Network hospitals
6000+
Incurred claim ratio
73.92%
Sum insured
Up to 2 CR
No. of Plans
11
Solvency Ratio
1.8
Pan India Presence
141
Network hospitals
6000+
Incurred claim ratio
73.92%
Sum insured
Up to 2 CR
No. of Plans
11
Solvency Ratio
1.8
Pan India Presence
141
SBI Arogya Premier Policy is a comprehensive health insurance plan that is designed to protect you and your family from uncertain medical expenses.
The plan comes with wide coverage and shells out several benefits to its policyholders such as coverage against in-patient hospitalization expenses, pre and post hospitalization, AYUSH treatments, maternity expenses, mental illness, HIV AIDS cover, internal congenital diseases, genetic disorders, etc. Any individual can buy this policy for himself/herself or for his/her family where the family includes a spouse, dependent children, parents, and parents-in-law.
In the section below explore more about the plan and its several features:
Entry Age
3 Months to 65 Years
Sum Insured
10 to 30 Lakhs
Plan Type
Individual/Family Floater
Policy Term
1 / 2 / 3 year
Initial Waiting Period
30 Days
Renewal
Lifetime Renewability
*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
In-patient & Out-patient coverage
Room Rent
Covered
ICU Charges
Covered
Pre-Hospitalization
Covered, up to 60 days
Post-Hospitalization
Covered, up to 90 days
Domiciliary Hospitalization
Covered
Daycare Treatment
141 Daycare procedures covered
OPD Charges
Not Covered
Coverage Terms
COVID-19 Treatment
Covered
Cataract
Not Covered
No Claim Bonus
10% of SI for every claim free year
Automatic Restoration
Available up to 100% of SI
Daily Hospital Cash
Not available
Organ Donor
Covered
Maternity Cover
Covered
New Born Baby Cover
Not covered
Alternative Treatments
AYUSH Treatment
Covered
IVF Treatment
Not Covered
Modern Treatment
12 Modern Treatment covered
Emergency Coverage
Ambulance
Covered
Air Ambulance
Covered
Compassionate Travel
Not Covered
Global Coverage
Not Covered
Wellness Programmes
E-Consultation
Not Covered
Health Check-Up
Available up to 5K
Second Medical Opinion
Not Covered
Vaccination
Not Covered
Limitations
Co-payment
Not Applicable
Sub-limits
Applicable for Mental Illness coverage
The room rent limit is the maximum amount of bed charge that you can claim if you are hospitalized.
Common room categories covered under room rent are:
Coverage status under SBI Arogya Premier Policy?
Under SBI Arogya Premier Policy, the room rent is covered.
The Intensive Care Unit (ICU) is a hospital special department where patients with severe medical conditions are treated.
Coverage status under SBI Arogya Premier Policy?
Under this plan, ICU charges are covered
Medical expenses incurred before the hospitalization of the policyholder.
Coverage status under SBI Arogya Premier Policy?
This plan covers medical expenses incurred during pre-hospitalization for up to 60 days.
Medical expenses incurred after the discharge of the policyholder from the hospital.
Coverage status under SBI Arogya Premier Policy?
This plan covers medical expenses incurred during post-hospitalization for up to 90 days.
Home hospitalization arrangement for the insured person due to unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get financial coverage.
Coverage status under SBI Arogya Premier Policy?
Under SBI Arogya Premier Plan, domiciliary hospitalizations are covered.
Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.
Coverage status under SBI Arogya Premier Policy?
This plan covers the expenses of 141 daycare procedures.
Covers the cost of doctor consultation and prescribed medical tests that may not require hospitalization.
Coverage status under SBI Arogya Premier Policy?
The plan does not offer coverage against OPD expenses.
COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. an approved center.
Coverage status under SBI Arogya Premier Policy?
Covid-19 Covered.
A common eye condition in which your vision gets blurred.
Coverage status under SBI Arogya Premier Policy?
Not Covered under the plan
For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as a no-claim bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain percentage that varies from plan to plan.
Coverage status under SBI Arogya Premier Policy?
The plan offers a cumulative bonus of 10% of the Sum Insured on every claim-free year. This bonus can be accumulated up to 50% and will get reduced by 10% in case of a claim under the Policy.
Automatic restoration is a benefit in which an insurance company restores the sum insured amount completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from plan to plan.
Coverage status under SBI Arogya Premier Policy?
