SBI Health Insurance: SBI Health Insurance Plans and Policy

SBI Health Insurance Plans: SBI General Insurance is a joint venture between the Insurance Australia Group (IAG) and the State Bank of India. Where SBI have owns 74% of the total capital, and the rest is IAG.


SBI General is currently operating through satellite resources in 110+ cities in India with the presence of other 350+ locations. And its distribution network consists of over 21,000 certified SBI and its associate bank employees and around 8000 insurance agents. The company follows a strong multi-distribution model, consisting of bancasuration, broking, and direct retail channels.

GIC Achievement of SBI Health Insurance

SBI General Insurance Company or SBI GIC has worked since 2010. It has established itself as a profitable insurance company with a wide customer base with India. SBI GIC has been awarded and honored many times by prestigious groups like the Indian Insurance Awards Group for outstanding performance in the insurance industry. The company has received special acknowledgment for reaching the under-segment of the country. SBI GIC has made its products widely available without compromising on quality and services.

All About SBI Health Insurance Plans

SBI Health Insurance is a complete health insurance solution covering a wide range of health insurance needs of individuals. Apart from health cover, SBI provides tax benefits against the premium paid towards the health insurance policy. You can avail cashless emergency and planned treatment at any of the company’s 3000+ networked hospitals with it. It provides health insurance to individuals, families and corporate segments.

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

In addition, to cover for basic medical illness, SBI Health Insurance provides protection against critical illness, ambulance expenses, pre and post hospitalization expenses, various other expenses and policy renewal benefits.

Features and benefits

Good coverage option: SBI offers several health insurance plans where the policyholder can choose the sum insured according to his requirements and financial limitations.

A wide range of add-ons to the plan: SBI Health Insurance offers several add-ons to complement your basic health insurance. Some of the riders provided remove the sub-limits on room rent, ICU fee, consulting fee, operation theater fee, etc.

Excellent customer support: The company provides 24×7 customer support to resolve issues, answer claims-related questions and other insurance-related questions.

Free Medical Examination: Policyholders are responsible for conducting free health check-ups upon completion of at least four claim-free years.

Easy purchase and renewal of plan: By following only a few simple steps it is possible to buy and renew plans online without any hassle.

Checklist before purchasing SBI Health Insurance

Before making a health insurance purchase, it is appropriate to analyze individual and family needs related to health insurance. One should look at all the important factors such as coverage, benefits, premium amount, policy term and so on.

The following are the documents that you should keep ready when purchasing SBI General Health Insurance.

  • Identity proof and address proof
  • A medical certificate, if necessary

SBI Health Insurance Plan List

SBI Health Insurance Plans

Let us take a detailed look at each health insurance policy offered by SBI Health Insurance.

Features of SBI Health Insurance Plans

  • SBI Health Insurance is a comprehensive health insurance policy, with comprehensive coverage of Rs. 50,000 to Rs. 5,00,000.
  • This policy does not insist on medical examination up to the age of 45 for people with no medical history.
  • The policy offers flexible planss under one roof – Metro Plan, Semi-Metro Plan and Rest of India.
  • Pre and post-hospitalization costs.
  • For every four claim-free years, Rs. Free medical checkup for up to. 2500.
  • The policy includes ambulance fees, daycare expenses, ICU fees, specialist fees, and other expenses as noted in the policy document.
  • The premium paid for this policy is tax-deductible.

There are three plans:

  • Plan A (Mumbai & Delhi) 100% 100% 100%
  • Plan B (Chennai, Kolkata, Bangalore, Ahmedabad, and Hyderabad) 80% 100% 100%
  • Plan C (Rest of India) 70% 80% 80%

The percentage of the amount mentioned in the above table is in relation to the applicable insurance claim amount. The company will pay only after examining the necessary bills and documents.

Plan details

  • Entry age from 3 months to 65 years
  • Planning Personal and Family
  • Sum Assured Minimum: 50,000, Maximum: 5,00,000
  • Medical screening for customers above 45 years only
  • Co-payment 10%
  • Waiting period 1 year

Arogya premiere plans

SBI GIC has designed a special plan for high net worth individuals that provides excellent coverage and comes with many benefits and add-ons.

