Compare Star Health vs SBI General Health Insurance Plans
| Star Health | SBI General | |
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| Claims Settlement Ratio ** | 81.62% | 62.73% |
| Number of Lives Covered * | 1,16,17,000 | 27,48,000 |
| Network Hospitals | 9,900 + | 6,000 + |
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| Medi Classic | Comprehensive plan | Family Health Optima | Arogya Sanjeevani | Retail Health | Arogya Premier | Arogya Plus | Arogya Sanjeevani |
| In-patient Treatment | |||||||
| Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covered | Covered | Covered | Covered |
| Room Rent | |||||||
Basic: 2% of base sum insured maximum up to Rs.5,000 Gold - 3 & 4 Lakhs: Rs.5,000 per day 5 to 25 Lakhs: Private single A/c Room |
Private single standard A/c Room | 3 & 4 Lakhs: Rs.5,000 per day 5 to 25 Lakhs: Single standard A/c room |
2% of sum insured subject to a maximum of Rs.5,000 per day | 1% of sum insured per day | Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day |
| ICU Charges | |||||||
| Covered | Actual | Covered | 5% of sum insured, max up to Rs.10,000 per day | 2% of sum insured per day | Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day. |
| Pre-hospitalization | |||||||
| Incurred for a period not exceeding 30 days prior to the date of hospitalization, for the disease/illness, injury | Up to 60 days | Up to 60 days | Up to 30 days | Up to 30 days | Up to 60 days | Up to 60 days | 30 days before the date of admission to the hospital |
| Post-hospitalization | |||||||
Basic: 60 days from the date of discharge from the hospital (payble 7% of hospitalization expenses maximum of Rs.5,000 per hospitalization) Gold: 60 days from the date of discharge from the hospital |
Up to 90 days | Up to 90 days | 60 days after discharge from the hospital | Up to 60 days | Up to 90 days | Up to 90 days | 60 days after discharge from the hospital |
| Day Care Procedures | |||||||
| All day care procedures are covered | All day care procedures are covered | All day care procedures are covered | All day care procedures are covered | 142 day care expenses covered | 142 day care expenses covered | 142 day care expenses covered | All the day care treatments |
| Domiciliary Treatment | |||||||
| Covered | Covered | Not Covered | Covered | 20% of the sum insured maximum up to Rs.20,000 | Insurer will cover reasonable and customary charges towards domiciliary hospitalisation. | Insurer will cover reasonable and customary charges towards domiciliary hospitalisation. | Not Covered |
| Emergency Ambulance | |||||||
| Up to Rs.750 per hospitalisation and overall limit of Rs.1,500 per policy period | Actual | Up to Rs.750 per hospitalisation and overall limit of Rs.1,500 per policy period | Up to Rs.2,000 per hospitalisation | 1% of sum insured per policy period up to a maximum of Rs.1,500 | Actual | Actual ambulance expenses or Rs.1,500 | Subject to a maximum of Rs.2,000 per hospitalisation. |
| Dental Treatment | |||||||
| Not Covered | 5 & 7.5 Lakhs: Rs.5,000 10 to 25 Lakhs: Rs.10,000 50 Lakhs to 1 Crore: Rs.15,000 |
Not Covered | Not Covered | Covered | Covered | Covered | Dental treatment necessitated due to disease or injury |
| Bariatric Surgery | |||||||
| Not Covered | 5 to 15 Lakhs: Rs.2,50,000 20 Lakhs to 1 Crore: Rs.500,000 |
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | |||||||
| Not Covered | 5 to 15 Lakhs: Rs.15,000 per policy period 20 & 25 Lakhs: Rs.20,000 per policy period 50 Lakhs to 1 Crore: Rs.30,000 per policy period |
3 & 4 Lakhs: Up to Rs.10,000 per policy period 5 to 15 Lakhs: Up to Rs.15,000 per policy period 20 Lakhs & 25 Lakhs: Up to Rs.20,000 per policy period |
Covers in-patient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy up to sum insured |
Ayurvedic medicine: Covered up to maximum 15% of sum insured per policy period up to a maximum of Rs.20,000 Homeopathic and Unani system of medicine:Covered up to maximum 10% of sum insured per policy period up to a maximum of Rs.15,000 |
Covered | Covered | Covered |
| Maternity Benefits | |||||||
| Not Covered | 5 Lakhs: Normal delivery - Rs.15,000 Caesarean - Rs.20,000 7.5 Lakhs: Normal delivery - Rs.25,000 Caesarean - Rs.40,000 10 to 25 Lakhs: Normal delivery - Rs.30,000 Caesarean - Rs.50,000 50 Lakhs to 1 Crore: Normal delivery - Rs.50,000 Caesarean - Rs.100,000 (24 months for first delivery from first inception of the policy) (24 months from claim under for next delivery) |
Not Covered | Not Covered | Not Covered | Reasonable and customary charges towards maternity expenses during hospitalisation are covered after first 9months from the date of inception of first policy | Covered but only under OPD section and up to OPD Limit specified in policy schedule. | Not Covered |
| New Born baby cover | |||||||
| Not Covered | 5 to 25 Lakhs: Rs. 100,000 50 Lakhs to 1 Crore: Rs. 200,000 |
Up to 10% of sum insured or maximum of Rs.50,000 subject to availability of the sum insured (from 16th day to till the expiry of the policy) (provided if mother is insured for 12 months without break) |
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Vaccination of the new born baby | |||||||
| Not Covered | 5 to 25 Lakhs: Rs.5,000 50 Lakhs to 1 Crore: Rs. 10,000 |
