Arogya Sanjeevani Health Insurance
Amit Many people find health insurance complicated. It is one of the main reasons keeping many people away from buying health insurance. To overcome this natural aversion to buy health aversion due to its complexity, IRDAI brought in the Arogya Sanjeevani Health Insurance. This is a scheme to simplify health insurance for everyone by offering a plain vanilla health insurance product to make it widely acceptable.
The Arogya Sanjeevani health policy is offered to individuals and also as a family floater plan. This plan was launched by the IRDAI on the 1st of April, 2020, to make health insurance more accessible and more understandable for everyone. The Sanjeevani Arogya Yojana is designed as a standard plan offered by all health insurance companies.
Most health insurance providers offer Arogya Sanjeevani scheme with similar benefits. The only difference between Arogya Sanjeevani plans of different companies is the level and quality of service provided by each of these companies.
Arogya Sanjeevani is a general health insurance plan. It offers coverage of sum insured ranging from Rs.1 lakh to Rs.5 lakhs. The plan offers comprehensive coverage – room rent, pre and post-hospitalization expenses, doctor’s consultation charges, and ICU charges, among others. Arogya policy also covers medical expenses related to COVID-19.
Arogya Sanjeevani Plans at a Glance
Health Insurance Company
Max Bupa Health Insurance
Care Health Insurance
Inclusions and Exclusions in Arogya Sanjeevani Insurance
Pre and Post-Hospitalization Expenses:
Arogya Sanjeevani policy includes pre and post-hospitalization expenses. Most often, pre and post-hospitalization expenses can add up to a significant chunk of the hospitalization bills. Buying the Arogya Health plan covers these expenses that are often not considered important. It can be beneficial nevertheless.
Many health insurance policyholders wonder if their existing health plan covers COVID-19 or not. Those who do not have any health insurance wonder how to cover expenses related to the treatment of COVID-19. Arogya Sanjeevani health plan offers coverage for COVID-19 and is a good option for those who do not have any form of general health insurance.
Arogya Sanjeevani health insurance offers Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH). With rising number of people choosing alternative treatments over allopathic treatments, Arogya Sanjeevani plan is good options for those who prefer want to look at traditional medicines.
ICU / ICCU Charges:
ICU and ICCU charges can burn a big hole in one’s pocket if these expenses are not prepared. With increasing overheads of hospitals and ICUs with high-tech medical equipment, there has been a significant rise in ICU charges. The more advanced the hospital, the more the charges. Arogya Sanjeevani policy covers ICU and ICCU charges too.
Did you know? Room rent can considerably add up to medical expenses during hospitalization? At times, room rent charges can be more than all the other expenses combined. The better the hospital, the higher is the room rent. Moreover, room rent charges in metros and larger cities are higher compared to towns and villages. Arogya Sanjeevani policy offers coverage for room rent too.
Ambulance costs can add up to medical bills significantly. Different types of ambulances have different charges. In addition, multiple visits to and from the hospital in an ambulance can cost a lot of money. Arogya Sanjeevani health plan offers ambulance services coverage, which makes it easy to meet these uncertain charges. Also, cardiac ambulances cost a lot more.
Many medical treatments may not require the policyholder to get admitted in the hospital and may require being in the hospital for only a few hours. Arogya Sanjeevani health insurance policies offer day-care procedure expenses.
Cataract surgeries can cost anywhere from Rs.40,000 and more. All health insurance plans do not offer coverage for cataract treatments. Arogya Sanjeevani health policy offers coverage for cataract surgeries. That makes it a good plan for aging and senior citizens, as they might require cataract treatments of greater intensity.
Diagnostic or Investigative Tests:
At times, people might go for investigative and diagnostic tests, which may not be necessary or prescribed by doctors. The cost of such tests is not covered by Arogya Sanjeevani health scheme.
Bed Rest or Rehabilitation Expenses:
Many diseases and treatments might require rest and rehabilitation. Arogya Sanjeevani Health Plan does not offer coverage for these expenses.
Gender change Treatment:
Gender change treatment expenses are not covered under Arogya Sanjeevani policy.
Cosmetic or Plastic Surgery:
Arogya Sanjeevani health plan does not offer coverage for cosmetic or plastic surgery. However, such surgeries may be a part of the main surgeries and might be considered for coverage based on the insurance company’s clauses.
Arogya Sanjeevani health plan does not offer coverage for maternity expenses.
Breach of Law:
If there is a breach of law and the policyholder is injured, the Arogya Sanjeevani policy does not offer coverage for hospitalization and treatment.
Treatments due to alcohol and drug consumption are not included in this health plan.
Key Features and Benefits of Arogya Sanjeevani Health Insurance Plan
Like most other health insurance plans, the Arogya Sanjeevani health insurance plan offers a cumulative bonus. It is generally a predefined percentage of the total sum insured.
One of the best benefits of the Arogya Sanjeevani insurance is that it offers lifetime renewability. This means; the policyholder can renew the policy for as long as they live and do not need to change their health policies after a certain age.