Features of Arogya Premium Policy

  • The most comprehensive coverage in the policy starts at Rs. 10 lakh and Rs. 30 million.
  • This policy comes with personal and family floater options.
  • The premium paid for this policy is eligible to receive tax benefits.
  • No medical examination is required for customers under age 55 and who do not have a medical history.
  • Expenses (pre and post-hospitalization) covered for 60 and 90 days respectively.
  • The company reimburses health check-up benefits of up to Rs. 5000 if no claim is made for four consecutive years.
  • The company offers a cumulative bonus of 10% on the sum insured for each claim-free year, (subject to a maximum bonus of 50% of the sum assured).
  • Maternity expenses begin 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 personal and family
  • Sum Assured Minimum: Rs. 10,00,000, Maximum: Rs. 30,00,000
  • The premium payable in advance
  • Medical examination only for those above 55 years of age
  • No Claim Bonus 10%
  • Discounts the cumulative bonus

Arogya Plus Plan

The plan (SBI Arogya Plus) designed to increase a policyholder’s health insurance with several coverage options. The plan ensures that policyholders do not spend too much on hospital bills.

Features of Arogya Plus Plans

  • The policy offers two plan options: individual and family plans, with the same amount for dependents or less than the sum assured for the primary party.
  • The plan has flat premium rates which are the same for all age groups.
  • Maternity expenses covered up to OPD limit.
  • The plan does not cover pre-existing disease for the first four years of the plan and there is some specified disease for the first year of the plan.
  • No medical examination is necessary for people under 55 years of age and who do not have a medical history.
  • The policy provides safeguards against 142 day care procedures and reimburses ambulance expenses up to Rs. 1500.
  • Under Section 80 D, the insured can claim tax benefits 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 personal and family
  • Sum Assured Minimum: Rs. 1 lakh, maximum: Rs. 3 lakhs
  • Premium for 1 Lakh SA: Rs. 8,900, 2 lakhs for SA: Rs. 13,350, 3 lakhs for SA: Rs. 17,800

Arogya topup plans

The SBI Arogya Topup Plan is the ideal health insurance to meet unexpected critical events over and above the basic health insurance plan.

Features of SBI Arogya Topup Plans

  • The plan comes with an individual and family floater option, where the family plan includes the policyholder, spouse and dependents as well as parents and parents.
  • No medical examination is required for clients under age 55 and who do not have a medical history.
  • Expenses (Pre and post) hospitalization covered for 60 and 90 days respectively.
  • The plans provides reimbursement of up to Rs. 5000 for ambulance fee.
  • The plan includes alternative recovery treatments such as Ayurveda, Yoga, Siddha, Unani, and Homeopathy (Ayush).
  • The plan provides a grace period of 30 days from the date of policy renewal.
  • Under Section 80 D, the insured can claim tax benefits of the Income Tax Act, 1961.

Plan details

  • Policy term 1,2, and 3 years
  • Entry age from 3 months to 65 years
  • Planning Individual and Family, Family Floater
  • Sum Assured Minimum: Rs. 1 lakh, maximum: Rs. 50 million
  • Premium waiver 5% discount for 2 years policy
  • 5% off for 3 years policy

Critical illness plan

SBI Critical Illness Policy protects the policyholder from at least 13 critical illnesses. If the policyholder discovers a critical illness, the plan offers a fixed amount, regardless of actual medical expenses. Health insurance helps you to bear the high cost of treatment of critical illness, leaving you financially stable.

Features of SBI Critical Illness Plan

  • This policy covers 13 critical illnesses such as paralysis, coma, blindness, prior heart attack, heart valve surgery, stroke, aortic graft surgery, major organ transplantation, coronary artery bypass grafts, multiple sclerosis, primary pulmonary artery hypertension, kidney failure and cancer. .
  • As per the terms of the policy, only one critical illness will be covered in a lifetime.
  • Under Section 80 D, the insured can claim tax benefits of the Income Tax Act, 1961.

Plan details

  • Policy term 1 and 3 years
  • Entry Age: Minimum: 18 years, Maximum: 65 years
  • Plan base personal
  • Sum Insured Rs. 2 lakhs. 50 lakhs.

Hospital Daily Cash Plans

SBI Hospital’s daily cash plans is specially designed to take care of the day to day medical expenses of the insured. The plan usually covers miscellaneous expenses that are not usually covered by traditional health insurance plans.

