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Reviewed by Finzony Finance TeamLast updated:
SBI General Arogya Supreme is a comprehensive hospitalisation plan with 20 basic covers and 8 optional covers. It comes in three plans: Pro for sum insured of ₹1 lakh to ₹5 lakh, Plus for ₹6 lakh to ₹20 lakh and Premium for ₹25 lakh to ₹5 crore. You can buy it on an individual basis, an individual family basis or a family floater, for a term of 1, 2 or 3 years. The base cover pays for stays of more than 24 hours, day care procedures, home treatment, AYUSH treatment, organ donor expenses, road ambulance, and pre and post hospitalisation expenses. It also covers mental healthcare, HIV/AIDS, bariatric surgery for eligible cases and advance procedures such as robotic surgery, up to 25% of the sum insured. Once in every policy year, Sum Insured Refill restores 100% of your base sum insured after you have used your cover. A Cumulative Bonus adds 15% of the base sum insured for each claim-free year, up to 100%. The higher plans add more: Plus and Premium include domestic air ambulance and emergency assistance and a Compassionate Visit benefit, and Premium gives unlimited e-opinions. Optional covers include Hospital Cash, Major Illness Benefit, Enhanced Cumulative Bonus, a deductible and a co-payment for a lower premium. Adults can join from 18 to 65 years and children from 91 days to 25 years. Renewal is for life.
Most affordable comprehensive plan with cashless access across a wide, growing hospital network.
Finzony reads Arogya Supreme as a practical, mid-priced hospitalisation plan for families that want a wide choice of sum insured without paying for extras they will not use. Its strengths are the Sum Insured Refill, which restores your full base sum insured once a year, a 15% Cumulative Bonus that can build to 100% (and to 200% with the optional Enhanced Cumulative Bonus), a sum insured range from ₹1 lakh to ₹5 crore, and a policy that can be used anywhere in India with no zone co-payment. Hypertension, diabetes and cardiac conditions that develop after you buy wait only 90 days, and pre-existing diseases wait 36 months with a 60-month moratorium. The trade-offs are clear. Maternity, newborn care, infertility treatment, treatment outside India and OPD are not covered, and consumables and other non-medical items are not paid. Several covers carry sub-limits, such as mental healthcare at 10% of the base sum insured or ₹50,000, whichever is lower, genetic disorders at ₹1 lakh and internal congenital conditions at 25% of the sum insured. The Pro plan stops at ₹5 lakh and leaves out domestic air ambulance and Compassionate Visit. Room rent can be limited to 1% of the base sum insured or a Single Private AC Room, so check your schedule. Specified conditions such as cataract, hernia and joint replacement wait 24 months. If you want the widest list of optional covers, compare it with SBI General's Super Health and Health Alpha. If you want a simpler plan with a strong refill and bonus, Arogya Supreme is a sensible place to start, and a quote for your age and city will tell you the real price.
SBI General Health Insurance
Key Insights
Founded
2009
SBI General Health Insurance was established 17 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
96.14% CSR, calculated as a 3-year average
SBI General Health Insurance settles 96.14% of all claims it receives, demonstrating strong credibility.
Network Hospitals
16,600+
SBI General Health Insurance has a network of 16,600+ hospitals, ensuring wide accessibility and convenience for policyholders.
You choose one of three plans. Pro covers sum insured of ₹1 lakh to ₹5 lakh, Plus covers ₹6 lakh to ₹20 lakh and Premium covers ₹25 lakh to ₹5 crore. The higher plans give larger limits for several covers.
Pre-hospitalisation is 30 days on Pro and 60 days on Plus and Premium. Post-hospitalisation is 60, 90 and 180 days.
Pays treatment expenses when you are admitted for 24 hours or more on a doctor's advice, including room rent, ICU, nursing, doctor fees, medicines, diagnostics, operation theatre charges and implanted devices.
Room rent is limited to 1% of the base sum insured, a Single Private AC Room, or actuals, as shown in your schedule. ICU is paid at 2% of the base sum insured or actuals. A higher room cuts other expenses pro rata, but not in an ICU.
Covers day care procedures at a hospital or day care centre, but not in the outpatient department.
Pro: ₹1, 2, 3, 4 and 5 lakh. Plus: ₹6, 7.5, 10, 12.5, 15, 17.5 and 20 lakh. Premium: ₹25, 30, 35, 40, 45, 50 and 75 lakh, and ₹1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5 and 5 crore.
