SBI Health Insurance Benefits: Plan Inclusions & Exclusions

Top Features From SBI Health Plans

Comprehensive Coverage: SBI Health Insurance plans offer extensive coverage for hospitalization, pre and post-hospitalization expenses, and daycare procedures
Maternity Coverage: Some plans provide maternity coverage, including expenses related to childbirth
Critical Illness Cover: Critical illness policies offer lump sum payouts upon diagnosis of specified critical illnesses
No-Claim Bonus: Policyholders may be eligible for a no-claim bonus, leading to an increase in the sum insured without a corresponding increase in premium
Affordable Top-up Option: SBI's Arogya Top-up Policy allows additional coverage over and above existing health insurance at affordable premiums
Cashless Hospitalization: Many SBI Health Insurance plans provide cashless hospitalization facilities at a wide network of hospitals
Family Floater Option: Family-friendly plans allow coverage for the entire family under a single policy
Daily Hospital Cash: Certain policies offer daily cash benefits for hospitalization and additional benefits for ICU admission

Exclusions Across SBI Health Plans

30-Day Waiting Period: SBI health insurance policy doesn’t cover expenses related to illness within the initial 30 days. Only accident-related claims are considered during this period
Investigation and Evaluation: Expenses for diagnostics or evaluations, including laboratory tests and imaging like X-rays or ultrasounds, are typically excluded from coverage due to their routine nature
Cosmetic or Plastic Surgery: They are generally excluded from SBI health insurance plans, except for reconstruction following accidents, burns, cancer, or medically necessary treatments addressing immediate health risks
Maternity Benefit: Most health policies do not cover expenses related to pregnancy, childbirth, or fertility treatments. If covered, there is often a waiting period for these benefits
Self-Harm: Treatment expenses for injuries resulting from suicide attempts or self-harm acts are not covered
Alcoholism/Substance Abuse: Medical insurance exclusions include treatment expenses for alcoholism, drug or substance abuse, and related conditions
Change-of-Gender Treatment: Expenses for any treatment, including surgical management, to change body characteristics to the opposite sex are excluded
Hazardous or Adventure Sports: Treatment expenses arising from participation in hazardous or adventure sports, such as para-jumping or mountaineering, are not covered
Dental, Vision, and Hearing: Insurance policies by SBI typically do not cover expenses for vision or hearing correction, as well as dental treatments