What does SBI Health Insurance cover?

SBI Health Insurance Coverage includes hospitalisation expenses, ICU charges, doctor fees, room rent, day-care procedures, pre- and post-hospitalisation expenses, maternity benefits, and alternative therapies under Ayurveda, Yoga, Unani, Siddha, and Homeopathy depending on the plan.

What are the exclusions in SBI Health Insurance?

Exclusions include cosmetic or aesthetic procedures, infertility treatments, self-inflicted injuries, substance abuse-related illnesses, routine dental and vision care, war or nuclear-related claims, and unproven or experimental treatments.

How can I customise my SBI Health Insurance Coverage?

You can enhance your policy with higher sum insured options, critical illness riders, maternity add-ons, OPD and dental covers, room rent upgrades, top-up plans, wellness benefits, and personal accident riders.

Does SBI Health Insurance provide cashless treatment?

Yes. Cashless claims are available at network hospitals. The hospital sends bills directly to SBI, and you pay only non-medical expenses like toiletries or meals.

Can I claim reimbursement for treatment at non-network hospitals?

Yes. You must pay upfront, collect all bills and medical documents, submit the reimbursement claim form, and SBI will credit eligible expenses to your bank account.

What daycare procedures are covered under SBI Health Insurance?

SBI Health Insurance Benefits include 500+ daycare treatments like dialysis, cataract surgery, chemotherapy, minor surgeries, and other procedures not requiring 24-hour hospitalisation.

Are maternity and newborn benefits included?

Yes, for applicable plans. These include normal delivery, C-sections, newborn care, and first-year vaccinations after completing the maternity waiting period.

Are alternative therapies covered under SBI Health Insurance?

Yes, certain plans provide coverage for Ayurveda, Yoga, Unani, Siddha, and Homeopathy treatments when medically necessary.

How can I increase my SBI Health Insurance Coverage?

You can opt for higher sum insured, super top-up or top-up plans, critical illness riders, maternity and newborn add-ons, and wellness programs to maximise your benefits.

Are critical illnesses covered under SBI Health Insurance?

Yes, depending on the plan or add-on. Coverage includes heart attack, stroke, cancer, kidney failure, and organ transplants, providing lump-sum or enhanced hospitalisation benefits.

Can I get OPD, dental, and vision coverage?

Yes, by adding optional riders. This ensures coverage for routine consultations, diagnostics, prescriptions, and basic eye or dental care.

Does SBI Health Insurance cover accidental injuries?

Yes. All accidents, including fractures, burns, trauma, and emergency surgeries, are covered from day one, including ICU, diagnostics, and hospitalisation expenses.

How do I check the network hospitals for SBI Health Insurance?

SBI Health Insurance Coverage allows you to access cashless treatment at network hospitals across India. The list can be checked on SBI’s website, mobile app, or through customer support.

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Q: Are pre-existing diseases covered under SBI Health Insurance?

Yes. Pre-existing conditions like diabetes, hypertension, thyroid disorders, and heart diseases are covered after the mandatory waiting period, ensuring long-term protection for chronic illnesses.

Q: What is the waiting period in SBI Health Insurance?

Waiting periods apply for initial illnesses (usually 30 days), pre-existing diseases (24–36 months), maternity (2–4 years), and specified procedures like cataract or joint replacement. Accidental hospitalisation is covered immediately.

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Claim Sеttlеmеnt Ratio

20,000+

Nеtwork Hospitals

15+ Lakh

Total Claims Sеttlеd

97%

Claim Sеttlеmеnt Ratio

20,000+

Nеtwork Hospitals

15+ Lakh

Total Claims Sеttlеd

SBI Health Insurance & Coverage Benefits

Customer Testimonials

Real experiences from our valued customers who have chosen our insurance coverage.

Have been associated with Ruchir and his team… They have provided me excellent guidance in choosing the right plans for myself and my family……always been available to assist with any insurance/claim queries.

