SBI Health Insurance Family Plans 2026

Q: What are the main waiting periods in SBI family plans?

In SBI’s Health Alpha plan, there is a 30-day initial waiting period during which illnesses are not covered, though accidents are covered from day one. There is a 2-year waiting period for specific listed illnesses and surgeries, and a 2-year waiting period for pre-existing diseases. SBI Health Alpha also allows the pre-existing disease waiting period to be reduced to one year. Waiting periods may vary depending on the specific policy.

Quick Overview

SBI health insurance family plans offer wide hospital coverage, strong claim settlement metrics, and multiple plan options. While its scale and stability inspire confidence, many family plans come with caps, conditional benefits, or higher costs once add-ons are included.

Coverage can vary significantly by variant, especially for features like restoration, maternity, room rent, and global treatment. Choosing the right SBI family plan depends heavily on understanding these limits and matching them to your family’s healthcare needs.

A single hospital bill can be enough to disrupt a family’s finances. When you're responsible for your spouse, children, or aging parents, that financial risk grows even more. As a result, many families start looking for a reliable health insurer to support them during these stressful times.

SBI General Insurance, backed by State Bank of India, has an average annual gross written premium of ₹3,328.51 crore (FY 2022–25), indicating a meaningful presence in the health insurance market.

It reports an average claim settlement ratio of 96.14% (FY 2022–25) and an incurred claim ratio of 81.23% (FY 2022–25), showing a strong claims-paying record and steady utilization of premiums.

The service experience is relatively smoother, with 20.51 complaints per 10,000 claims (FY 2022–25). SBI currently has a network of 16,600+ hospitals across India.

In this article, we break down SBI health insurance family plans in simple terms so you understand what you’re actually buying, what is covered, and whether it's the right fit for your needs.

Best SBI Health Insurance Plans For Family

Plan Name	Variants	Key Features	Drawbacks
Health Alpha	Alpha Select has limited coverage, targeting tier 2 cities. Alpha Ultimate allows all benefits and optional covers.	35+ add-ons like maternity and newborn coverage, unlimited restoration, endless sum insured for one claim, and a bonus up to 10x.	Too complex, some benefits are applicable only for a higher sum insured.
Health Edge	-	Basic cover, restoration once per year, PED waiting period of 24 months.	Lower sum insured options, limited bonus, and too many add-ons
Super Health	Elite, Prime, Premier, Platinum, and Platinum Infinite differ mainly by room rent limits, ICU limits, sub-limits on treatments, and eligibility for higher benefits.	Unlimited restoration up to 200% of the sum insured, broad coverage, global treatment option, bonus, and multiplier features.	It can get expensive, multipliers limited to listed illnesses, lower variants have ICU and treatment caps, and global cover is conditional.
Arogya Supreme	Pro has strict room rent caps. Plus increases limits. Premium offers the highest room rent and longer post-hospitalization.	Core cover with restoration once per year, a cumulative bonus, domiciliary, and modern treatment cover.	Pro and Plus have room rent limits, fewer rider options, maternity and advanced benefits less comprehensive.

Premiums for the SBI Health Alpha Family plan

Profiles	Premiums
(Family Floater, 2A): Ages (31, 32)	₹14,161
(Family Floater, 2A 1C): Ages (36, 34, 4)	₹20,577
(Family Floater, 2A 2C): Ages (41, 38, 6, 2)	₹27,841
(Family Floater, 2A): Ages (54, 55)	₹31,620

Premiums for SBI Health family plans vary by age, location, medical history, lifestyle habits, sum insured, and the add-ons you choose. Above are the Health Alpha Ultimate plan premiums for different family structures.

Note: Premiums are for people seeking a ₹15 lakh sum insured, residing in Delhi - 110010, with necessary and mandatory add-ons.

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What Is Covered And Not Covered In SBI Health Family Plans

What’s Covered	What’s Not Covered
In-patient hospitalization	Investigation and evaluation only
Pre-hospitalization expenses	Rest cure, rehabilitation, and respite care
Post-hospitalization expenses	Obesity or weight control treatments
Day care treatments	Gender change or related treatments
Organ donor expenses	Cosmetic or plastic surgery
Modern treatments (robotic surgery, stem cell therapy, etc.)	Hazardous or adventure sports injuries
AYUSH treatments (Ayurveda, Homeopathy, etc.)	Treatment breaching the law
Road ambulance charges	Unproven treatments or experimental procedures
Domiciliary treatments	Sterility and infertility treatments
-	Maternity (unless specifically covered)
-	Wellness or rejuvenation therapies
-	Dietary supplements or alternative substances
-	Substance abuse or alcohol-related treatments

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Ditto’s Take on SBI Health Family Plans

SBI Health Insurance looks reassuring if you focus only on the metrics. Its claim settlement ratio sits in a healthy range, incurred claim ratios are reasonable, and complaint numbers are not alarming. From a credibility standpoint, SBI is not a risky insurer. However, strong numbers alone do not always translate into a smooth family health insurance experience.

Most SBI family plans are either limited in their base coverage or become complicated and expensive with riders. Benefits like maternity, global treatment, higher refills, or enhanced bonuses come with longer waiting periods or extra cost.

As a result, you often end up paying more to reach a comparable level of coverage.

If you want a comprehensive, low-friction family health plan with strong built-in benefits and fewer caps, we recommend comparing SBI’s plans with other insurers.

Note: SBI General Insurance is a non-partner insurer for Ditto. This review is for educational purposes only and is based on publicly available data such as disclosures, annual reports, brochures, and policy documents.

Frequently Asked Questions

What is the age limit, and who can be covered under SBI’s family floater plans?

Most SBI family floater plans cover you, your spouse, and dependent children, and many also allow parents or parents-in-law on the same policy. Adult entry ages and maximum age limits vary by plan, while dependent children can usually stay covered until around age 25–26, subject to each policy’s terms. Always check the specific policy brochure for exact eligibility.

Should I include my parents in the same SBI family floater or buy a separate plan?

In most cases, it is better to buy a separate health insurance plan for your parents instead of adding them to an SBI family floater. Adding parents significantly increases the premium since pricing is based on the oldest member, and their claims can quickly exhaust the shared sum insured meant for the rest of the family. A separate plan gives your parents dedicated coverage without affecting your family floater benefits.

What are the main waiting periods in SBI family plans?

For SBI’s Health Alpha plan, you have a 30-day initial waiting period where illnesses are not covered (accidents are covered from day one), a 2-year waiting period for specific listed illnesses and surgeries, and a 2-year waiting period for pre-existing diseases. The big plus is that SBI Health Alpha lets you reduce the PED waiting period to one year. Waiting periods vary from policy to policy.

Last updated on: 22 Dec, 2025