurance Policy?

The following are the steps to apply for the SBI Health Insurance Policy:

SBI Health Insurance Policy Online Application

  1. Visit https://www.sbigeneral.in/health-insurance/.
  2. Choose the number of people to be insured as well as their age.
  3. Select the city where you stay.
  4. Enter your name, gender, and mobile number.
  5. Choose the type of an existing illness or underwent any sort of surgical procedure.
  1. Select your preferred the SBI health insurance plan and make the payment of the premium.
  2. Once, you have made the premium payment, you will the policy document at your registered email address.

How to Renew SBI Health Insurance Plans?

The steps to renew SBI Health Insurance plans are as follows: 

  1. Visit https://www.sbigeneral.in/policy-renewal.
  1. Choose ‘Health Policy’.
  2. Click on ‘Continue’ button.
  3. You will be redirected to a new page.
  4. From the drop down menu under the ‘Policy Type’, select your insurance policy.
  5. Next, enter your policy number and click on ‘Get Quote’. 
  1. One of the executives from the insurance company will get in touch with your regarding the same.

 SBI Health Insurance Claim Process

The process for initiating a claim under an SBI health insurance plan is as follows:

  1. Claim Notification: Contact SBI General Insurance Company to report your accident or illness through a phone call or SMS. Obtain the claim number or reference number.
  2. Completion of Pre-authorisation Form: Acquire the pre-authorisation form, complete it, and submit it at the network hospital where you are receiving treatment. 
  1. Submission of Required Documents: The hospital will handle the submission of all necessary medical documents to the insurance company or its Third-party Administrator (TPA).
  2. Approval Process: The insurer or TPA will assess all submitted documents and make a decision to approve or reject the claim request.
  3. Claim Settlement: Following your discharge from the hospital, the insurer will settle the medical bills directly with the network hospital.

Eligibility Requirements for SBI Health Insurance Plans

The minimum age to purchase an SBI health insurance policy is 18 years of age, however if both parents are covered by the same health insurance plan, children as young as three months can also be covered.

Necessary Documents for SBI Health Insurance Application

You need to submit the following documents to file a claim under a SBI health insurance policy:

  1. Completed and signed claim form.
  2. Valid photo identification card.
  1. Know Your Customer (KYC) form.
  2. Copy of the SBI health insurance policy.
  3. Original hospital discharge summary. 
  4. Doctor's prescription for diagnostic tests.
  5. Doctor consultation letter, treatment recommendations, and medical references.
  1. Original itemised hospital bills and payment receipts.
  2. Original pharmacy bills, accompanied by prescriptions.
  3. Original receipts for medical expenses.
  4. Original medical reports.
  5. Original death certificate or post-mortem report (in the case of accidental death). 

Key Benefits of SBI Health Insurance Plans

The following are the benefits of SBI Health Insurance Policy:

Wide Net of Network Hospitals: SBI Health Insurance has tied up with over 20,000 network hospitals throughout India. The company’s goal is to offer top quality and easily accessible healthcare services to its policyholders.

Wide Range of Products and Services: SBI General Health Insurance has wide range of products and services which comprises plans ranging from family, individual, top up, floater, critical illness, hospital daily cash to loan insurance policy.

Huge Operating Network: One of the effective ways to keep customers happy is by providing them easy access to reach without any sort of hurdles. SBI Insurance has huge operating networks across the country. It has 24,700+ branch offices, digital partners, agents banks, and more.

24/7 Customer Support: SBI Health Insurance Policy has strong customer support system. The policyholders can get claim support and resolve their issues and queries associated to their policy at any point.

Additional Covers: SBI General Health Insurance has lots of plans that have additional covers daily hospital ash cover, critical illness cover, global treatment cover, accident care cover, and others. Policyholders can opt for these additional covers by paying extra premium charge.

Tax Savings: SBI Health Insurance plans allows the customer to avail tax savings under Section 80D of The Income Tax Act, 1961.

Plan Variants: Most of the SBI General Health Insurance plans has customizable options and multiple sum insured amounts. This provides the policyholders an option to purchase the insurance policy as per his financial capacity.

Customizable Plans: SBI health insurance plans are customizable which helps individuals to choose base cover as well as value added benefits according to their needs. 

