SBI Health Insurance Benefits: Plan Inclusions & Exclusions

Top Features From SBI Health Plans

Benefits of SBI Health Insurance Plans

Wide coverage : SBI medical insurance plans provide comprehensive coverage with a wide variety of health risks covered for an individual and for his/her family
Convenience : SBI medical insurance plans can be conveniently bought online. The plans offered by the company are easily accessible with the huge presence of SBI bank branches. Pre-policy medical check-ups are not needed till 45 years of age for almost all SBI health insurance plans which makes it easy to avail
Flexible : Most of the SBI medical insurance plans come with an option of flexibility to choose from various coverage options.This helps the buyer to choose the plan variant based on their need
Customisation : One of the most important benefits offered by SBI medical insurance plans is the customisation which allows the buyer to customise the plan based on their need and affordability
Cashless facility : SBI General Insurance Company is tied up with 6,000+ network hospitals to offer cashless healthcare treatment facilities to customers. Network hospitals can be easily located with the help of their website
Quick claim settlement : Claim process for SBI health plans is quite easy and simple. With the easy and hassle-free process of claims, the settlement is done quickly
Additional coverage benefits: There are various riders or add-ons offered for SBI health plans which allows its buyers to enhance the coverage. Add-ons are optional and can be availed at an additional premium cost
Tax benefit : The premiums paid for SBI medical insurance plans qualify for tax deduction under Section 80D of the Income Tax Act, 1961. Premiums paid towards coverage availed for self, spouse, dependent children and parents can be claimed for a tax deduction. Following are the details of tax deductions allowed under Section 80D of the IT act.

Exclusions Across SBI Health Plans

Though sbi medical insurance plans offer a wide range of coverages,there are certain general exclusions apply for the plans

Following are the exclusions under SBI health insurance plans

Expenses incurred for the treatment of illnesses or an injury incurred within 30 days of commencement of the policy
Expenses incurred for specific illnesses like benign prostatic hypertrophy, diabetes and related complications, cataract, non-infective arthritis, hypertension, heart disease, treatment of spondylosis, hysterectomy, surgery of varicose veins and surgery for prolapsed intervertebral disc etc are not covered for 24 months from commencement of the policy
Expenses incurred for the treatment of pre-existing illnesses is not covered for 48 months from the date of commencement of the policy
Any illness/injury directly or indirectly caused by war, hostilities, invasion, acts of foreign enemies, commotion, civil war, rebellion, unrest, insurrection, revolution and nuclear weapons/materials
Treatments outside the geographical limit of the policy
The cost of external appliances like contact lenses, spectacles, hearing aids, crutches, dentures, wheeling chair, artificial limbs, and artificial teeth etc are not covered
Cosmetic or aesthetic treatments, surgery for change of gender and plastic surgery etc. are not covered
Expenses incurred for the treatment of external or internal congenital illnesses are not covered
Sexually transmitted diseases, AIDS/HIV are not covered
Alcohol and drug abuse
Deliberate and intentional self-injury, suicide or attempt suicide are not covered

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FAQs

Following are the major and important 13 critical illnesses covered under SBI General’s critical illness insurance plan

Open Chest CABG
Cancer of specified severity
Open heart replacement and repair of heart valves
Aorta graft surgery
Stroke resulting in permanent symptoms
Kidney failure requiring regular dialysis
First heart attack of specified severity
Major organ/bone marrow transplant
Primary pulmonary arterial hypertension
Coma of specified severity
Multiple sclerosis with persisting symptoms
Permanent paralysis of limbs
Total blindness

Health insurance portability refers to the shifting of health insurance plans from one insurance provider to another insurance provider with all the existing benefits carried along. Portability gives the benefit of selecting the suitable plan of your choice with the existing benefits like no claim bonus accumulated and waiting period etc continued

SBI health insurance plans come with a free look period of 15 days during which the policyholder can decide whether to continue with the policy or not. In case, insured is not satisfied with the terms and conditions of the policy, he/she can cancel it without any charges within this free look period of 15 days. However, it’s important and mandatory to state the reason for the cancellation of the policy

Premiums for SBI health insurance plans can be paid online or also through offline mode. Following are the modes through which online payments can be made

Net banking
Credit card
Debit card

However, payment can also be done offline through the below ways

Cash/cheque at nearby SBI bank branches
Electronic Clearing System (ECS)
Drop boxes

Co-payment is a system of cost-sharing in health insurance plans wherein the insured is required to bear a fixed out-of-pocket cost for covered services. This can also be in a fixed percentage. A fixed percentage of the claim amount needs to be paid by the insured and the remaining will be paid to the insurance company

Yes. SBI health insurance plans come with a 30 days grace period. In case you fail to make a premium payment within the due date for premium payment, you can still make the payment within 30 days from the due date. The benefits will continue during the grace period

Below are the treatments and illnesses that are excluded from domiciliary treatment cover

Asthma
Diarrhoea and all types of Dysenteries and Gastroenteritis
Insipidus and Diabetes Mellitus
Influenza, Cough and cold
Bronchitis
Nephritic Syndrome and Chronic Nephritis
Epilepsy
Hypertension
Arthritis, Rheumatism and Gout
All Psychiatric and Psychosomatic disorders
Pyrexia of unknown origin for less than 10 days
Tonsillitis and Upper Respiratory Tract infection including Laryngitis and pharyngitis

SBI health insurance is quite beneficial as the plans offered by the company offer a range of comprehensive coverage benefits which ensure that most medical costs get covered. Moreover, the company offers a range of health insurance plans so that you can choose a plan as per your coverage needs. The claim process of SBI health insurance plans is simple ensuring that you get cashless assistance in emergencies for a smoother experience

You can make a claim under your SBI health insurance policy in a cashless manner or through reimbursement. Cashless claims are available if you get admitted to a networked hospital. In case of a non-networked hospital or if your cashless claim is not approved, you can opt for reimbursement claims wherein you bear the medical expenses initially and then get them reimbursed by the company. The claim process for each of these types of claims has been explained earlier above

SBI believes in a quick and easy claim settlement process and allows you to get your claims settled in the easiest possible manner. In case of claims, you can contact the toll-free number of the company 1800 102 1111 and register your claim. You can also send a SMS to 561612 by writing ‘CLAIMS’ in the message text. You can send an email to customer.care@sbigeneral.in to intimate the company about your claim or simply intimate it online at the link https://www.sbigeneral.in/portal/claim/claims-intimation. Once your claim is intimated, the company would get in touch with you and guide you with the claim settlement process.

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