Features of daily cash plan of hospital

  • The policyholder gets Rs. Daily cash benefit up to Rs. 2000 per day hospitalized.
  • The policyholder gets Rs. Daily cash benefit up to Rs. 4000 per day in ICU hospitalization.
  • The policyholder gets Rs. Daily cash benefit up to Rs. 4000 per day for accidental hospitalization.
  • Expenses (Pre and post) hospitalization covered for 30 and 60 days respectively.

Plan details

  • Policy term for individuals: 1, 2, 3 years, For the family: 1 year
  • Entry Age: Minimum: 18 years, Maximum: 65 years, Children from 3 months of age

What is not under SBI Health Insurance?

  • Diseases occurred within 30 days from the inception of the policy.
  • Some surgeries like hernia and hydrocele will be covered after a waiting period of 1 year from the beginning of the policy.
  • Cataract, hysterectomy etc. will be covered 2 years after the waiting period.
  • Surgery of joint replacement will be covered after three years from the date of change of policy.
  • Transmitted diseases (HIV AIDS and other sexually transmitted diseases) not covered under SBI General Health Insurance.
  • Treatment of alternative medicines like acupressure, acupuncture, naturopathy, osteopaths, etc. are not covered under SBI Health Insurance.
  • Treatment arising from pregnancy is not covered.
  • Congenital diseases are not covered.

SBI Health Insurance Renewal Process

SBI General offers its customers a comfortable and secure online policy renewal facility. The process is quick and user friendly. It is possible to renew your SBI Health Insurance plan with a few simple clicks. Follow the steps below 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 you want to renew.

Step 3: Now click on renewal option for instant SBI Health Insurance online renewal.

Step 4: Digital payment of the policy premium using any payment option given on the website and complete the policy renewal process.

Step 5: You will receive an authentication email at your registered email address. Download your acknowledgment receipt in an online renewal for future reference.

SBI’s Mediclaim Policy

Value Added Benefits of SBI’s Mediclaim Policy

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

  • Removing the room and ICU reduces the sub-limit
  • Removal of sub-limits on operating and consulting fees

Inclusion of SBI’s Mediclaim Policy (expenses head & export limit in rs.)

  • Up to 1% of coverage amount per day with medical treatment room, board and nursing expenses and service charges etc.
  • In intensive care unit medical treatment up to 2% of the coverage amount per day
  • Admissible claims under 1 and 2 during the policy period, 25% of the sum insured per claim / injury per claim.
  • Per injury / injury up to 40% of sum insured as per consultant and expert claim.
  • Anesthesia, Blood, Oxygen, OT Charges, Surgical Appliances up to 40% Sum Assured / Injury per claim.
  • Pre-hospitalization up to 10% of eligible hospitalizations done 30 days before the date of hospital admission
  • Post-hospitalization up to 10% of eligible hospitalization expenses occurring after 60 days of discharge from hospital.
  • 1% of ambulance coverage amount up to a maximum of Rs. 1,500.
  • Free Medical Check-up Free Medical Check-up – 1% of coverage amount with a maximum of Rs. 2,500 for every four claim-free years.
  • Parental Care: The attendant’s nursing expenses for the care of parents over 60 years of age. Available to persons over 60 years of age. Attendant nursing expenditure post discharge from hospital Rs. 500 or actual, whichever is less per day, maximum 10 days per hospitalization. Costs can be reimbursed for a period of more than 15 days during the entire policy term.
  • Child Care: The attendant charges escort to take care of the child below 10 years. Available for children under 10 years old. The attendant escort fee of Rs. 500 for each full day of hospitalization, subject to a maximum of 30 days during the policy period.
  • Cataract 15% of the limit amount, maximum Rs. 25,000 per eye, subject to exclusion of the first two years.
  • Accident Hospitalization 25% of the Sum Insured available subject to a maximum limit of Sum Insured up to a maximum of Rs. 1 Lakh. In case of accidental hospitalization. Payable only once per person per policy.
  • Alternative treatment (with the definition of hospital of a company receiving treatment in an Ayurvedic hospital subject to treatment and which is registered with any local government bodies) Reimbursement of Ayurvedic treatment, up to 15% of the maximum amount of coverage per policy period , Maximum Rs. 20,000 and a maximum of 10% coverage amount per policy period in Homeopathy and Unani treatment, maximum Rs. 15000.
  • Reasonable and customary fees for domicile hospitalization in the policy definition, subject to a maximum coverage amount up to 20% in the policy definition. 20,000, whichever is lower.
  • Beneficiary Benefit – The benefit available to the policyholder is more than 10 years and less than 60 years. Rupee. The duration of the given period not exceeding 5,000 per policyholder, if the policyholder is hospitalized for any bodily injury or illness which is covered under the policy, for a period of 10 consecutive days or more. Acceptable only once during the policy term.
  • Co-payment on all eligible allowable claims in non-qualified hospitals 10% on all eligible allowable claims
  • Cashless facility in SBI General’s network hospitals
  • Coverage for select day surgery procedures where less than 24 hours of hospitalization is required. Day selects surgery where less than 24 hours of hospitalization is required for specified procedures.