Nakul N

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

Have been associated with Ruchir and his team… They have provided me excellent guidance in choosing the right plans for myself and my family……always been available to assist with any insurance/claim queries.

Nakul N

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

My heartfelt thanks to the OneAssure team for making my insurance claim process effortless. Right from the very first interaction, they demonstrated professionalism, clear communication, and an impressive command of the procedures involved. Their swift updates, timely guidance, and persistent follow-through removed all the stress from what could have been a complicated experience.

Anju Renjith

I am truly grateful for the support and guidance I received in settling my insurance claim. The entire process was handled with great professionalism, clarity, and efficiency. Their prompt response, deep knowledge of the procedures, and consistent follow-ups ensured a smooth and hassle-free experience.Thank you once again for your invaluable help, highly recommended!

Yogesh Meena

I recently had the pleasure of purchasing health insurance for my parents through this company, and my experience has been exceptional...The team was incredibly patient and took the time to explain every detail to me. No matter how many times I asked questions, they were always calm and thorough in their explanations. Their professionalism and dedication made a significant difference in helping me make an informed decision.

Akash Kumar

OneAssure helped me understand my needs and choose a product that was right for me. There was no pressure tactics or mis-selling. This experience was respectful, informed, and completely stress-free.

Shreya Goyal

Had a great experience with OneAssure during my insurance claim process. A special shoutout to Sunad Raj for his exceptional support, he was professional, responsive, and guided me every step of the way. Thanks to his consistent follow-ups and clear guidance, the entire claim settlement was smooth and hassle-free. Highly recommend OneAssure for their service and transparency!

Sanjay Dakalia

The team is very professional and prompt. I would have all my health and life insurance needs met through them.

Harish Jindal

Very professional service from Ruchir & Aman. They were recommended by a friend who had a positive experience with them. I have taken both health and life policies through them and they have advised me well throughout the process and found the best options available in the market. I had a medical condition due to which it was difficult to find a suitable health policy in the market, however this team was able to find one for me. I would recommend their services to anyone looking to buy health or life insurance.

Siddhartha Saha

Wonderful experience with Prost. Right from suggesting the insurance products to claim process the entire experience hai been seamless. They do not mis-sell and are very transparent. Sundar Raj from the team has been wonderful and ensured prompt guidance. All the best Ruchir and keep up the good work!

Adarsh Ravindranathan

verdict

Our Verdict: SBI Health Insurance Coverage

Pros

Value-added benefits like no-claim bonuses, health check-ups, and top-up options.

Covers hospitalisation, daycare, AYUSH, organ donor treatment, and optional maternity/add-ons.

Flexible sum‑insured options up to ₹2 crore for individuals and families.

Extensive hospital network with 20000+ cashless facilities nationwide.

Cons

Routine OPD or non-hospitalisation treatments often excluded.

Waiting periods for pre-existing diseases.

Sub-limits or riders may apply for advanced treatments.

Higher premiums for comprehensive coverage.

Pros

Value-added benefits like no-claim bonuses, health check-ups, and top-up options.

Covers hospitalisation, daycare, AYUSH, organ donor treatment, and optional maternity/add-ons.

Flexible sum‑insured options up to ₹2 crore for individuals and families.

Extensive hospital network with 20000+ cashless facilities nationwide.

Cons

Routine OPD or non-hospitalisation treatments often excluded.

Waiting periods for pre-existing diseases.

Sub-limits or riders may apply for advanced treatments.

Higher premiums for comprehensive coverage.

Final Verdict

SBI General Insurance provides reliable health protection with wide coverage for hospitalisation, daycare, organ donor expenses, AYUSH therapies, and optional maternity. Its extensive network and flexible sum-insured options make it suitable for families and individuals. Add-ons like top-up plans and wellness benefits allow customization based on lifestyle and medical needs....

