Overview
The SBI Super Health Prime plan is a comprehensive health insurance policy offering essential coverage with a focus on affordability. It includes features like in-patient hospitalization, pre- and post-hospitalization expenses (60-90 days respectively), daycare treatments (up to Base SI), and domiciliary care (up to Base SI). The plan provides unlimited restoration for any ailments, a short waiting period of two years for pre-existing diseases, and annual health check-ups. It also covers modern treatments and AYUSH therapies both up to Base SI, enhancing its appeal for diverse healthcare needs.
Experts' Review
Written by Nikhil Nair
Senior Writer
SBI’s Super Health Prime plan is a basic yet comprehensive health insurance solution that offers several attractive features. Its unlimited restoration benefit ensures continuous financial protection during multiple claims, while the short waiting period of two years for pre-existing diseases is particularly beneficial for individuals managing chronic conditions.
The inclusion of daycare treatments and AYUSH therapies adds versatility to the plan. Additionally, the Domestic Help/Staff Cover add-on is a unique feature that allows policyholders to extend coverage to their domestic staff, which is uncommon in most health insurance policies.
On the downside, SBI General Insurance's credibility and operational efficiency in claims processing have raised concerns, which may impact the overall experience for policyholders. While the plan offers essential benefits, it is not among our top recommendations due to these operational challenges. Buyers should carefully evaluate these factors before opting for this policy.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
Maternity benefits not offered, which is a notable gap.
Doctor consultations are not covered, which could be a drawback for some.
SBI
Key Insights
Founded
2009
SBI was established 16 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
96% claims settled in 30 Days
SBI settles 96% of all claims it receives demonstrating strong credibility.
Network Hospitals
16,600+
SBI has a strong network with over 16,600 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
21 complaints per 10,000 claims registered
SBI experiences a moderate number of complaints, indicating room for improvement in addressing customer concerns.
Features
All
Great
Good
Co-payment
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.
Customisable
Choose a co-payment between 10% and 20% to reduce premiums.
Room Rent
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre existing diseases waiting
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 after just 2 years. It’s probably the best deal you can get to be honest.
Pre/Post hospitalization
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 90 days after discharge. This includes the cost of medication by the way.
Add-ons
Enhanced ReInsure
Recommended
Restores the cover unlimited times up to 200% of the sum insured for any illness.
Enhanced Cumulative Bonus Safeguard
Recommended
Your bonus amount will not be affected if the claim is less than Rs. 1,00,000 in the entire year.
Voluntary Co-Payment
Choose a co-payment between 10% and 20% to reduce premiums.
Accidental Hospitalization Additional Cover
Additional 2x cover of base sum insured applicable for emergency-caused directly due to an accident.
Wellness Benefits
Get Health Assistance (A.I. Personal Fitness coaching), Dietician and Nutrition E-consultation along with unlimited gym membership. Additionally, the insurer offers renewal discount based on the number of steps walked by the insured members.
Aggregate Deductible
Choose deductible between ₹1,00,000 and ₹3,00,000 and get a discount on premiums.
Domestic Help/Staff Cover
Covers the domestic help/staff member up to the defined limits.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
In respect of the existing diseases, disclosed by the insured and mentioned in the policy schedule (based on insured's consent), policyholder is not entitled to get the coverage for specifed ICD codes.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Internal congenital diseases
Diseases of gall bladder including cholecystitis
Pancreatitis
All forms of cirrhosis
Perianal abscesses
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
2 years Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
After a close look at the waiting periods, we can say that the waiting periods on this policy are excellent. Especially the PED waiting period which is better than usual.
What's missing in the policy
Maternity benefits not offered.
Doctor consultations are not covered.
Customer Reviews
V
Vasudha Sharma
Unlimited restoration for any ailments is a fantastic benefit!
V
Vidya Verma
Short waiting period of two years for pre-existing diseases is quite good.
V
Vikas Gupta
Annual health check-ups included help in preventive care.
Z
Zuber Joshi
Need to check if 'unlimited restoration' has any fine print or conditions.
Y
Yasmin Khan
SBI's operational efficiency can sometimes be a concern for public sector insurers.
V
Vishal Patel
Seems like a basic yet comprehensive plan with essential features.
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Frequently Asked Questions
Does Super Health Prime have 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 2-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.
Does Super Health Prime have room rent restrictions?
Does Super Health Prime offer a restoration benefit?
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