SBI Health Insurance Customer Care Number

Given below are the contact details of SBI General Insurance Company:

  1. Phone No. (Weekdays – 8am to 8 pm): 1800 102 1111
  2. Health Claims Helpline No (24/7): 1800 210 3366, 1800 210 6366
  3. Email Id: customer.care@sbigeneral.in / customer@sbi.co.in

FAQs on SBI Health Insurance

  • What do SBI Health Insurance pre-hospitalization expenses include?

    Pre-hospitalization expenses encompass the costs incurred before a patient is admitted for treatment to the hospital. These expenses typically cover medical tests, medicines, vaccinations, and doctor's fees.

  • What do SBI Health Insurance post-hospitalization expenses include?

     Post-hospitalization expenses, though similar in nature, pertain to costs incurred after the patient is discharged from the hospital following treatment.  

  • What does SBI Health Insurance cover for daycare surgeries or treatments?

    SBI health insurance provides coverage for a range of daycare surgeries and treatments. This includes procedures such as chemotherapy, tonsillectomy, cataract surgery, and more.  

  • What are the age requirements for purchasing SBI Health Insurance policies?

    To purchase an SBI health insurance policy, the minimum age requirement is 18 years. Additionally, children as young as three months can be included in the coverage if both parents are registered under the same health insurance plan.  

  • What is the maximum policy duration for SBI Health Insurance Policies?

    SBI health insurance policies offer policy durations of up to three years, providing flexibility to policyholders.  

  • When should I notify the SBI Health Insurance company regarding reimbursement or planned cashless periods?

    It is advisable to inform the insurance company as soon as possible in cases of reimbursement or planned cashless hospitalisation periods to ensure a smooth claims process.  

  • Can I receive a refund if I don't make any claims during a policy period?

    No, there is no refund for policyholders who do not make any claims during a policy period. However, you may be eligible for a cumulative bonus of 5%, which can accumulate up to a maximum of 25%.  

  • Do SBI General Insurance Health policies offer lifetime renewability?

    Yes, health insurance policies provided by SBI General Insurance offer the benefit of lifetime renewability to all policyholders.  

  • Is maternity benefit included in SBI General Insurance Health policies?

    Yes, certain SBI General Insurance policies offer maternity coverage, including plans like the Arogya Premier Policy.  

  • What is the age limit for senior citizens in SBI General Insurance health plans?

    SBI General Insurance health plans extend coverage to senior citizens up to the age of 65 years.  

  • What is the term of the policy for senior citizen health insurance plans offered by SBI General Insurance?

    The health insurance policies designed for senior citizens by SBI General Insurance are available for policy terms of one year, two years, and three years, providing flexibility and choice to policyholders. 

Latest Updates and News on SBI Health Insurance

New SBI Super Health Insurance Plan

SBI General Insurance, a leading insurer in India, has introduced 'Super Health Insurance,' a comprehensive health insurance product designed to meet customers' diverse healthcare needs while alleviating the financial burden associated with medical expenses and hospitalisation. This policy offers an extensive range of coverage, including 27 standard and seven optional coverages. With four plans to choose from, customers can opt for sum insured amounts ranging from Rs. 3 lakh to Rs. 2 crore, and policy tenures spanning one to three years.  

The product is designed to cater to a wide range of customers from various income groups, including lower-income individuals and NRIs. It includes unique features like the 'ReInsure Benefit' that allows for a refill of the sum insured from the first claim onwards, among other benefits. 

Anand Pejawar, Director at SBI General Insurance, expressed the company's commitment to providing quality healthcare access through comprehensive health insurance solutions. The 'Super Health Insurance' product is part of their mission to offer the best-in-class coverage and features. It includes innovative elements such as a wellness cover with the 'Walk Healthy Benefit,' enabling customers to earn health benefits by achieving step goals on a dedicated app, leading to a reduction of up to 30% on renewal premiums. 

20 September 2023

SBI Health Edge Insurance Plan

SBI General Insurance has launched a fully customizable digital-only health insurance product named ‘Health Edge Insurance’. It is a single comprehensive plan having nine basic indemnity covers and 18 optional covers which allow policyholders to design a customized health insurance policy according to their needs. The policy offers multiple sum insured options that range from Rs.3 lakhs to Rs.25 lakhs along with long-term policy options for up to three years. 

26 April 2023
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