Arogya Sanjeevani Health Insurance Policy
About the Arogya Sanjeevani Health Insurance Policy
Arogya Sanjeevani Health Insurance Policy is the newly formulated Standard Health Insurance Product (SHIP) mandated by the Insurance Regulatory and Development Authority of India (IRDAI) effective from April 01, 2020. In response to the COVID-19 pandemic, IRDAI mandated all health insurers to put forward a basic as well as a standard health insurance policy for both individuals and for families.
Arogya Sanjeevani Policy revolves around simplifying health insurance for customers by presenting a basic and standard policy offered by all the health insurers with exactly the same benefits. However, the plan’s premium and the services offered during the purchase process, claim settlement, and other related processes differ from one health insurance service provider to another.
Under the Arogya Sanjeevani policy, the policyholders can avail coverage ranging from Rs.1 lakh to Rs.5 lakh. The plan also covers the hospitalization expenses due to COVID-19. It offers comprehensive coverage for hospitalization expenses including pre and post-hospitalization expenses, bed charges, nursing charges, ICU & doctor consultation charges, and much more. Another highlight of the Arogya Sanjeevani Policy is that it requires no medical check-ups up to 45 years of age.
Arogya Sanjeevani Health Insurance Policy offers two types of coverage options:
- Individual Plan: Under this option, only one policyholder is the beneficiary.
- Family Floater Plan: This option extends to the entire family of the primary policyholder. Dependents, such as spouse, children, parents and parents-in-law can be included in a single policy to avail the benefits of the Arogya Health Insurance Scheme.
Benefits of Arogya Sanjeevani Health Insurance Policy
The Arogya Sanjeevani Health Insurance Policy is a huge milestone for health insurance in India, especially for consumers. It is definitely the most consumer-centric health insurance product in India. Arogya Health Insurance Scheme is oriented toward the health insurance needs of the major segments of consumers in the country.
The aim was to simplify health insurance in India by offering a basic and standard policy with the exact same coverage by all the health insurers in the country. By launching Arogya Sanjeevani Insurance, IRDAI ensured that the whole process of choosing and buying health insurance becomes easy for the customer. The most attractive highlight of the Arogya Sanjeevani Policy is the significantly higher affordability of the plan compared to other health insurance plans. With a wide-ranging coverage at highly reasonable premiums, the plan is designed for various income groups.
The Arogya Sanjeevani Health Insurance policy is also very flexible. It provides various sum insured options ranging from Rs.1 Lakh to Rs.5 Lakh. The policy is also available in individual as well as on a family floater basis which helps in addressing the diverse insurance needs through a single policy. Furthermore, the policy also covers the hospitalization expenses related to COVID-19 which provides policyholders and their family members robust financial protection in these challenging times.
Some other lucrative benefits offered by the Arogya Sanjeevani Health Insurance Policy are:
- Universal Coverage and Terms
The coverage and the terms and conditions are universal for the plan regardless of the health insurer. This simplifies the whole process of process selection for the customer from one end to another. It also leaves no room for confusion in the policy buyers’ minds because of its universal coverage and terms.
- No-Claim Bonus
Policyholders are eligible for a 5% bonus on the sum insured for each claim-free year. The calculation of the No-Claim Bonus is cumulative with a maximum limit of 50%.
- Low Co-Payment
The Arogya Sanjeevani Insurance features a low co-payment of 5% without a reduction in the sum insured. The share of the claim amount borne by the policyholder at the time of claim settlement is known as co-payment.
- Lifetime Renewability
Since the policy comes with no age restriction at the time of renewal, it can be renewed by the insured throughout their lifetime.
- Covers New Age Treatments
The Arogya Sanjeevani Policy also provides coverage for new-age treatments such as Balloon Sinuplasty, Deep Brain stimulation, Oral Chemotherapy, Immunotherapy, and much more.
- Tax Benefits
Policyholders can avail tax benefits for the premiums paid towards the Arogya Plus plan under Section 80D of the Income Tax Act,1961. This is part of the normal ceiling limit of Rs.25,000 for regular policies and Rs.50,000 per annum for senior citizens.
- Value for Money
Arogya Sanjeevani Insurance offers comprehensive coverage at highly economical premiums and provides the best value for money. This also makes it an ideal choice for first-time policy buyers.
Key Inclusions in the Arogya Sanjeevani Health Insurance Policy
Under the Arogya Sanjeevani Health Insurance Policy, the general or health insurance provider will be liable to pay the policyholder for the following expenses:
Hospitalization Expenses: Policyholders can claim for hospitalization expenses up to 2% of the sum insured subject to a maximum of Rs. 5,000 per day of hospitalization, if the duration of treatment was more than 24 hours. This includes doctor consultation fees, nursing expenses, room rent, bed charges, hospital stay, etc.
Pre & Post-Hospitalization Expenses: Coverage for pre-hospitalization expenses for 30 days prior to the date of admission. Post-hospitalization expenses are also covered for a fixed period of 60 days from the date of discharge.