SBI General Insurance provides reliable health protection with wide coverage for hospitalisation, daycare, organ donor expenses, AYUSH therapies, and optional maternity. Its extensive network and flexible sum-insured options make it suitable for families and individuals....

Key Coverages & Benefits Offered Under SBI Health Insurance

Get a clear understanding of what SBI Health Insurance covers and what it doesn’t to choose the right plan confidently for you and your family.

Inclusions

Optional maternity and newborn benefits, depending on chosen plan or add-ons.

Alternative therapies under Ayurveda, Yoga, Unani, Siddha, and Homeopathy (plan-dependent).

Organ donor medical and surgical expenses during transplantation.

Emergency ambulance charges up to plan limits.

Day-care treatments like dialysis, cataract surgery, chemotherapy, and minor surgeries.

Pre‑ and post-hospitalisation expenses for a specified number of days.

In‑patient hospitalisation: Covers room, ICU, nursing, doctor fees, medicines, and procedures.

Exclusions

Experimental or unproven medical treatments not approved by regulatory authorities.

Injuries or illnesses caused by war, terrorism, or nuclear events.

Routine dental, vision, and preventive check-ups.

Pre-existing diseases before completion of the waiting period.

Self-inflicted injuries, suicide attempts, or substance abuse-related illnesses.

Infertility treatments, IVF, and assisted reproductive procedures.

Cosmetic or aesthetic procedures unless medically required due to accidents or burns.

Inclusions

Optional maternity and newborn benefits, depending on chosen plan or add-ons.

Alternative therapies under Ayurveda, Yoga, Unani, Siddha, and Homeopathy (plan-dependent).

Organ donor medical and surgical expenses during transplantation.

Emergency ambulance charges up to plan limits.

Day-care treatments like dialysis, cataract surgery, chemotherapy, and minor surgeries.

Pre‑ and post-hospitalisation expenses for a specified number of days.

In‑patient hospitalisation: Covers room, ICU, nursing, doctor fees, medicines, and procedures.

Exclusions

Experimental or unproven medical treatments not approved by regulatory authorities.

Injuries or illnesses caused by war, terrorism, or nuclear events.

Routine dental, vision, and preventive check-ups.

Pre-existing diseases before completion of the waiting period.

Self-inflicted injuries, suicide attempts, or substance abuse-related illnesses.

Infertility treatments, IVF, and assisted reproductive procedures.

Cosmetic or aesthetic procedures unless medically required due to accidents or burns.

Claims Process

How to file SBI claims?

SBI Health Insurance & Coverage Benefits

How Coverage and Benefits Vary in SBI Health Insurance

Variation in Sum Insured Options

Different plans offer varied sum-insured ranges, from basic to high-value cover, allowing customers to choose protection based on medical costs in their city.

Difference in Hospitalisation Coverage

While all plans cover in-patient care, advanced plans may provide broader benefits such as higher room rent eligibility, ICU limits, and enhanced treatment coverage.

Add-Ons and Optional Covers

Benefits like critical illness cover, maternity cover, or accidental hospitalisation may be included only through specific riders or plan upgrades.

Coverage for Day-Care and Special Treatments

Some plans include comprehensive day-care procedures, AYUSH treatments, and organ donor expenses, while others offer only basic hospitalisation cover.

Family Floater vs Individual Coverage

Coverage differs based on whether the policy is individual or floater, affecting how the sum insured is shared or allocated among family members.

Restoration and No-Claim Bonuses

Higher-tier plans offer sum-insured restoration and generous no-claim bonuses, while basic plans may provide limited or no such rewards.

Network Hospital Access

Cashless treatment benefits vary depending on the hospital network linked with the specific plan, influencing convenience and claim experience.

Variation in Sum Insured Options

Different plans offer varied sum-insured ranges, from basic to high-value cover, allowing customers to choose protection based on medical costs in their city.

Difference in Hospitalisation Coverage

While all plans cover in-patient care, advanced plans may provide broader benefits such as higher room rent eligibility, ICU limits, and enhanced treatment coverage.