Automatic Restoration of Sum Insured up to 100% is available under the plan.
It is a cash amount that you receive each day during the time of hospitalization.
Coverage status under SBI Arogya Premier Policy?
The Daily hospital cash is not available under the plan.
It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body.
Coverage status under SBI Arogya Premier Policy?
Under the plan, Organ Donor expenses are covered.
It refers to the cover that includes expenses for normal and c-section procedures deliveries.
Coverage status under SBI Arogya Premier Policy?
Maternity expenses are covered after the first 9 months of the policy inception.
It takes care of the medical expenses that arise due to the hospitalization of the newborn baby in case of unforeseen circumstances. Some of the common treatments that are covered under the newborn cover are listed below and these common treatments can vary from plan to plan:
Coverage status under SBI Arogya Premier Policy?
Not covered
Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.
Coverage status under SBI Arogya Premier Policy?
AYUSH treatment is covered under this plan.
In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:
Coverage status under SBI Arogya Premier Policy?
Not available
Medical treatments that demand modern technology such as robotic surgeries, stem cell therapy, etc.
Coverage status under SBI Arogya Premier Policy?
SBI Arogya Premier covers 12 modern treatment procedures up to 50% of the sum insured.
An ambulance is used to move the patient from home to hospital, transfer to another hospital, and take them for different tests outside the hospitals.
Coverage status under SBI Arogya Premier Policy?
Actual ambulance expenses including air ambulance or INR 1,00,000 whichever is lower will be covered per hospitalization.
Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.
Coverage status under National Arogya Sanjeevani Plan?
Actual ambulance expenses including air ambulance or INR 1,00,000 whichever is lower will be covered per hospitalization.
Refers to the traveling expenses of a family member of the insured person in case the policyholders get admitted to a hospital outside his/her residential city.
Coverage status under SBI Arogya Premier Policy?
Not available
Any kind of medical/health emergency when you are outside of India.
Coverage status under SBI Arogya Premier Policy?
Not available
If a policy offers E-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.
Coverage status under SBI Arogya Premier Policy?
Not available.
A facility where the policyholder can avail free health check-ups after fulfilling the company's policies.
Coverage status under SBI Arogya Premier Policy?
Health Check-up benefit is available up to INR 5 K per insured only after 4 claim-free years.
If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company’s network of medical practitioners.
Coverage status under SBI Arogya Premier Policy?
Not available.
Coverage against the expenses incurred on vaccinations is provided by the insurance companies.
Coverage status under SBI Arogya Premier Policy?
The plan does not cover vaccination cover.
In the co-payment clause, policyholders have to pay a portion of the hospitalization expense on their own and the insurer will pay the rest of the amount.
Coverage status under SBI Arogya Premier Policy?
Co-payment is not applicable under the policy.
Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder.
Coverage status under SBI Arogya Premier Policy?
Applicable for Mental Illness coverage.
Here is a chart representation of the premiums for a rough idea in both the cases- individual policy and family floater policy. Let's look at both cases:
Sum Insured (in Rs.) | 10 Lakh | 15 Lakh | 20 Lakh | 25 Lakh | 30 Lakh |
Premium (in Rs.) | 9,385 | 10,677 | 11,598 | 12,290 | 12,834 |
Sum Insured (in Rs.) | 10 Lakh | 15 Lakh | 20 Lakh | 25 Lakh | 30 Lakh |
Premium (in Rs.) | 22,273 | 25,507 | 27,813 | 29,544 | 30,906 |
No-Pre Medical Tests Required
Mental Illness Coverage
HIV/AIDS
Genetic Disorders
There is no pre-insurance medical check-up for policy buyers less than 55 years of age subjected to the condition that the buyer does not have any medical history. In case one has any medical history then it is to be mentioned to the health insurance company at the time of buying the SBI Arogya Premier Policy.
SBI Arogya Premier Policy offers coverage against the expenses incurred towards the treatment of Mental Illness. The coverage shall be provided if the hospitalization is prescribed by a Medical Practitioner for Mental Illness, or if the hospitalization is done in Mental Health Establishment. The plan covers the mental illness upto the Sum Insured (Sub limit INR 1,00,000 whichever is lower)
The plan covers the policyholder for the expenses incurred for Inpatient treatment due to any condition caused by HIV/AIDS.
SBI Arogya Premier policy offers coverage against genetic disorders and internal congenital diseases up to INR 1,00,000 and 10% of the sum insured respectively.
