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SBI Health Insurance
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SBI Health Insurance

SBI Health Insurance has a range of health insurance plans catering to every insurance need with some innovative and unique features at affordable prices. Boasting a diverse portfolio of health insurance plans, SBI General Insurance caters to the needs of its captive clientele served by the largest public sector bank in the country in particular, and a wide cross-section of the society in general.

What is SBI Health Policy?

SBI Health Insurance is a non-life insurance policy, covering the expenses required for meeting medical emergencies, both as in and out-patient. SBI Health Insurance Policy delivers a comprehensive coverage for medical expenses and surgeries when the policyholder is hospitalized during the policy term.

Additional coverage is extended to pre and post hospitalization expenses for specified periods, ambulance charges, and variants offering a host of other innovative covers, including technology-driven treatment in day-care facilities. The coverage can be enjoyed by the policyholder, both as cashless hospitalization and reimbursement of incurred expenses.

SBI General Health Insurance is different from SBI Mediclaim, as the latter by nature limits the scope of cover both in terms of expenses and range of services. SBI Health Insurance Plans score over others not only by the variety of coverage but also in terms of reach and affordability, enabling the policyholder with financial security when faced with skyrocketing healthcare costs in medical emergencies.

About SBI General Insurance Company

Launched in 2010, SBI General Insurance Company is operating as a joint venture of SBI, and IAG - Insurance Australia Group. Consequent to the stake sale by IAG in March 2020, currently the Joint Venture stakeholders are SBI, Napean Opportunities LLP, WP Honey Wheat Investment, PI Opportunities Fund, and Axis New Opportunities. SBI Health Insurance comprises of multiple plans in different flavors in the Retail space, for an individual as well as a family offering customers with an eclectic range of choice.  They have a reach stretching across 24000 SBI Group Branches and 6400 Regional Rural Banks with a pan India presence in 114 + cities and 350 + alternative locations through satellite resources. The human resource strength of SBI Group is backed by 10000 agents reaching every nook and corner of the country. 

Why Should You Choose SBI Health Insurance Policy? 

SBI Health Insurance Plans comes with a range of benefits including cashless hospitalization, critical illness cover, daily cash benefit, personal accident insurance, top-up plans, and many more. These plans are delivered to a wide customer-base through a robust distribution model comprising of Agency, Retail Direct Channels, and Broking.

Some of the key highlights that make SBI Health Insurance eminently suited to a large number of individuals are:

  • 6000+ Network Hospitals
  • 52% of Incurred Claim ratio
  • 24000+branches
  • iAAA rating for highest claim paying ability
  • Claims handled over Rs 110 billion
  • Easy Portability
  • Lifetime renewability
  • Pre-policy medical check-up is not required until the age of 45 years 

Features and Benefits of SBI Health Insurance Plans

Plans offered by SBI General not only aim at offering better healthcare through SBI Cashless Health Insurance in over 6000 plus network hospitals across India but also to instill a sense of security. SBI Health Insurance for account holders covers almost 1.5 crore individuals ensuring a broad captive audience. Though it is primarily SBI Accidental Insurance, it is symbolic of the range in their portfolio, attracting every section of Indian society.

Some of the features and benefits that help SBI Health Insurance stand out are:

SBI Health Insurance Features:

  • Wide Coverage Options: SBI Health Insurance is delivered both in the retail and corporate space. Accordingly, the sum insured range permits customers to choose in harmony with needs and financial resources.
  • Flexible Plans: The different types of plans delivered to suit the taste of policyholders in a broad spectrum of preferences and factors related to financing and location.
  • Multiple Add-on Options: Not only in the type of health insurance plans on offer, but there are also a host of add-on riders to enable the policyholder to enhance the ambit of cover to include different charges. Even the removal of sub-limit is permitted.
  • Liberal Pre-policy Screening: In most of the plans, pre-policy medical screening is waived until the age of 45 years with no underlying health conditions. In some plans, the age bar is even higher at 55 and 65 years respectively.
  • Ease of Operating: The comfort level of the policyholder is paramount in SBI Health Insurance to seamless online purchase, renewal, and claim settlement process. Servicing of policies is handled by a dedicated customer support team working 24/7. 

