Arogya Sanjeevani policy is a new, standard health insurance policy set by the IRDAI effective from the 1st of April, 2020. It will be offered by most health insurance companies in India. This standard plan provides for a basic health insurance cover of between Rs. 1 lakh to Rs. 5 lakhs. The policy terms & conditions for this remain the same across all health insurance companies in India.
As the coverage and the terms & conditions of the Arogya Sanjeevani health policy are universal for all insurance providers, the buyer has the liberty to purchase this policy from any insurer. However, the premium rates and customer service can vary from one insurance provider to another.
Learn About Arogya Sanjeevani Insurance
Arogya Sanjeevani Policy is an all-in-one health plan that will look after your financial needs in times of medical emergency.
|Sum Assured||Rs. 1 – 5 Lakhs|
|Policy Term||1 year|
|Co-pay||5% of sum assured|
|Eligibility Criteria||Adult – 18-65 years
Dependent children – 3 months – 25 yrs
|Special Benefits||Plastic surgery and dental cover in case of injury or illness|
|No Claim Bonus||5-50|
|Policy Type||Individual / Family Floater|
This policy offers multiple benefits to the policyholder and his/her family depending upon the type of plan purchased. Arogya Sanjeevani Policy was launched on 1st of April 2020. People who wish to buy the policy can get covered with multiple insurance benefits. Let’s go through the coverages, features, and benefits of Arogya Sanjeevani health insurance policy:
What is Included in Arogya Sanjeevani Cover?
Following are the Arogya Sanjeevani Standard Health Insurance Coverages:
Pre-Hospitalization: Your insurance company will cover the cost of treatment required as a preparation for hospitalization for a specific ailment. Depending on the terms of your insurance policy, you can receive this benefit for 30 days before hospitalization.
Hospitalization: Under the Arogya Sanjeevani Policy, one can claim the cost of treatment during hospitalization from their insurer. Various things like nursing expenses, room rent, hospital stay, bed charges, etc. form a part of this coverage. Your insurer may put a cap of 2% of the sum insured up to Rs.5,000 per day on hospitalization. If the patient is admitted in a critical care unit like Intensive Care Unit (ICU) or Intensive Cardiac Care Unit (ICCU), your insurer may pay 5% of the sum insured up to Rs. 10,000/- per day. Fees of the medical practitioners like surgeons, consultants, anaesthetists, special attending doctors, etc will be covered under the Arogya Sanjeevani Policy. The coverage also includes charges for oxygen, operation theatre charges, surgical appliances, anaesthesia, blood, medicines and drugs, etc.
Post Hospitalization: Some surgeries or ailments may require a patient to continue treatment after getting discharged from the hospital. Arogya Sanjeevani Policy will cover such expenses under Post Hospitalization. The period until when the insurer will be liable to pay these charges depends upon the terms and conditions of the policy. Usually, Post Hospitalization costs are covered for 60 days after discharge.
Room Rent/Doctor’s Fee and Nursing Expenses: Room Rent usually has a cap on the percentage of the sum insured of the policy. Arogya Sanjeevani Policy will pay 2% of the sum insured up to Rs. 5000/- per day.
ICU and ICCU Expenses: In the case of intensive Care Unit (ICU), the room rent paid will be 5% of the sum insured up to Rs. 10,000/- per day.
Ambulance Charges: The cost of transporting a patient with the help of an on-road Ambulance will be borne by the insurance company. The cap for this expense is Rs. 2000/- per hospitalization during the policy period.
Daycare Treatment: For these out-patient treatments, 50% of the sum insured can be claimed.
Dental Treatment and Plastic Surgery: The expenses related to Dental treatment and Plastic surgery will be covered up to the limit of sum insured of the policy.
AYUSH Care: The expenses related to AYUSH treatment in a hospital offering these services will be covered up to the limit of sum insured.
Cataract Treatment: The cost of this treatment will be covered up to 25% of the sum insured or Rs. 40,000/- (whichever is lower) by the insurance company for each eye.
Stem Cell Therapy: This comes under out-patient treatment and thus it has a cap of 50% of the sum insured during the policy period.
New-age/Modern Treatment: A New-age/Modern treatment that is mentioned in the policy will be covered under out-patient treatment. It will have a cap of 50% of the sum insured.
Benefits of Arogya Sanjeevani Policy
Lifelong Renewability: While the entry-level for the purchase of this policy is limited to those between the ages 18 to 65 years, this policy comes with lifelong renewability, as long as you renew it on time.
Affordable Premium: Since this is a basic, standard policy set by the IRDAI, the health insurance premium for the same is comparatively lower than other health insurance policies in the market.
Low Co-payment: Every health insurance company comes with its own set of co-payment limitations. Some at least have a 10-20% co-payment involved, while some come with no co-payment at all. In this case, this policy comes with a minimum co-payment of 5% only, i.e. during claims, you will have to pay 5% of the expenses from your pocket.
Individual & Family Floater Available: The Arogya Sanjeevani Policy comes with two plans available: An Individual Health Policy (One policy each for a family member) and a Family Floater Health Insurance (One policy for the entire family).
With the availability of varying health insurances online, you could easily end up being confused about making the right choice. This is when Arogya Sanjeevani policy comes into the picture to help in simplifying health insurance by providing a basic, standard plan that will be offered by all health insurance companies, with the same benefits. This policy can be bought by individuals as well as families.