All You Need To Know On Arogya Sanjeevani Policy

ByAmrina Alshaikh

Introduction 

Arogya sanjeevani policy is a health insurance policy launched by the IRDAI to simplify health insurance. It is a basic, standard plan offered by all health insurance companies, with similar health insurance benefits.

The only thing that differentiates one insurance company from another is the service offered by the healthcare provider during the buying and claim process. Cashless hospitals in the insurance company’s network and policy premium also mark differences between different companies.

Arogya sanjeevani policy

Arogya sanjeevani policy is a health insurance plan designed by the IRDAI. The standard insurance coverage addresses the basic healthcare needs of the Indian populace. IRDAI has also announced Corona rakshak and Corona kavach health insurance policy that cover costs of coronavirus treatment and hospitalisation.

The insurance under Arogya sanjeevani policy is available from all general insurance providers in India, starting from April 1, 2020. The standard policy offers basic health insurance coverage from Rs. 1 Lakh to Rs. 5 Lakh. The policy covers treatment costs of COVID-19 apart from covering the medical expenditures due to hospitalisation. Policies like Corona kavach health insurance policy are COVID-19-specific.

How is Arogya sanjeevani policy different from other health insurance policies

IRDAI is urging insurance companies to create affordable and easy-to-understand products. Health insurance can be confusing because of the formal language in policy documents, among other factors. To avoid that, IRDAI has issued certain guidelines for health insurance companies to form a standard health insurance product, which is the Arogya sanjeevani policy.

Eligibility and other details

  • Minimum entry age: 18 years for adults and 91 days for children
  • Maximum entry age: 65 Years for adults and 25 years for dependent children
  • Cover type: Individual and family floater
  • Policy term: 1 year
  • Sum insured: Multiple sum insured options up to Rs. 5 Lakh in multiples of Rs.50,000.
  • Relationships covered:
  • For individual policy: A single policyholder can benefit from Arogya sanjeevani policy.
  • For family floater: self, spouse, dependent son and daughter, parents and parents in law. A maximum of 2 adults and 3 children can be covered under a single policy.
  • Premium: monthly/quarterly/half-yearly/yearly premiums
  • Renewal: Lifetime 

Thus, Arogya sanjeevani is an all-in-one health plan that looks after your financial needs in the times of a medical emergency.

Arogya sanjeevani policy—Features

  • All daycare treatments covered: Daycare treatments are treatments done under general anaesthesia in a hospital or a daycare centre. Daycare treatments take less than 24 hours. Under this plan, all the daycare treatments are covered.
  • Cashless claim settlement in the network hospitals of the insurance provider: You can settle your claims on a cashless basis in the network hospitals of your insurance provider.
  • Same premium across the country: For Arogya sanjeevani policy, there is the same premium across the country, and there is no zone-based premium.
  • In-patient hospitalisation: The in-patient hospitalisation feature takes care of the ICU and nursing room charges, operation theatre charges, doctor and surgeon fees, and other medical expenditures.

Arogya sanjeevani policy—health insurance benefits

Below are some benefits of the Arogya sanjeevani policy:

  1. Pre-hospitalisation covers medical expenditures of upto 30 days before the date of hospitalisation.
  2. Post-hospitalisation covers medical expenditures of upto 60 days after discharge from the hospital.
  3. AYUSH cover takes care of in-patient medical expenses towards non-allopathic treatments like Ayurveda, Yoga & Naturopathy, Unani, Siddha & Homeopathy up to the Sum Insured limit.
  4. Daycare treatment covers medical expenses made towards treatment or surgery requiring less than 24 hours of hospitalisation.
  5. Road ambulance cover reimburses expenditures upto Rs. 2000 per hospitalisation event for ambulance services for treatment.
  6. Cataract treatment pays for medical expenses upto 25% of Sum Insured or Rs. 40,000, whichever is lower per eye in case of a treatment or surgery for Cataract.
  7. Modern treatment covers medical expenditures for any technologically advanced treatment or surgery that is listed in the policy.
  8.  For each claim-free policy year, you get a cumulative bonus of 5%. The policy must be renewed without break. The bonus is a maximum of 50% of the sum insured. If a claim is made in any specific year, the cumulative bonus accrued is reduced at the same rate at which it was accrued.