SBI Health Insurance Benefits:

  • Plan Basis: Different SBI Health Insurance plans cater to Individuals, family floater or the entire extended family comprising of self, spouse, dependent parents, and parents-in-law.
  • Flexible Entry Age: SBI Health Policy comes with a liberal entry age regime that extends from 3 months to 65 years.
  • Expense Cover: Different types of expenses are covered normally or through an add-on to include room, board, surgical procedures, diagnostics, OT and ICU charges, nursing, consumables including medicines and drugs, ambulance, and many more.
  • Pre and Post Hospitalization Expenses: Generally, the options encompassing such expenses range either as 30 and 60 days or 60 and 90 days, as per different SBI Health Insurance plans.
  • Special Covers: There are a host of special covers extended by some SBI Health Insurance Plans which allow Domiciliary Hospitalization expenses subject to conditions. Maternity expense is covered both with and without 9 month waiting period. Accidental Death cover is another addition. There is a plan exclusively for Critical Illness, other than rider covering 13 listed diseases. Arogya Plus even covers for out-patient treatment expenses.
  • Health Checkup: Some plans include free medical checkup facility after specified 4 claim-free years limited to Rs.5000
  • Renewal: SBI Health Insurance plans come with a lifelong renewability option.
  • Day Care Cover: Coverage extends to 142 daycare procedures, which do not require overnight hospitalization due to technological advancement.
  • Tax Benefit: All SBI Health Insurance plans enjoy tax savings under Section 80D of the Income Tax Act, 1961 subject to compliance of conditions 

Types of SBI Health Insurance Plans

SBI Health Insurance has a portfolio encompassing different types of plans to suit every individual preference. Each SBI General Health Insurance is laced with unique features providing extensive coverage for medical expenses, making them attractive. Presently, there are nine distinct SBI Health Insurance Plans catering to a broad spectrum of customers.

  • Arogya Premier Policy
  • Arogya Plus Policy
  • Arogya Top-up Policy
  • Retail Health Insurance Policy
  • Critical Illness Insurance Policy
  • Hospital Daily Cash Insurance Policy
  • SBI Group Health Insurance
  • Loan Insurance Policy
  • Arogya Sanjeevani Policy 

Eligibility Criteria for SBI Health Insurance Policy:

Since the number and types of health insurance plans are varied in number, it is imperative to check for eligibility criteria of each, so that an informed choice can be made to buy the best option. Here’re SBI health insurance eligibility norms: 

Eligibility norms across all SBI Health Insurance

Plan

Basis

Entry Age (Yrs)

Policy Term

Sum Insured

Arogya Premier

Individual and Family

3 months to 65

1, 2, and 3 yrs

Rs 10L to 30L

Arogya Plus

Individual and Family

3 months to 65

1, 2, and 3 yrs

Rs 1L to 3L

Arogya Top-up

Individual and Family

3 months to 65

1, 2, and 3 yrs.; Family 1 yr

Rs. 1L to 10L

Retail Health insurance

Individual and Family

3 months to 65

1 yr

Rs 50 to 5L

Critical Illness Insurance

Individual

Up to 65

1  and 3 yrs

Up to Rs 50L

Hospital Daily Cash Insurance

Individual and Family

18  to 65

1, 2, and 3 yrs.; Family 1 yr

Daily cash- Rs 2000-4000

Group Health Insurance

Individual and Family

3 months to 65

1 yr

Rs. 1L to 5L

Loan Insurance

Individual

18 to 60

3 yrs

Fixed or reducing

Arogya Sanjeevani

Family floater

Up to 65

1 yr

Rs. 1L to 5L

SBI Health Insurance Plans Explained 

Different types of health insurance plans of SBI General are explained below:

Arogya Premier Policy:

This SBI Medical Insurance is specially designed for high net-worth individuals with a wide range of coverage of medical expenses.