A medical check-up can be required for ₹50 lakh and above if you are above 45 and have an existing condition.
Pays expenses before admission (30 days on Pro, 60 days on Plus and Premium) and after discharge (60 days on Pro, 90 days on Plus, 180 days on Premium), for the same illness or injury.
Both are paid on a reimbursement basis only.
Pays a fixed daily amount if you are hospitalised for more than 24 hours: ₹500 for up to 5 days, ₹1,000 for up to 10 days, ₹2,500 for up to 15 days or ₹5,000 for up to 45 days. It pays double in an ICU.
Paid after a 24-hour deductible, on a benefit basis with no cashless, and it does not reduce the sum insured.
Pays a lump sum of 100% of the sum insured, up to ₹25 lakh, on first diagnosis of any of 30 listed illnesses, including cancer, heart attack, CABG, stroke, kidney failure, major organ transplant and Alzheimer's disease.
A 30-day wait applies to any illness except accidents, and it does not apply if you have more than 12 months of continuous cover. Hypertension, diabetes and cardiac conditions wait 90 days, and COVID-19 waits 15 days. The 39 listed conditions and procedures wait 24 months, and pre-existing diseases wait 36 months. The Major Illness Benefit waits 90 days. Waits are reduced to the extent of prior cover if you port or migrate, and they start again for any increase in sum insured.
Initial waiting period
Expenses for any illness in the first 30 days of the first policy are excluded, except for accidents. This does not apply if you have more than 12 months of continuous cover, or to COVID-19, Major Illness, hypertension, diabetes and cardiac claims, which have their own waits.
Specified diseases and procedures
39 listed conditions and procedures, such as cataract, hernia, joint replacement and stones, wait 24 months, unless an accident caused them. Genetic disorders and internal congenital diseases are on this list.
Pre-existing diseases
Declared and accepted pre-existing diseases are covered after 36 months. If a listed disease is also pre-existing, the longer wait applies.
Conditions or treatments that the policy clearly says it will not cover.
These conditions and procedures are excluded for the first 24 months of continuous cover, even if they begin after the policy starts and even if you declared them. The wait does not apply to claims arising from an accident. If one of them is also a pre-existing disease, the longer wait of 36 months applies.
Insurer
SBI General Health Insurance plans and claim process
Arogya Supreme is a comprehensive health insurance plan from SBI General with 20 basic covers and 8 optional covers. It pays hospitalisation expenses and comes in three plans, Pro, Plus and Premium, with a sum insured from ₹1 lakh to ₹5 crore and a policy term of 1, 2 or 3 years.
Pro covers ₹1 lakh to ₹5 lakh, Plus covers ₹6 lakh to ₹20 lakh and Premium covers ₹25 lakh to ₹5 crore. Higher plans get longer pre and post hospitalisation periods, a higher cataract limit (₹1 lakh per eye instead of ₹50,000), higher road ambulance and Recovery Benefit amounts, and domestic air ambulance and Compassionate Visit, which Pro does not have.
Pro offers ₹1, 2, 3, 4 and 5 lakh. Plus offers ₹6, 7.5, 10, 12.5, 15, 17.5 and 20 lakh. Premium offers ₹25, 30, 35, 40, 45, 50 and 75 lakh, and ₹1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5 and 5 crore.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official SBI General Health Insurance website before purchasing.
Contact Details
1800 102 1111
Headquarters: 9th Floor, A & B Wing, Fulcrum Building, Sahar Road, Andheri (East), Mumbai – 400099, Maharashtra, India.
The aforementioned ratios have been averaged over three years (FY24-FY26)
For adults 18 and above, with a 90-day wait and a 30-day survival period, and the cover ends after one claim. Pre-existing major illnesses are not covered.
Adds 1.5 times or 2 times your base sum insured for in-patient treatment after an accident, once your base sum insured is fully used.
Available once in a policy year, and Sum Insured Refill does not apply to it.
Raises the bonus by 25% on Pro, or 50% on Plus and Premium, each claim-free year, up to 200% of the base sum insured.
Once taken, it cannot be dropped at a later renewal.
Protects your Cumulative Bonus and Enhanced Cumulative Bonus percentage at the next renewal after a small claim.
Only if your claim in the expiring policy does not exceed ₹50,000, and only if you take it when the policy starts.
Lowers your premium if you share 10% or 20% of every admissible claim. You get a 15% discount for a 10% co-payment and 30% for a 20% co-payment.
Once chosen, it cannot be removed at a later renewal.
Lets you take any room in the hospital except a suite or above.