Day-care Coverage: The policy provides coverage for all day-care treatments up to 50% of the sum insured. Note that the procedures normally taken on an out-patient basis are not included under day-care treatment.
ICU / ICCU Charges: ICU charges are covered under the Arogya Sanjeevani Policy up to 5% of the sum insured capped at Rs. 10,000 per day.
Ambulance Charges: The policy provides coverage for road ambulance charges up to Rs.2,000 per hospitalization.
AYUSH Treatment: Inpatient treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) systems of medicines is covered under the Arogya Sanjeevani Insurance up to a specified limit of sum insured.
Plastic Surgery and Dental Treatments: Plastic surgery and dental treatments are only covered under the plan if they are necessitated due to a disease or an injury.
Cataract: Expenses for the treatment of Cataract are covered under the plan. Coverage is subject to a limit of 25% of the sum insured or Rs.40,000, whichever is lower, each eye.
New Age Treatments: Arogya Sanjeevani Health Insurance Policy also covers modern treatments including Robotic surgeries, Bronchial Thermoplastics, Intravitreal injections, stem cell therapy, etc. Coverage is limited to 50% of the sum insured.
Key Exclusions in the Arogya Sanjeevani Health Insurance Policy
The insurance provider is not liable to cover any expenses for Arogya Sanjeevani Health Insurance Policy under the following conditions:
- Non-medical expenses
- Surgical treatments for obesity and weight-related problems
- STDs/AIDS/Venereal Diseases
- Intentional cosmetic or plastic surgery
- Treatments necessitated due to participation in hazardous or adventure sports
- Treatment that is taken outside India
- Treatments for alcoholism, drug or substance abuse, or any other addiction.
- War-like situations
- Illness or conditions caused by a nuclear, chemical, or biological attack
- Dietary supplements
- Maternity, sterility, fertility, childbirth, pregnancy-related expenses
- Domiciliary hospitalization and OPD treatment.
- Outpatient Department Expenses
Review and Ratings for Arogya Sanjeevani Health Insurance Policy
The Arogya Sanjeevani Health Insurance Policy is an excellent and prudent initiative by IRDAI. It is a delicately designed policy that provides a strong financial overlay to the policyholders for hospitalization expenses. The greatest benefit that it offers to the Indian customer is the simplicity and ease of selecting basic and affordable health insurance with comprehensive coverage. It also helps to reduce the challenges that people are facing during the COVID-19 pandemic.
The Arogya Sanjeevani Policy has received a phenomenal response from customers across the country. Its lucrative benefits have compelled many people to buy it since its launch in April 2020. Here are the reviews by some of the customers that were delighted by the Arogya Sanjeevani Health Insurance Policy:
- Excellent Affordability, Saurabh Verma
I had been looking for a basic and affordable plan for myself for a long time but there were no options that I was sure about. Either they were too expensive, or they were providing less coverage at lower costs. The Arogya Sanjeevani Policy is a perfectly designed policy for me and I’m sure for many people out there. It provided comprehensive coverage at highly affordable premiums. Best value for money!
- Simple and Easy, Naman Sundriyal
I am so thankful to IRDAI for introducing the Arogya Sanjeevani Policy. This is exactly what we as consumers needed in such challenging times. Now, I don’t need to go through never-ending insurance product brochures from different companies to select health insurance for myself and my family. Choosing health insurance has never been easier!
- Wide Coverage, Sartaj Singh
I looked through Arogya Sanjeevani Policies from different insurers and all of them provide such extensive coverage at such reasonable prices. Modern Treatments, AYUSH treatments, cataract surgeries, and so much more. Basically, just about everything that I need medical coverage for.
Arogya Sanjeevani Health Insurance FAQs
Are COVID-19 hospitalization expenses covered under the Arogya Sanjeevani Policy?
Yes, hospitalization expenses for treatment of COVID-19 are covered under the Arogya Sanjeevani Policy.
Does this policy offer a Co-Payment option?
Arogya Health Insurance Scheme allows a co-payment of 5%, without a reduction in the sum insured.
Does the policy offer lifetime renewability?
There is no restriction on the age at the time of renewal of the policy, which means that the policyholders can easily renew their policies throughout their lifetime.
What is the eligibility criteria for the policy?
The minimum and maximum entry age for the policy is 18 years and 65 years respectively. For the inclusion of dependent children under the family floater plan, they must be aged 3 months to 25 years.
Does the Arogya Sanjeevani Health Insurance Policy offer portability?
Yes, Arogya Sanjeevani Policy allows you to port your existing health insurance policy to this policy.
What are various options for sum insured under the Arogya Sanjeevani Policy?
The sum insured options under the Arogya Health Insurance Scheme range from Rs. 1 Lakh to Rs.5 Lakh with a difference of Rs.50,000 i.e., Rs.1 lakh, Rs.1.5 lakh, Rs.2 lakh, Rs.2.5 lakh, Rs.3 lakh, Rs.3.5 lakh, Rs.4 lakh, Rs.4.5 lakh and Rs.5 lakh.