Key Features

The key features of this health insurance policy are:

  • Suitable for Individual and family
  • Free of any Sub-limits
  • Pre and Post Hospitalization expenses up to 60 and 90 days respectively
  • Domiciliary Hospitalization
  • Cumulative Bonus: 10% of the sum insured for every claim-free year to a maximum of 50%
  • No pre-issue medical check-up till 55 years of age without any medical history 

Policy Coverage:

  • Sum Insured ranging from Rs 10 lakh to Rs 30 lakh
  • Expenses for 142 Day Care procedures
  • Maternity Expenses
  • Hospital expenses covering room rent, boarding, doctor fees, Operation Theatre and ICU charges, medicines consumed and Nursing
  • Reimbursement of health check-up up to Rs 5000 for 4 claim-free years 

Arogya Plus Policy:

Arogya Plus Policy from SBI Health is designed to provide enhanced health insurance coverage with multiple options and coverage.

Key Features

The key features of this health insurance policy are:

  • Under this SBI Family Health Insurance, the sum insured can be availed as individual, and family floater basis
  • Facility for out-patient treatment is provided
  • No pre-issue medical check-up is required till the age 55 years, without any medical history 

Policy Coverage:

  • Multiple sum insured ranging from Rs 1, 2 and 3 lakh
  • OPD sum Insured will depend on Age, Premium and Family type
  • Hospital expenses covering room rent, boarding, doctor fees, Expenses of operation theatre and ICU charges, medicines consumed and Nursing
  • Pre and Post Hospitalization expenses up to 60 and 90 days respectively
  • Premium is flat Rs. 8900, Rs.13350 and Rs.17800 for sum insured Rs.1, 2 and 3 lakh respectively
  • Alternative treatment expense cover is offered

Arogya Top-up Policy:

The primary aim of the Arogya Top-up Policy is to augment the health insurance cover at low premium rates. The sum insured in the top-up policy can be availed only when the base policy coverage is exhausted.

Key Features

The key features of this health insurance policy are:

  • Wide coverage
  • Ayush related expenses are entertained
  • No medical health check-up up to the age of 55 years
  • Tax benefits under Section 80D of the Income Tax Act

Policy Coverage:

  • Sum Insured from Rs 1 to 10 lakh
  • Expenses for 142 Day Care procedures are covered
  • Hospital expenses covering room rent, boarding, doctor fees, operation theatre and ICU charges, medicines consumed and Nursing
  • Pre and post-hospitalisation cover 

Retail Health Insurance Policy:

It is an SBI Health Insurance Policy aimed to deliver wide comprehensive coverage providing some unique features.

Key Features

The key features of this health insurance policy are:

  • Plan sum insured can be availed as individual and floater basis
  • No pre-issue medical screening till 45 years of age without any medical history
  • Zonal flexible plan options such as Metro, Semi Metro and Rest of India Plan
  • Complete insurance protection for entire family 

Policy Coverage:

  • Certain pre-existing diseases are covered after a waiting period of 1 year
  • Ambulance charges
  • Hospital expenses covering room rent, boarding, doctor fees, Operation Theatre and ICU charges, medicines consumed and Nursing
  • Pre and post-hospitalization expenses are covered for 30 and 60 days respectively
  • Extensive coverage starting from Rs 50,000 to Rs 5,00,000 

Critical Illness Insurance Policy

SBI Critical illness Health Plan is designed to cover certain lifestyle diseases such as cancer, heart attack and related ailments, kidney failure, and diabetes. It is a standalone Critical illness Policy for an individual, differing from a typical health insurance plan, where the sum insured is paid on diagnosis irrespective of the cost of hospitalization.

Key Features

The key features of this health insurance policy are:

  • Covers 13 critical illnesses
  • Multiple plan options
  • Free look period of15 days to cancel the policy
  • No pre-issue medical screening till the age of 45 years
  • Sum insured payable on diagnosis of any of the listed critical illnesses

Policy Coverage:

  • Sum insured to be availed maximum up to Rs.50 lakh
  • Two policy term options available- 1 and 3 years
  • Critical illness covered:
  • Cancer
  • Primary Pulmonary Arterial Hypertension
  • Kidney failure
  • Multiple Sclerosis
  • CABG
  • Major Organ Transplant
  • Aorta Graft Surgery
  • Stroke
  • Heart Valve Surgery
  • Myocardial Infarction
  • Blindness
  • Coma
  • Paralysis

Hospital Daily Cash Insurance Policy:

This is a unique SBI Health Policy that is specifically designed to meet the daily cash requirements of the policyholder during a hospitalisation, which is apart from the in-patient expenses.