The eligibility criteria applies to SBI’s Mediclaim Policy

The entry age (minimum) for SBI General’s health insurance policy – retail is 18 years. Children age (up to 3 months) can be covered, provided that one parent concurrently covered. The maximum age of admission is 65 years.

Boycott of SBI’s Mediclaim Policy

  • Any disease, condition or injury for which the person has been diagnosed, received medical treatment, had signs and / or symptoms before the first policy was established, as long as 48 consecutive months have passed, the date of the establishment of the first policy after. Insurance company.
  • Any disease is contracted within the first thirty days of the commencement of the policy.
  • Hernia and hydrocele will be covered after a waiting period of 1 year
  • Hysterectomy and cataract will be covered after a waiting period of 2 years
  • Joint replacement surgeries will be covered after a 3-year waiting period, except those performed due to an accident.
  • Treatment with alternative medicines
  • Treatment in relation to pregnancy and childbirth.
  • Congenital disease.
  • All costs related to AIDS and related diseases.
  • Drug / alcohol use / misuse.

Required documents

Documents required to purchase SBI Health Insurance Policy

The following documents are required to purchase an SBI Health Insurance Policy:

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

Documents claiming SBI Health Insurance Policy

Given below list of documents necessary to file a claim against SBI General Health Insurance Policy.

  • Hospital details: The hospital details should be provided where the insured was undergoing treatment. Details may include treatment name, duration of treatment, number of doctors, nurses and beds available.
  • Hospital bills: All original bills issued by the hospital authorities should be produced at the time of claiming for the policy.
  • Discharge Report: Submit the original discharge report.
  • Other Reports: Original report in respect of treatment, lab report, other test report and medical bill will have to be submitted.
  • Follow-up details: The insured is required to send details regarding follow-up and future line of treatment along with the original bills.
  • Claim Form: All documents mentioned in the list have to be submitted correctly and signed Claim Form.

Documents required to purchase SBI’s Mediclaim Policy

To avail health insurance policy, a person has to submit some documents. Some documents include

Identity proof –

  • PAN card
  • Aadhaar card
  • passport, etc.

Address proof –

  • Aadhaar card
  • Passport
  • driving license, etc.

Medical certificate, if necessary

Documents required to claim SBI’s Mediclaim Policy

The following is a list of documents to be submitted for filing a claim:

  • Completed claim form
  • Valid photo ID
  • Original discharge card / certificate / death summary
  • Prescription copies for clinical trials, treatment advice and medical references
  • Original test report
  • Original hospital bills and receipts
  • Hospital and related basic medical expenditure receipt
  • Original pharmacy bill with prescription

SBI Health Insurance for Account Holders

SBI has a wide presence with around 23,000 branches. Health insurance policies provided by SBI GIC are available to SBI account holders.

Adults between 18 and 65 years of age, and children from 3 months to 18 years of age can opt for a health plan. There is a waiting period of one year for the diseases specified in the policy. The policy holder can make cashless and reimbursement claims. Pre-policy medical tests are not required until the age of 65 for people with no medical history. Insurance coverage varies from Rs. 50,000 to Rs. 5,00,000. Cashless treatment is available in 3000+ networked hospitals across the country. Under this plans, pre and post hospitalization expenses are covered. The premium paid for a health insurance policy is eligible for tax benefits under Section 80D of the Income Tax Act, 1961.