The plan will not cover any expenses for the treatment of illnesses such as Ulcers, Tonsillectomy, Hernia, cataracts, Sinusitis, Gallbladder Stones, or Chronic Renal Failure during the first year of operation of the policy.
Injury or Death due to Suicide.
Stay in a hospital without undertaking any active regular treatment by the medical practitioner.
Any expenses incurred during the treatment of injuries that occurred during adventurous activities.
SBI Health Insurance offers a wide range of health insurance plans to fulfill the medical needs of individuals, families, and senior citizens.
Comprehensive plan
A comprehensive health insurance plan with 9 base covers and 18 optional covers offering a wide range of sum insured from 3 to 25 Lakhs.
Unique Features
Comprehensive plan
A comprehensive health insurance plan that offers a 15% increase in cumulative bonus for every claim-free year and comes with 8 optional coverage options.
Unique Features
Family Floater Plan
A fixed premium plan that offers coverage up to 3 Lakhs and offers protection against the expenses incurred during OPD and hospitalization.
Unique Features
Standard Plan
A standard health insurance plan that comes with a coverage of 10 Lakhs. Moreover, the plan comes with a 5% Co-pay, applicable on all the admissible claims.
Unique Features
Affordable Plan
A family floater plan for metro and non-metro cities offering wide coverage of INR 5 Lakhs. No pre-policy medical check-up is required to avail of this policy.
Unique Features
Individual/Family Floater Plan
An all-inclusive insurance cover to cater to your health & fitness needs. It is an individual and family floater policy with 7 optional covers to select from.
Unique Benefits
Individual/Family Floater Plan
This plan is designed to provide healthcare coverage to individuals with disabilities and HIV/AIDS offering a sum insured of INR 4 and 5 Lakhs.
Unique Features
Corona Kavach
A standard corona-specific health cover that protects you from COVID-19. The plan covers room rent, ICU expenses, and home care expenses for up to 14 days.
Unique Benefits
Corona Rakshak
The plan offers a lump sum benefit equal to 100% of the sum insured on the diagnosis of COVID-19.
Unique Benefits
Individual
SBI Personal Accident plan provides protection against accidental death, loss of life, and disabilities, it offers a cumulative bonus along with add-ons for ambulance charges.
Unique Benefits
Top-up policy
The policy comes into action post exhaustion of your current health plan and provides affordable premiums with various benefits.
Unique Benefits
Critical Illness policy
The plan offers coverage against 13 critical illnesses & financial support irrespective of the actual medical expenses, & comes with two policy tenures enabling customization.
Unique Features
Hospital Daily Cash
The policy provides a fixed amount to the claimant for each day of hospitalization and expenses like traveling, food, and much more.
Unique Features
Loan Insurance Policy
SBI Loan Insurance policy helps you to repay your outstanding loan in case you are a victim of any of the listed 13 critical illnesses/accidental death/unemployment.
Unique Features
Group Insurance Policy
This plan is available for individuals and families, wherein the plan will take care of medical expenses with affordable premium rates.
Unique Features
Saral Suraksha
Designed for individuals between the ages of 18 to 70 years, the plan offers coverage for accidental death, permanent, total, and permanent partial disability.
Unique Benefits
Saral Suraksha
The plan is designed uniquely for providing travel support, loss of passport, round-the-clock assistance, and many more benefits.
Unique Benefits
Saral Suraksha
A combination plan wherein you can secure both health and life, providing comprehensive coverage for medical emergencies and an assured life cover
Unique Benefits
Group Personal Accident
A versatile Group accident plan covering accidental death, ambulance cover, child education cover, adaptation allowance, and more.
Unique Features
Group Loan Policy
A unique health insurance policy that can be availed for 5 years, covers 15 critical illnesses, accidental death, accidental hospitalization, and more.
Unique Features
SBI Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, SBI Health Insurance ensures that you are medically secured, irrespective of the city you reside in.
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Yes, SBI Arogya Premier Policy covered up to 12 advanced procedures up to 50% of the sum insured.
No, Arogya Premier policy does not offer a co-payment option.
SBI General Arogya Premier Policy covers health check-up expenses up to INR 5K per insured, after 4 consecutive claim-free years.
Customers under the age of 55 years who have no medical history are not required to undergo a pre-policy medical exam to buy SBI Arogya Premier Policy.
No, SBI Arogya Premier Policy does not offer coverage for eye treatments.
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Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.
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