Key Features

The key features of this health insurance policy are:

  • Daily cash allowance both during hospital stay and convalescence
  • No pre-issue medical screening till 45 years of age without any medical history
  • Multiple plan options
  • Maximum benefit to be availed for 30 to 60 days

Policy Coverage:

  • Hospitalization due to illness or accidental injury
  • Plans options:
    1. Cover for 30 days
    2. Cover for 60 days
  • Daily Cash Benefit ranging from Rs 2000 to Rs 5000
  • Convalescence expenses cover up to Rs 5000

SBI Group Health Insurance (Corporate):

SBI Group Health Insurance protects you and your family against an eventuality leading to hospitalisation. The policy offers extensive coverage and keeps your savings protected during an emergency situation.

Key Features

The key features of this health insurance policy are:

  • Plan choice of Individual and Family Floater
  • Medical expenses up to 30- and 60-days covering pre and post-hospitalization periods respectively
  • No pre-policy medical check-up till 65 years of age without any medical history

Policy Coverage:

  • Sum Insured from Rs 1 to 5 lakh
  • Hospital expenses covering room rent, boarding, doctor fees, Operation Theatre and ICU charges, consumed medicines, drugs, and Nursing etc. are offered 

Loan Insurance Policy:

SBI customers who avail of different loans are eligible for SBI Mediclaim Policy for Account Holders. This is a packaged policy specifically designed to align with loan disbursals.

Key Features

The key features of this health insurance policy are:

  • No pre-policy medical check-up till the age of 55 years and the sum insured up to Rs1 Crore
  • The policy can be availed for a maximum of 3 years
  • The sum insured can either be fixed or reducing, as per the choice of the policyholder

 Policy Coverage:

  • Critical illness cover for 13 listed diseases
  • Personal Accident cover for death as in SBI Accidental Insurance
  • Coverage for loss of job

Arogya Sanjeevani Policy:

It is a comprehensive SBI Mediclaim Policy designed to cover the entire family in a single policy. This plan comes in handy in covering the senior citizen parents or in-laws in the family.

Key Features:

  • No pre-policy medical check-up till the age of 45 years
  • Cumulative Bonus: 5% of the sum insured for every claim-free year to a maximum of 50%
  • Lifelong renewability

Policy Coverage:

  • Sum insured minimum Rs.1 lakh and maximum up to Rs.5 lakh
  • Hospital expenses covering room rent, boarding, doctor fees, operation theatre and ICU charges, consumed medicines and drugs, and nursing
  • Ambulance charges are covered
  • Pre and Post Hospitalization medical expenses are covered for 30 and 60 days respectively
  • An alternate mode of treatment expenses under AYUSH Cover 

Inclusions and Exclusions in SBI Health Insurance Policy

It is imperative for the policyholder to comprehend the exclusions and be aware of their impact, in the light of multiple SBI Health Insurance Plans. While there are general exclusions, there may be plan specific exclusion also, unless specified otherwise.

General Exclusions:

  • A 30 days hiatus from the date of inception for coverage to be admissible
  • A waiting period of 4 years is applied to any pre-existing disease
  • A waiting period of 1 year is applied to specific diseases like Ulcers, Tonsillitis, Hernia, Hydrocele, Cataract, Sinusitis, gall Bladder stones and Chronic Renal failure
  • Treatment taken abroad
  • Congenital diseases
  • Experimental and unproven treatment
  • HIV / AIDS and STD
  • Diseases related to substance abuse, intoxicants, and drugs
  • Acts of war, military operations, terrorism, etc.
  • Nuclear and radioactive peril

Policy Specific:

  • Outpatient treatment, until specifically covered
  • Alternative treatment, until specifically covered
  • Pregnancy and childbirth, until specifically covered
  • Deductible equal to first 24 hours hospitalization for Daily Cash insurance
  • Alternate modes of treatment, until specifically covered 

Claim Process of SBI Health Insurance

SBI health insurance offers cashless and reimbursement claim facility and ensures a seamless claim settlement without a hassle. 