Claim Procedure with SBI Health Insurance

Cashless Claim Procedure:

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

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

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

Reimbursement Claim Procedure:

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

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

Step 3: Within seven working days from the date of claim, the company will reimburse the claim amount

Network Hospital for Cashless Treatment

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

SBI Health Insurance Policy Review

It has always focused on helping its customers. It make better informed decisions that provide them with better healthcare and a sense of security. It offers health insurance plans ranging from Rs. 50,000 to Rs. 50 lakhs. If the client has no medical history, no pre-policy medical examination is required. SBI General Health Insurance offers a personal and family floater plan under a health insurance plan, covering self-spouse, children and dependent parents.

The policyholder can choose the flexible plan option according to the place of treatment. The company also provides lifetime renewable options to its customers. Health insurance is a quick and simple process to purchase and renew policies. They can be availed in few simple steps from the company portal.

Health plans offered by the company include pre and post hospitalization expenses. Policyholders can conduct a free health check up to a certain amount and are also eligible to receive claim bonuses and discounts. Health insurance coverage under SBI GIC can be extended by attaching additional coverage. Most importantly, the company offers a vast network of over 3000 hospitals across the nation where you can get cashless treatment.

The premium paid for these health insurance planss is taxable under section 80D of the Income Tax Act, 1961.

Question & Answer

Q: Why SBI Health Insurance Plan?

Ans: It is important to cover yourself against sudden illness or injury that can leave you financially devastated and under extreme stress. SBI General’s health insurance plans help manage your medical expenses, ensuring the quality, health and happiness of your family.

Q: What are the pre and post hospitalization expenses covered?

Ans: Pre-hospitalization expenses mean the patient is taken to a hospital for the purpose of treatment. These expenses include:

  • Medical tests
  • Medicine
  • Vaccination
  • Doctor’s fees

The costs of post hospitalization are similar in nature, but once the patient goes out of the hospital after treatment, it is incurred.

Q: What covers are provided under daycare surgery / treatment?

Ans: SBI Health Insurance covers treatments like chemotherapy, tonsillectomy, cataract etc. under day care surgery / treatment.

Q: What is the age limit to purchase an SBI Health Insurance Policy?

The minimum age to purchase an SBI Health Insurance policy is 18 years; However, children under 3 months can also be part of health coverage if both parents are enrolled under the same health insurance plans.

Q: What is the maximum age of SBI health insurance policies?

Ans: SBI Health Insurance Policy comes with a policy term of up to three years.

Q: What are Family Floater Policies? How is the premium calculated on the SBI Health Insurance Plan?

Ans: Family floaters are policies where the whole family is covered under one insurance plan. The premium is calculated on the basis of the oldest person covered under the plan.

Q: What is the waiting period to approve coverage in case of emergency?

Ans: SBI Health Insurance offers a grace period of 30 days, in which the policyholder is not entitled to pay health care expenses, although the insurer accepts hospitalization due to accidents. There is no waiting period during the renewal of old policies.

Q: Does SBI General Health Insurance cover alternative treatments?

Ans: Alternative medical treatments such as reflexology, aromatherapy, chiropractic, osteopathy, naturopathy, acupuncture, and acupressure are not covered by health insurance policies from SBI General.

Q: How can I check the status of my policy for SBI General Health Insurance Policy?

Ans: You can check the status of your SBI Health Insurance Policy by visiting the official website of SBI General Health Insurance. Log in with login ID and password, enter the policy number and check the status of your policy.

Q: What is the procedure for cancellation of policy under SBI Health Insurance Policy?

Ans: A free look period offered by company 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 stamp duty charges. You have to submit the duly filled form along with the original policy documents to the SBI branch.

Q: How to fill SBI Health Insurance Form?

Ans: The policyholder is required to fill in part of Form A which includes details such as personal details, policy number, insurance history, details of hospitalization, details about the claim and bank details of the insured. Part of the form is to be filled by the officials of B Hospital.

Q: What is SBI Health Insurance Premium?

Ans: SBI Health Insurance Premium is a fee paid against the health coverage provided by the company. The company offers some methods of payment:

  • Cash payment at nearest branch
  • Online premium payment

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


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