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SBI

SBI

Arogya Supreme Premium

SBI Arogya Supreme Premium is a 2.0 version of SBI Arogya Supreme Plus and doesn't exactly present any upgraded features, except for 60 and 180 days (Supreme Plus has a 60 and 90-day span) of coverage of pre- and hospitalisation, respectively. The plan has an extensive 4 year waiting period for PEDs and disease-wise sub-limits on cataracts, modern treatments, mental illness, and genetic disorders. Additionally, the policy also has a nominal No-Claim Bonus of only 15% (up to 100%) with clawbacks and SBI’s poor credibility metrics isn’t doing this policy any favours too! If you are looking for a comprehensive policy that is worth your premiums, you need to start looking for plans from other insurers!

What's good here?

coPay

You’ll never have to split the bill

The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.

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prePost

Pre & Post hospitalization expenses covered

No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.

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dayCare

Day Care treatments covered

If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.

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healthCheckup

Free Health Checkups every year

If you’re planning on getting a full body checkup every year just to make sure you’re in fine working condition, the insurer will cover the costs.

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ayush

Covers Alternative Medicine

Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.

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restoration

Good Restoration Benefit

Even after you claim part of the cover on one occasion, you will have 100% of the cover restored, so that you can use this benefit in the event you have to endure multiple hospitalizations.

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ncb

Special Bonus for being healthy and not claiming insurance

Your sum insured increases by 15% each year, so long as you make no claims during this period. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 100%. Also, the bonus amount will reduce at same rate each time you make a claim. But hey, it's still a bonus.

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domiciliary

Full coverage even if you are forced to hospitalize at home

The insurer will bear the costs even if you are hospitalized at home due to a condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.

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What's bad here?

special mention
warning
Be aware of

Has disease wise sub-limits

Your insurance cover won’t be fully available in case you are treated for Cataracts, Modern Treatments, Mental illness, Genetic Disorder and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.

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ped

Long waiting period for pre-existing diseases

If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems only after 4 long years. It could be much shorter you know? Like 2 years perhaps!

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What's okay here?

roomRent

You can pick a Single Private room but nothing fancy

You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.

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Add-ons

No Claim Bonus Protector

With this add-on, your no-claim bonus will not be clawed back if the claim is less than ₹50,000.

Hospital Cash

The insurer pays a lumpsum by adding a fixed sum (daily cash) every day until the day of discharge so you can deal with any potential loss in income during this time. The money will be reimbursed to you after you submit the required documents post-discharge, and while this looks like a neat benefit to have, we don’t recommend it since the benefit doesn’t compensate for the extra premium you pay.

Co-payment

This benefit helps to opt for co-payment of 10% to 20%.

Per Claim Deductible

With this, the insurance company reduces the premiums you must pay for the plan. But remember, if you ever have to make a claim, then you’ll be expected to pay a sum before the insurance company settles the claim. This amount is called the deductible. So if you want to buy a policy at a better price, you can opt to pay a higher deductible i.e. you can pay lower premiums by offering to pay a sum (a deductible) everytime a claim comes up.

Enhanced Cumulative Bonus

With this add-on, you get bonus of 50% for every claim free year upto 200% of the base sum insured instead of the in-build bonus available in the policy. Remember, you cannot opt out of this rider at renewal once you opt for this rider.

Major Illness

With this add-on you get a lumpsum payment in the event you are diagnosed with critical illnesses outlined in the policy document.

Accidental Hospitalization Additional Cover

With this paid add-on, the insurer will provide an additional 1.5x or 2x of base sum insured applicable for emergency-caused directly due to an accident.

Frequently Asked Questions

Yes. Arogya Supreme Premium imposes 4 kinds of waiting periods -
  • 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
  • Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
  • Pre-Existing Disease Waiting Period: There's a 4-year waiting period for any pre-existing disease you may have while buying the policy.
  • 90-Day Waiting Period: Hospitalizations won’t be covered for Diabetes, Hypertension and Cardiac conditions if these are not diagnosed as PEDs at the time of purchase.
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