Add-Ons and Optional Covers

Benefits like critical illness cover, maternity cover, or accidental hospitalisation may be included only through specific riders or plan upgrades.

Coverage for Day-Care and Special Treatments

Some plans include comprehensive day-care procedures, AYUSH treatments, and organ donor expenses, while others offer only basic hospitalisation cover.

Family Floater vs Individual Coverage

Coverage differs based on whether the policy is individual or floater, affecting how the sum insured is shared or allocated among family members.

Restoration and No-Claim Bonuses

Higher-tier plans offer sum-insured restoration and generous no-claim bonuses, while basic plans may provide limited or no such rewards.

Network Hospital Access

Cashless treatment benefits vary depending on the hospital network linked with the specific plan, influencing convenience and claim experience.

How to Choose

How to Choose the Right Health Insurance Coverage

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What is the Waiting Period in SBI Health Insurance?

A waiting period is the time after policy inception during which certain illnesses, treatments, or pre-existing conditions are not eligible for claims. Accidents are covered from day one.

Initial Waiting Period

Most illnesses (excluding accidents) are subject to a standard 30-day waiting period from the start of the policy. Claims for these illnesses cannot be made during this period.

Pre-Existing Disease (PED) Waiting Period

Pre-existing conditions disclosed at policy purchase become eligible only after a waiting period of 36 months of continuous coverage under standard health plans.

Specific Illness / Procedure Waiting Period

Certain treatments, such as cataract, hernia, joint surgeries, and other specified procedures, typically have a 24-month to 36-month waiting period depending on the plan.

Maternity & Newborn Waiting Period

For plans offering maternity and newborn coverage, the waiting period ranges from 9 months to 4 years depending on the variant and whether both parents are covered.

Optional Cover Waiting Periods

Optional benefits such as OPD, dental, or critical illness riders may also have separate waiting periods, generally between 24 and 48 months.

Initial Waiting Period

Most illnesses (excluding accidents) are subject to a standard 30-day waiting period from the start of the policy. Claims for these illnesses cannot be made during this period.

Pre-Existing Disease (PED) Waiting Period

Pre-existing conditions disclosed at policy purchase become eligible only after a waiting period of 36 months of continuous coverage under standard health plans.

Specific Illness / Procedure Waiting Period

Certain treatments, such as cataract, hernia, joint surgeries, and other specified procedures, typically have a 24-month to 36-month waiting period depending on the plan.

Maternity & Newborn Waiting Period

For plans offering maternity and newborn coverage, the waiting period ranges from 9 months to 4 years depending on the variant and whether both parents are covered.

Optional Cover Waiting Periods

Optional benefits such as OPD, dental, or critical illness riders may also have separate waiting periods, generally between 24 and 48 months.

Diseases Covered/not Covered

Diseases Covered/Not Covered Under SBI Health Insurance

Diseases Covered

Daycare Treatments

Maternity & Newborn Care (Plan-Specific)

Infectious Diseases

Accidental Injuries

Critical Illnesses (Plan-Specific)

Lifestyle Diseases

Chronic Conditions (After Waiting Period)

General Illnesses & Hospitalisation

Diseases Not Covered

War, Terrorism, or Nuclear Risks

Non-Medically Necessary Treatments

Self-Inflicted Injuries & Suicide Attempts

Substance Abuse & Addiction-Related Illnesses

Infertility & Reproductive Treatments

Cosmetic & Aesthetic Treatments

Congenital & Genetic Disorders

Pre-existing Diseases (Before Waiting Period)

Diseases Covered

Daycare Treatments

Maternity & Newborn Care (Plan-Specific)

Infectious Diseases

Accidental Injuries

Critical Illnesses (Plan-Specific)

Lifestyle Diseases

Chronic Conditions (After Waiting Period)

Diseases Not Covered

War, Terrorism, or Nuclear Risks

Non-Medically Necessary Treatments

Self-Inflicted Injuries & Suicide Attempts

Substance Abuse & Addiction-Related Illnesses

Infertility & Reproductive Treatments

Cosmetic & Aesthetic Treatments

Congenital & Genetic Disorders

Pre-existing Diseases

Pre-Existing Diseases Covered Under SBI Health Insurance

Diabetes

Covers blood sugar-related conditions, including complications such as neuropathy, retinopathy, or kidney issues, after the pre-existing disease waiting period.

