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 Group Health Insurance is a comprehensive plan, as it provides wider coverage to its customers as well as their family members. Group health insurance policy by SBI offers multiple sum insured options and many benefits for its customers. With SBI Group Health Insurance, policyholders can avail cashless emergency as well as planned treatments in any of the 20000+ network hospitals of the company. All the hospitalization expenses such as in-patient hospitalization and daycare treatments are covered under the SBI Group Health Insurance Policy. Besides cover for basic medical expenses, SBI health insurance also offers many other protections such as ambulance expenses, pre and post-hospitalisation expenses, several other expenses and policy renewal benefits too.
Entry Age
18 Years
Maximum Age
65 Years
Sum Insured
1 L | 2 L| 3 L| 4 L| 5 L
Plan Type
Individual/Family Floater
Policy Term
N/A
Initial Waiting Period
30 days / 1 year for specified diseases.4 years for pre-existing diseases.
*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.
With comprehensive coverage options, SBI Group Health Insurance lets you customize your health insurance plan as per your requirements:
In-patient & Out-patient coverage
Room Rent
Not Covered
ICU Charges
Covered
Pre-Hospitalization
Covered up to 30 days
Post-Hospitalization
Covered up to 60 days
Domiciliary Hospitalization
Covered
Daycare Treatment
Covered
OPD Charges
Not covered
Coverage Terms
COVID-19 Treatment
Covered
Cataract
Not Covered
No Claim Bonus
Not Applicable
Automatic Restoration
Not Applicable
Daily Hospital Cash
Available
Organ Donor
Not Covered
Maternity Cover
Not Covered
New Born Baby Cover
Not Available
Alternative Treatments
AYUSH Treatment
Not Covered
IVF Treatment
Not Available
Modern Treatment
Not covered
Emergency Coverage
Ambulance
Covered
Air Ambulance
Not Available
Compassionate Travel
Not Available
Global Coverage
Not Available
Wellness Programmes
E-Consultation
Not Available
Health Check-Up
Not Available , Ony Pre Health Checkup Available
Second Medical Opinion
Not Available
Vaccination
Not Available
Limitations
Co-payment
Applicable,10% on admissible claims
Sub-limits
Not Available
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 Group Health Insurance?
Under SBI Group Health Insurance Plan, the room rent is not covered.
The Intensive Care Unit (ICU) is a hospital special department where patients with severe medical conditions are treated.
Coverage status under SBI Group Health Insurance?
Under SBI Group Health Insurance Plan, ICU charges are covered up to 2% /day for the Sum Insured.
Medical expenses incurred before the hospitalization of the policyholder.
Coverage status under SBI Group Health Insurance?
Under SBI Group Health Insurance Plan medical expenses incurred during pre-hospitalization are covered for up to 30 days.
Medical expenses incurred after the discharge of the policyholder from the hospital.
Coverage status under SBI Group Health Insurance?
Under SBI Group Health Insurance Plan medical expenses incurred during pre-hospitalization are covered for up to 60 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 Group Health Insurance?
Under SBI Group Health Insurance, domiciliary hospitalization is covered subject to a maximum of 20% of the Sum Insured or INR 20000, whichever is less.
Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.
Coverage status under SBI Group Health Insurance?
SBI Group Health Insurance covers the expenses of daycare treatment up to SI.
Covers the cost of doctor consultation and prescribed medical tests that may not require hospitalization.
Coverage status under SBI Group Health Insurance?
SBI Group Health Insurance does not cover OPD charges.
COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. an approved center.
Coverage status under SBI Group Health Insurance?
Covid-19 Covered.
A common eye condition in which your vision gets blurred.
Coverage status under SBI Group Health Insurance?
SBI Group Health Insurance Plan does cover cataract treatment.
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 Group Health Insurance?
The cumulative Bonus is not available under SBI Group Health Insurance.
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 Group Health Insurance?
Under SBI Group Health Insurance automatic restoration is not available. This Policy may be renewed by mutual consent every year.
It is a cash amount that you receive each day during the time of hospitalization.
Coverage status under SBI Group Health Insurance?
The daily hospital cash is available under SBI Group Health Insurance as an add-on benefitsubject to a maximum of 20% of the Sum Insured or INR 20000, whichever is less.
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 Group Health Insurance?
Under SBI Group Health Insurance, organ donor expenses not are covered.
It refers to the cover that includes expenses for normal and c-section procedures deliveries.
Coverage status under SBI Group Health Insurance?
Under the SBI Group Health Insurance Plan, maternity expenses are not covered.
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 Group Health Insurance?
Under SBI Group Health Insurance Plan, the newborn baby cover is not available
Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.
