Arogya-health-insurance-coverage

New age treatments covered in Arogya Sanjeevani Health Insurance Plan

Understanding Arogya Sanjeevani Health Insurance Policy 

Arogya Sanjeevani is recently formulated basic health insurance plan by the Insurance Regulatory and Development Authority of India. This has to be mandatorily offered by all insurance companies since 2020. This insurance plan came into action from 1st April 2020 offered by all general insurance companies across India. This health insurance policy provides a basic health  coverage ranging from Rs.1 lakh to  Rs.5 lakhs. Other than covering the medical expenses incurred due to hospitalisation it also covers treatment costs of the recent COVID-19 virus.

The following types of plans are available through the Arogya Sanjeevani Health Insurance Plan:

  • Individual plan: A single person insured will be a beneficiary of Arogya Sanjeevan plan.
  • Family floater plan: Multiple members of family of the person insured will become beneficiaries of Arogya Sanjeevani policy.

Arogya Sanjeevani Health Insurance Plan is a comprehensive health cover that will look after any financial requirements during times of medical needs.

The Insurance Regulatory and Development Authority of India or IRDAI has mandated the insurance providers to make products that are affordable and are easy to understand. Health insurance plans can be quiet complex due to its jargons, nuances and many other factors. For the layman, all this can be quite confusing and time consuming. To get rid of this, the IRDAI has put forth specific guidelines for health insurance providers  to create a benchmark health insurance plan, the– Arogya Sanjeevani Policy. 

Launched in April of 2020, the Arogya Sanjeevani is just like other health insurance plans that gives financial compensation to people who are hospitalised in case of injuries and other illnesses up to a certain sum insured. The insured person can make use of the cashless facility across the network hospitals of its  insurer and also get their expenses taken care of. 

In this, the  insurance companies offering this product, the only variable factor is that of the premium and the method of bringing a customer. The buyer has options to choose by making  a decision depending on the credibility of the insurer and the cost of premiums, in spite of comparing big check  list of complex features across different policies.

Why is this policy important?

The primary goal to launch the Arogya Sanjeevani Health insurance policy is to develop the basic healthcare facilities for the general  public. This plan has all the requisite and  mandatory covers like the pre and post-hospitalisation, including the Covid-19 cover, day-care treatments, hospitalisation costs, and also provides tax benefits. 

The other aim  is to bring standardised products to provide simple and useful policy terms for all, irrespective of the insurance providers. This policy also provides bonus facility, in which, increase in sum insured is up to a limit of 5% without having any increase in current premium payment. This condition is true across all insurers. Regarding the waiting period, and one-year policy term is standard across the board. 

Another aim is to have interchangeability between insurance providers. To that extent, the policy becomes easily portable. If certain facilities are better with an insurer, then a person can easily choose them  without having to worry about the changes in the policy benefits, coverage and various other features.

Various Coverage & Benefits of Arogya Sanjeevani

  • Arogya Sanjeevani Health Insurance Plan is a basic one and a  standard policy is put up by the IRDAI. In addition, the premiums for the policy are comparatively low compared to other health policies offered in the industry.
  • Also, the expenses of AYUSH  are covered, provided that the policyholder chooses to go for an optional treatment instead of the regular allopathic treatment.
  • Arogya Sanjeevani Health Insurance plan provides an option to choose from Rs.40,000 or 25% of the Total Sum Insured for a Cataract Surgery.
  • It also gives coverage for Uterine Artery Embolization and HIFU
  • It covers the diagnosis and hospitalisation expenses for COVID-19 as well.
  • It covers Balloon Sinus plasty and volatile cases of  sinus inflammation, and blockages caused in the nasal passage of a patient.
  • This policy also covers Deep Brain Stimulation for treating the Parkinson’s Disease and also the Tourette syndrome.
  • The policy has Oral Chemotherapy expenses covered in its coverages.
  • The policy offers coverage for Immunotherapy.
  • Also, the policy covers ONM or the Operative Neuro Monitoring.
  • Basic coverage of ICU and ICCU bills
  • It has Pre & Post hospitalisation costs covered in the policy
  • Additionally, it covers ambulances charges up to the limit of Rs. 2000/- each hospitalisation in the policy period.
  • Arogya Sanjeevani Health Insurance Plan will pay two percent of the total Sum Insured up to a limit of Rs. 5000/- per day for expenses such Room Rent, Doctor’s Fee and other Nursing Expenses.
  • For OPD visits which are also called as Daily Care Treatments, half the amount of the total Sum Insured can be claimed by the insured under this policy.
  • Further new age treatments like the Stereotactic Radio Surgeries, Bronchial Thermoplasty and Robotic Surgeries are also covered among others.