Hypertension (High Blood Pressure)

Treatment of complications arising from high blood pressure, including heart or kidney issues, is covered post waiting period.

Thyroid Disorders

Both hypothyroidism and hyperthyroidism are included after the waiting period. Hospitalisation, medications, and diagnostic tests are eligible.

Asthma & Chronic Respiratory Conditions

Chronic asthma, bronchitis, and other respiratory illnesses are covered once the waiting period is over, including hospitalisation and emergency care.

Hyperlipidemia & Cholesterol-Related Conditions

High cholesterol, triglycerides, and related complications are covered after the waiting period.

Heart Diseases (Stable Conditions)

Certain stable heart conditions like coronary artery disease, previous stenting, or bypass surgeries are covered after completing the waiting period.

Obesity-Related Illnesses

Complications caused by obesity, such as sleep apnea or joint problems, may be covered post waiting period, based on medical necessity.

Digestive & Gastrointestinal Disorders

Chronic conditions like GERD, ulcers, or liver-related issues are covered after the applicable waiting period.

Diabetes

Covers blood sugar-related conditions, including complications such as neuropathy, retinopathy, or kidney issues, after the pre-existing disease waiting period.

Hypertension (High Blood Pressure)

Treatment of complications arising from high blood pressure, including heart or kidney issues, is covered post waiting period.

Thyroid Disorders

Both hypothyroidism and hyperthyroidism are included after the waiting period. Hospitalisation, medications, and diagnostic tests are eligible.

Asthma & Chronic Respiratory Conditions

Chronic asthma, bronchitis, and other respiratory illnesses are covered once the waiting period is over, including hospitalisation and emergency care.

Hyperlipidemia & Cholesterol-Related Conditions

High cholesterol, triglycerides, and related complications are covered after the waiting period.

Heart Diseases (Stable Conditions)

Certain stable heart conditions like coronary artery disease, previous stenting, or bypass surgeries are covered after completing the waiting period.

Obesity-Related Illnesses

Complications caused by obesity, such as sleep apnea or joint problems, may be covered post waiting period, based on medical necessity.

Digestive & Gastrointestinal Disorders

Chronic conditions like GERD, ulcers, or liver-related issues are covered after the applicable waiting period.

Customize Plan Options

How to Customize SBI Health Insurance for Maximum Coverage

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SBI Health Insurance & Coverage Benefits

Related Health Insurance Plans

Senior Citizen Health Plan

Secure against age-related medical costs
Tailored for seniors healthcare needs

Family Health Plan

One policy covers the entire family
High sum insured with cashless care
Multiple coverage options based on your family needs

Maternity Health Plan

Covers delivery, newborn care, and maternity expenses
Reduces financial stress of childbirth costs

Senior Citizen Health Plan

Secure against age-related medical costs
Tailored for seniors healthcare needs

Family Health Plan

One policy covers the entire family
High sum insured with cashless care
Multiple coverage options based on your family needs

Maternity Health Plan

Covers delivery, newborn care, and maternity expenses
Reduces financial stress of childbirth costs

Coverage & Benefits

Still Confused? Get Expert Guidance

Our insurance experts are here to help you make the right choice. Get personalized recommendations based on your specific needs and budget.

Claim Settlement

FAQs Frequently Asked Questions

Our insurance experts are here to help you make the right choice. Get personalized recommendations based on your specific needs and budget.

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