  • Cashless: Also referred to as SBI Cashless Health Insurance, it is the preferred mode with SBI General boasting more than 6000 network hospitals. To avail this benefit, as preauthorization approval is provided by the insurer or the TPA at the hospital. Planned hospitalization can be intimated to the insurer or at the TPA, 72 hours prior to the admission, while in case of emergency hospitalization, it should be intimated within 24 hours.
  • Reimbursement: The claim should be intimated at the Toll-Free number 1800 22 1111 or 1800 102 1111. The duly completed Claim Form, along with all the endorsed Bills and Hospital Records and medical documents in original, is submitted to the TPA or the insurer. The claim is settled within 30 days of receipt of a valid claim.

Renewal Process of SBI Health Insurance

Generally, SBI Health Insurance Premium fall due on or before the policy anniversary, and it has to be paid to keep the policy in force. Usually, a grace period of 15 days is permitted for renewal. The renewal premium is paid with the understanding that no new illness has been contracted during the previous 12 months. Any addition of illness may result in a proportional increase in premium. Suppression of facts, on the other hand, may result in denial of coverage to the policyholder. The health policy may be renewed both Offline and Online.

Steps for Online SBI Health Policy Renewal:

  • Register as a user and log in at the official portal
  • Invoke the “Renew Your Policy” tab and input details of the policy to be renewed
  • Click on “Renew”
  • Make digital payment to complete the renewal process

Steps for Offline SBI Health Policy Renewal

  • Visit the branch office
  • You can approach an agent or broker as well
  • Pay the premiums buy cheque
  • Get the policy renewed instantly

How to Buy SBI Health Insurance Policy?

Before buying SBI Health Insurance, it is important to make a critical analysis of the parameters of health insurance. The critical factors to consider are coverage, benefits, premium, and policy term. It is wise to compare health insurance plans before committing to the final purchase. There are two modes by which an SBI Health Insurance policy can be purchased.

  1. Offline:
  • It is done by visiting the nearest SBI branch office
  • The dealing officer will suggest and provide the application form
  • The duly signed and completed form with all the requisite details has to be submitted to the concerned department
  • Consequent to successful verification of the proposal form, the policy document with be sent to the registered address
  • The progress of the application will be intimated at the registered email ID at all stages 
  1. Online:
  • Visit the insurer’s online portal or that of a suitable aggregator and invoke “Buy Online” and input the details and click "Proceed."
  • A quotes section will open with all the plans on view
  • Choose a suitable plan by clicking on the “Buy” button
  • Pay the premium online. The soft copy of the policy document is mailed to the registered email Id 

Documents Required to Buy SBI Health Insurance Policy

Irrespective of SBI Health Insurance purchased offline or online, the documents required are standard. However, there may be additional requirements for a specific plan sought by the insurer. The standard list of documents is listed below.

  • Identity Proof: It is a standard KYC requirement complied with the help of valid photo identity cards like EPIC, PAN, aadhaar, driving license, a passport to name a few.
  • Age Proof: It is crucial as it has a bearing with entry age compliance in addition to the applicable premium rate. Lower the age; lower is the premium. Any of the valid ID cards with the incorporated date of birth is accepted. Besides, birth certificate or school leaving certificates are other valid documents.
  • Residence Proof: Any of the already mentioned valid ID cards other than PAN, suffice as address proof. In addition, any current utility bill like electricity or telephone is accepted.
  • Income Proof: It depends on the category of the customer. For salaried applicants, salary slips, form 16, and ITR are sufficient. For self-employed applicants, balance sheet, P&L statement, and bank statement, apart from ITR are essential.

SBI Health Insurance FAQs:

Written By: Paisawiki - Updated: 10 July 2020

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