Few of the various new age treatments covered under this policy are mentioned in detail below:

  1. AYUSH treatments

Treatments under the Non-allopathic category like Ayurveda, Unani, Homeopathy and Siddha are all provided in the policy for up to a certain limit of the sum insured.

  1. Various Dental care and plastic surgery

In case of any accidents or injury, if you are needed to undergo any type of dental treatments or maybe  plastic surgery, all the expenses of those treatments will be covered by the policy. This cover is to be allowed up to certain sum insured in the plan.

  1. Cataract surgery

Also, the treatment for cataract will be covered for up to twenty five percent of the sum insured depending on the limit of upto Rs. 40,000/eye

  1. Other New Age treatments

In order to develop Arogya Sanjeevani policy to be suitable for the modern times, coverage for several other new-age treatments is covered in breadth of the plan. The coverage extended for these treatments are limited to half the amount of the total sum insured. 

Along with these treatments, others which fall in the category of new-age treatments and are covered by the plan and these would include…

  • Uterine Artery Embolisation or UAE and High intensity focused ultrasound or HIFU- These operations are needed to remove the blockage of blood through arteries.
  • Balloon Sinus plasty- This procedure is carried out  in severe problem of rhino sinusitis or sinus inflammation, and blockages in the nasal passage of a patient.
  • Deep Brain Stimulation- In this the placement of electrodes which transmit electric signals to perform various bodily functions. This treatment is used in the treatment of Parkinson’s Disease and Tourette syndrome.
  • Immunotherapy- This helps in the betterment of the immune system to make patients body fight cancer much better.
  • Oral Chemotherapy- In this medicine is given orally for fighting cancer
  • Vaporisation of The Prostate- In this men with enlarged prostate are treated. The Vaporisation process is carried out using either the laser energy or electrosurgery.
  • Intra Operative Neuro Monitoring (IONM)- In the process of a surgery, certain neural structures are required to be constantly checked. This can be done with IONM. During this treatment electrophysiological methods like ElectroEncephaloGraphy (EEG), electromyography (EMG) are used.
  • Intravitreal Injections- This procedure  is used to cure various medical issues related to the retina of the eye. Intra vitreal injections are given directly in the patient’s eye by a medical professional in regular periods of time.
  • Stem cell therapy – These cells of the body have a fixed function. Therefore, they are used in the treatment or even prevention of an illness or a disease.
  • Robotic surgeries
  • Stereotactic Radio Surgeries- This is used to perform various operations like giving an injection, biopsy, implantation, ablation, among others. It makes use of a three-dimensional coordinate system to target a small area.
  • Bronchial Thermoplasty-This is used to cure severe cases of Asthma. It has controlled, therapeutic radio frequency energy on the patient’s air channel. This assists in clearing the congestion that causes an Asthma attack.

There are various exclusions under Arogya Sanjeevani health insurance plan—

  1. Cost for Diagnosis
  2. Medical expenses during  activities which break societal law, taking part in hazardous activities and substance abuse
  3. Undergoing cosmetic surgery or gender change treatments
  4. Undergoing inorganic Weight control treatments
  5. Vision correction
  6. Treatments for Infertility
  7. Medical conditions experienced due to war
  8. Rehabilitation
  9. Expenses incurred during Maternity
  10. Dietary supplements
  11. Medicinals expenses incurred out of  India

”Treatments

What is the limit of sum insured in the Arogya Sanjeevani?

The upper limit to the total sum insured under Arogya Sanjeevani is Rs.5 lakhs.

Is there any waiting period in Arogya Sanjeevani Plan?

Yes, there is waiting period in the Arogya Sanjeevani Plan. Initially it is 30 days but waiting period for certain diseases is for 24 months, and for pre-existing diseases it is 48 months. However, waiting period is not applicable in case of an accident.

Will I be able switch my existing health insurance policy to Arogya Health Plan?

Yes, you can easily switch your existing health insurance policy to Arogya Sanjeevani Plan. However, it is possible only if there are no lapses in the policy and also the process is simple and quick.

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