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Daily Cash for Accompanying an Insured Child | |||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Rs.500 for each completed day of hospitalisation of a child below 10 years of age, subject to maximum of 30 days during the policy period. | Not Covered | Not Covered | Not Covered |
| Organ Donor Expenses | |||||||
Basic: Not Covered Gold: Covered |
Covered | 10% of sum insured or Rs.100,000 | Not Covered | Covered | Covered | Not Covered | Not Covered |
| Vaccination (In case of post bite treatment) | |||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Health Check-up | |||||||
Up to 1% of the average basic sum insured subjected to max of Rs.5000 is payable Sum insured 2 lakhs & above) |
5 Lakhs: Rs.2,000 7.5 Lakhs: Rs.2,500 10 Lakhs: Rs.3,000 15 Lakhs: Rs.4,000 20 & 25 Lakhs: Rs.4,500 50 Lakhs to 1 Crore: Rs.5,000 (Once in a block of every claim free years of continuous renewal) |
3 Lakhs: Rs.750 4 Lakhs: Rs.1,000 5 Lakhs: Rs.1,500 10 Lakhs: Rs.2,000 15 Lakhs: Rs.2,500 20 Lakhs: Rs.3,000 25 Lakhs: Rs.3,500 (available after every claim free year per policy) |
Not Covered | 1% of sum insured up to a maximum of Rs.2,500 for every 4 claims free year | Rs.5,000 for every 4 claims free year | Not Covered | Not Covered |
| Hospital daily allowance | |||||||
| Not Covered | 5 Lakhs: Rs.500 7.5 & 10 Lakhs: Rs.750 15 & 20 Lakhs: Rs.1000 25 Lakhs: Rs.1,500 50 Lakhs & 1 Crore: Rs.2,500 (maximum 7 days/occurrence is payable) |
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Co-pay | |||||||
| No co-pay if entry age is below 60 years / 20% co-pay for ages above 60 years | No co-pay if entry age is below 60 years / 20% co-pay for ages above 60 years | No co-pay if entry age is below 60 years / 20% co-pay for ages above 60 years | 5% co-pay applicable on all claims | No co-pay for treatment in Network / 10% in Non Network Hospitals | No co-pay for all treatment | No co-pay for all treatment | 5% Co pay applicable on all claims |
| Pre-existing diseases coverage | |||||||
| Covered after a waiting period of 4 years | Covered after a waiting period of 4 years | Covered after a waiting period of 2 years | Covered after 4 years of continuous coverage without break | Covered after 4 years of continuous coverage. | Covered after a waiting period of 4 years | Covered after a waiting period of 4 years. | Covered after a waiting period of 4 years. |
| Restore Benefit | |||||||
| 200% of Base Sum Insured for unrelated illness/diseases | 100% of Base Sum Insured for unrelated illness/diseases | Thrice up to 100% of Base sum insured for plans with sum insured 3 lakhs and above | Not applicable | Not Covered | Covered up to 100% of base sum insured | Covered up to 100% of base sum insured | Not Covered |
| General waiting period | |||||||
| 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
| Renewal Benefit / Cumulative Bonus | |||||||
Basic: 5% of the basic sum insured for every claim free year subject to a maximum of 25% Gold: 25% of basic sum insured in the second year and additional 20% of the basic sum insured for each subsequent years subject to a maximum of 100% |
5 Lakhs: 50% on base sum insured for every claim free year and up to 100% 7.5 Lakhs to 1 Crore: 100% of the basic sum insured for every claim free year |
25% of Sum Insured after first year if claim free and additional 10% for the subsequent years (Maximum allowable bonus is 100%) |
5% on base sum insured for every claim free year and up to 50% | 5% every year, maximum up to 25% of sum insured | 10% every year, maximum up to 50% of sum insured | Not Covered | 5% every year, maximum up to 25% of sum insured |
| Emergency Air Ambulance | |||||||
| Not Covered | Up to Rs.2,50,000 per hospitalization, not exceeding Rs.5,00,000 per policy period | 3 to 5 Lakhs: Not Covered 5 to 25 Lakhs: Up to 10% of the sum insured |
Not Covered | Not Covered | Up to Rs.100,000 | Not Covered | Not Covered |
| Available sum insured options | |||||||
Basic plan: 1.5 to 15 Lakhs Gold plan: 3 to 25 Lakhs |
5 Lakhs to 1 Crore | 3 to 25 Lakhs | 1 to 5 Lakhs | 50,000 to 5 Lakhs | 10 to 30 Lakhs | 1 to 3 Lakhs | 1 to 5 Lakhs |
| Policy can be purchased for | |||||||
| 1/2 years | 1/2 years | 1 year | 1 year | 1/2/3 years | 1/2/3 years | 1/2/3 years | 1 year |
| Eligibility criteria | |||||||
| 5 Months to 65 years. Therefore only renewals will be accepted without capping on the exit age | Adults from 18 to 65 years (dependents 3 months to less than 25 years) | Adults from 18 to 65 years (dependents 16 days to less than 25 years) | Adults from 18 to 65 years (dependents 3 months to less than 25 years) | Adults from 18 to 115 years (dependents 91 days to 17 years) | Adults from 18 to 115 years (dependents 91 days to 17 years) | Adults from 18 to 75 years (dependents 91 days to 17 years) | Adults from 18 to 65 years (dependents 91 days to 17 years) |
| Renewability | |||||||
| Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life |
| Claims loading | |||||||
| No Loading | No Loading | No Loading | No Loading | No Loading | Loading | Loading | No Loading |
| Portablity(At the time of renewal) | |||||||
| Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| Tax Benefits Limit | |||||||
| Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D |