A key feature of the Arogya Sanjeevani scheme is its copayment feature. The policy has a mandatory co-payment feature. This means; the policyholder is liable to pay the co-payment percentage of the claim. The insurer pays the remaining amount. However, a low co-payment is one of the key attractions of this plan.
Easy claim process:
Arogya Sanjeevani health plan is fully executed digitally and follows a paperless approach. All its functions can be completed online, digitally. This makes it easy and fast.
Room rent capping:
Most health insurers that offer Arogya Sanjeevani Health Plans apply a room rent capping clause in the policy. This means; there is a limit to the amount of room rent that a policyholder can claim.
Available in two types:
The Arogya Sanjeevani insurance is available in two types – individual plan and a family floater plan that offers coverage to the entire family in one umbrella policy.
The premium for Arogya Sanjeevani health insurance can be paid yearly, quarterly, or monthly. There is a grace period of 15 days offered to policyholders.
Eligibility criteria for Arogya Sanjeevani Health Insurance
The Arogya Sanjeevani health policy is inclusive and can be bought for a wide range of age groups.
Anyone in the age group of 18 years to 65 years can buy this health policy. The plan is available for individuals as well as for families. Hence, policyholders can choose a personal policy or insure their whole family under one Arogya Sanjeevani plan.
Those who have children can purchase the Arogya Sanjeevani scheme for dependent children between the ages of three months to 25 years. The family floater plan offers coverage for children, parents, and parents-in-law.
How to cancel Arogya Sanjeevani Health Insurance Policy?
The Arogya Sanjeevani health plan has simple and easy cancelation rules. Every new policyholder is given a 15-day free-look period. If the policyholder decides to give up the policy within 15 days, they are refunded the premium amount minus any normal costs incurred by the insurance company.
A policyholder can cancel the plan at any point with a 15-day notice. The insurance company refunds the premium balance according to the rates specified. Here’s how the insurance company calculates the premium refund.
Time of cancelation
3 to 6 months
How to buy Arogya Sanjeevani Health Plan
The process of buying the Arogya Sanjeevani health insurance plan is easy and quick. The plan can be purchased online or electronically. All insurance companies sell this plan online. Selling it online reduces the service costs and is economical for the insurer as well as the buyer.
To buy the Arogya Sanjeevani policy, the policyholder should first compare the premium cost using the Arogya Sanjeevani policy premium calculator, which is available on all health insurance companies’ websites. Once the policyholder has chosen the plan, they must fill in the application form with current information. The insurance company then issues the policy to the applicant.
However, just like other health insurance plans, insurance companies must issue a physical copy of the policy document. The policy document has all the essential terms, conditions, and clauses that the policyholder must go through. New policy buyers have a free-look period of 15 days. If they do not wish to continue the policy, they can surrender the policy within 15 days.
What is not covered under the Arogya Sanjeevani Policy?
Claim made after exhausting deductible
Arogya Sanjeevani plans do not pay for claims made after the exhausted deductible. The policyholder must be aware of the amount that they claim and the fine print in the policy agreement.
Pre-existing diseases are not covered under Arogya Sanjeevani insurance plans. Arogya health plans have a waiting period for pre-existing diseases as offered by different health insurance companies.
Hospitalization without doctor’s recommendation
Arogya Sanjeevani scheme does not cover hospitalization without doctor’s recommendation. To avail coverage, the policyholder must have a doctor’s prescription for the treatment with a detailed diagnosis report.
Pre-natal & post-natal expenses
Arogya Sanjeevani health insurance plan does not cover pre-natal and post-natal expenses. Hence, the policyholder must ensure that they go through the policy documents and clauses carefully.
Who should buy the Arogya Sanjeevani Policy
Those who do not have a general health insurance plan
In today’s day and age, health insurance is a necessity. With the rise in diseases and medical costs, it is essential to be prepared for medical expenses. Many people avoid buying health insurance because they find it expensive or confusing. Arogya Sanjeevani health scheme is designed to address these issues.
The standardised health insurance plan is offered by numerous health insurance companies with the same features and benefits. The only thing that might differ is the service provided by the insurer. If you’re a young person who wants to buy a general health insurance plan at an affordable rate, Arogya Health Plan is the right option.
It offers a sum insured in the range of Rs.1 lakh to Rs.5 lakh at an affordable premium that can be paid on a yearly, half-yearly, quarterly or monthly basis.
Those looking for insurance protection against COVID-19
The Coronavirus pandemic is a serious health concern and fairly unpredictable. Hence, it is better to be financially prepared for the disease. The treatment cost of Coronavirus can range from a few thousands to a few lakhs depending on its severity. Such a huge medical expenditure can eat into people’s savings and drive them into debt. The Arogya Sanjeevani Health Insurance Plan offers comprehensive coverage against a wide range of ailments and health conditions; including COVID-19.
Those looking to complement corporate health plan with a basic plan
Those who have insurance coverage provided by their employers must always buy a separate personal or family floater health plan to complement the corporate plan. The corporate plan will cease to be on retirement or a change of job. Arogya Sanjeevani is an affordable plan that provides comprehensive coverage to complement the group health insurance plan coverage.