Available only for a sum insured of ₹5 lakh to ₹20 lakh, and only when the policy starts.
Lowers your premium if you bear the first ₹10,000 or ₹25,000 of a claim yourself. For ₹5 lakh and ages 19 to 35, the discount is 23% for a ₹10,000 deductible and 49% for ₹25,000.
Only when the policy starts. It does not apply to covers such as mental healthcare, HIV/AIDS, advance procedures, cataract, road ambulance and Recovery Benefit.
Hypertension, diabetes and cardiac conditions
A 90-day wait applies to all claims for hypertension, diabetes and cardiac conditions, except where the condition is pre-existing and disclosed when you buy.
Major Illness Benefit
If you add the optional Major Illness Benefit, a 90-day wait applies from the start of the first policy.
COVID-19
A 15-day wait applies to all claims for COVID-19.
Higher sum insured
If you raise your sum insured, the waits start again only for the added amount. Waits are reduced to the extent of prior cover if you port or migrate without a break.
Your premium depends on your age, sum insured, plan and city. As an illustration in the prospectus, on the Pro plan with a ₹5 lakh sum insured in Zone 2, before loading and taxes, a 30 or 35-year-old pays ₹5,982 a year and a 60-year-old pays ₹15,956. A family of six (2 adults, 2 children and 2 parents) pays ₹38,903 on a floater. Get a quote for your own age and city.
After you use your base sum insured and bonus, in full or in part, SBI General refills 100% of your base sum insured once in a policy year. On a floater the refill is shared by the family. A single claim cannot exceed your base sum insured plus bonus, and an unused refill expires at the end of the year.
At each renewal after a claim-free year, SBI General adds 15% of your base sum insured, up to 100%. The bonus reduces at the same rate if you claim. With the optional Enhanced Cumulative Bonus, it grows by 25% (Pro) or 50% (Plus and Premium) a year, up to 200%.
Any illness waits 30 days, except accidents. Hypertension, diabetes and cardiac conditions wait 90 days, and COVID-19 waits 15 days. The 39 specified diseases and procedures wait 24 months, and pre-existing diseases wait 36 months. The optional Major Illness Benefit waits 90 days.
Yes. Room rent is covered up to 1% of the base sum insured, or a Single Private AC Room, or actuals up to the sum insured, as shown in your policy schedule. If you take a higher room, other expenses are reduced pro rata, except in an ICU. The optional Any Room Upgrade lets you take any room except a suite, for ₹5 lakh to ₹20 lakh.
No. Childbirth, miscarriage (unless caused by an accident), lawful termination of pregnancy and newborn care are excluded, and there is no optional cover for them. Ectopic pregnancy is paid. If you need maternity cover, compare it with a plan that offers it.
Yes, after 36 months of continuous cover, if you declared them when you bought the policy and SBI General accepted them. The wait is reduced by the cover you held with a previous insurer if you port without a break. After 60 continuous months, no claim can be contested except for proven fraud.
Recovery Benefit pays a lump sum of ₹5,000 (Pro), ₹10,000 (Plus) or ₹15,000 (Premium) if you are hospitalised for more than 10 continuous days. Domestic emergency assistance arranges medical evacuation, including air ambulance, when you are 150 km or more from home, up to ₹5 lakh on Plus and ₹10 lakh on Premium. It is not available on Pro.
Adults can join from 18 to 65 years and children from 91 days to 25 years, and renewal is for life. A family can include you, your spouse, dependent children, and dependent parents or parents-in-law, on an individual, individual family or floater basis.
Discounts include 10% for buying online or direct, 5% for two or more adults on individual policies, a 2.5% loyalty discount, 4% for a 2-year term and 6% for a 3-year term. Zone 2 gets a 30% regional discount, and a 10% or 20% co-payment gives a 15% or 30% discount. Paying monthly or quarterly adds a 2% loading.
For cashless treatment, intimate SBI General within 24 hours of an emergency admission or at least 72 hours before a planned one, and use a network hospital. For reimbursement, intimate within 48 hours of admission or before discharge, and send the documents within 30 days of discharge. SBI General must settle or reject a claim within 30 days, or 45 days if it needs an investigation. The claims toll-free numbers are 1800 210 3366 and 1800 210 6366.
Yes. Renewal cannot be refused because you claimed, and there is no loading for your own claims. A new policy has a 30-day free look period, and you get a refund of the premium less a proportionate risk premium, medical examination costs and stamp duty if you have not claimed.