Coverage status under SBI Group Health Insurance?
Not Covered Under SBI Group Health Insurance.
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 Group Health Insurance?
Under SBI Group Health Insurance IVF treatment is not covered.
Medical treatments that demand modern technology such as robotic surgeries, stem cell therapy, etc.
Coverage status under SBI Group Health Insurance?
Under SBI Group Health Insurance modern treatments are not covered.
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 Group Health Insurance?
Under SBI Group Health Insurance Plan, Ambulance expenses are covered by 1% of SI up to a max. of ` INR 1500.
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?
Under SBI Group Health Insurance Plan, Air Ambulance is not covered.
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 Group Health Insurance?
Under SBI Group Health Insurance compassionate plan is not covered.
Any kind of medical/health emergency when you are outside of India.
Coverage status under SBI Group Health Insurance?
Under SBI Group Health Insurance Global coverage is 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 Group Health Insurance?
Under SBI Group Health Insurance e-consultation is not covered.
A facility where the policyholder can avail free health check-ups after fulfilling the company's policies.
Coverage status under SBI Group Health Insurance?
Under SBI Group Health Insurance, a health checkup is not covered. Only a pre-acceptance Health Check is not mandatory for people covered under SBI General Group Health Insurance.
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 Group Health Insurance?
Under the SBI Group Health Insurance second medical opinion is not covered.
Coverage against the expenses incurred on vaccinations is provided by the insurance companies.
Coverage status under SBI Group Health Insurance?
Under SBI Group Health Insurance Plan, vaccination expenses are not covered.
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 Group Health Insurance?
It is applicable under SBI Group Health Insurance, Co-Payment on claims in non-network hospitals - 10% on all eligible admissible claims.
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 Group Health Insurance?
Not Applicable under SBI Group Health Insurance.
SBI Group Health Insurance has multiple advantages that policyholders can avail after the purchase.
Minimal Waiting Period
Multiple discount options
Large Sum Insured
Benefit at the network hospital
No medical checkup up to age 65
Large Sum Insured
Get tax relief under section 80D
With SBI Group Health Insurance policyholders get a waiting period of 30 days and 1 year for specified diseases and 4 years for pre-existing diseases.
Policyholder gets coverage of 30 Days Pre and 60 Days Post Hospitalisation Expenses.
Policyholders get a Wide Coverage of Sum Insured – From 100,000 up to 500,000.
When an individual purchases SBI Group Health Insurance he can get cashless treatment at over 2,0000 Network Hospitals
When an individual purchases SBI Group Health Insurance he can get No pre-policy medical test up to the age of 65 years for people with no medical history
Policyholders get Multiple Coverage Options – Individual & Family Floater, you and your legal spouse and two legal & dependent children.
Amount paid towards the premium of this plan is eligible for tax relief under Section 80D of the Income Tax Act, 1961.
Permanent diseases or health conditions that are not included under SBI Group Health Insurance is
Complications or treatment arising out of pre-existing conditions and treatment of illnesses such as ulcers, tonsillectomy, hernia, cataract, sinusitis, adenoidectomy, chronic renal failure during the first year of operation of the policy
Any disease contracted during the first 30 days of commencement of the policy is excluded.
One year of the waiting period is mandatory for certain specified diseases like hernia and other treatment expenses will not be compensated.
Stay in a hospital without undertaking any active regular treatment by the medical practitioner.
Treatment with alternative medicines like acupuncture, acupressure, osteopath, naturopathy, chiropractic, reflexology and aromatherapy.
Treatment taken outside India.
Pregnancy treatment or complications like postnatal treatment, abortion, childbirth, or any prenatal miscarriage.
Outpatient treatment.
Congenital diseases.
Expenses related to AIDS and related diseases.
Hospitalization out of war, riot, strike, and nuclear weapons
Use/Abuse of intoxicating drugs or alcohol.
Listed ailments after 48 months
Pre-existing diseases after 48 months
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
Comprehensive/ Family Floater Plan
A policy designed to provide coverage to you and your family. Providing high SI of 30 lakhs, it covers maternity expenses to childbirth.
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
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.
See More Health Insurance Articles
See More Health Insurance Articles
No, SBI Group Health Insurance does not cover Maternity charges.
No, SBI Group Health Insurance does not cover Air Ambulance charges.
Yes, SBI Group Health Insurance covers ICU charges (2% /day for ICU).
No, policyholders are not covered for COVID-19 under SBI Group Health Insurance.
SBI Group Health Insurance the policyholders get a waiting period of 30 days and 1 year for specified diseases and 4 years for pre-existing diseases.
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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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