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Arogya Sanjeevani Policy – Is It the Perfect Health Plan for India?

By Juhi Walia
04 October 2022, 11:36 AM

Health is wealth. The global pandemic has made everyone realize the importance of being healthy and fit. With the pandemic and the rising rate of medical inflation, it has become crucial to be financially fit as well as to face unexpected health emergencies. Health insurance works like a financial cushion for you and your family during medical emergencies and it is an important necessity today. 

Arogya Sanjeevini health insurance is a standard health insurance plan set out by the Insurance Regulatory and Development Authority of India (IRDAI) from the year 2020. The aim is to provide wider health insurance coverage at an affordable rate of premium. Let’s know more about the Arogya Sanjeevani plan.

Arogya Sanjeevani Health Insurance Plan 

All the general and health insurance providers across the country offer the Arogya Sanjeevani health insurance plan as a standard health insurance policy to offer sufficient coverage at an affordable cost. The policy offers standardized coverage with many flexible features and yearly renewability. Arogya Sanjeevini health insurance is available in two plans:

  • Individual Health Insurance Plan: Individual plan provides coverage for one person only i.e., the policyholder. 
  • Family Floater Health Insurance Plan: The family floater plan provides an umbrella coverage that includes the health care needs of the entire family. Beneficiaries under this plan are multiple family members. 

To know whether the Arogya Sanjeevani health plan is suitable for your health insurance needs or not, you need to understand the pros and cons of the health insurance policy. Let’s now understand the key features and benefits of the Arogya Sanjeevani health insurance plan and the cons of the policy to help you make an informed decision. 

Key Features and the Benefits of the Arogya Sanjeevani Health Insurance Plan

The following are the key features and benefits of the Arogya Sanjeevani health insurance plan:

1. Eligibility

Indian citizens (including non-resident Indians) between the age of 18 years to 65 years can avail of coverage under the Arogya Sanjeevani policy. The policy also allows you to include children from the age of 3 months to 25 years under the family floater plan. If the child becomes financially independent after 18 years of age, he/she can avail of an individual plan.  

2. Wider Coverage

Arogya Sanjeevani policy offers you wider health insurance coverage to address your diverse healthcare needs. The scope of coverage under the policy includes in-patient expenses, 30 days of pre-hospitalization and 60 days of post-hospitalization cover, COVID-19 treatment cost, ambulance expenses up to INR 2,000 per hospitalization, AYUSH treatment cover, dental treatment due to an injury or illness, cataract treatment expenses (limits apply) and day-care procedures, etc. The coverage offered under the policy may range from INR 50,000 to INR 10 lakhs without any pre-medical check-ups. 

3. Flexible

Arogya Sanjeevani health insurance plan is extremely flexible both in terms of payment and coverage. The policy allows you to pay the premium in any of these frequencies – monthly, quarterly, half-yearly, or one-time, as per your convenience. When it comes to coverage, the policy allows you to cover your spouse, children, parents, and parents-in-law under the family floater plan. 

4. Simplicity

Arogya Sanjeevani policy offers uniform coverage with a standard feature which makes it a simple and easy-to-understand health insurance plan. This helps you claim the benefits without any doubts and hassles whenever you face medical emergencies. 

5. Affordable

One of the main plus points of the Arogya Sanjeevani policy is that the policy is quite affordable for a reasonable amount of coverage. You can meet your and your family’s health care needs and avail of quality treatments at a reasonable rate of premium.

6. No Claim Bonus

You get rewarded for maintaining good health in terms of no claim bonus benefits on each claim-free year. The accumulated no-claim bonus can go up to 50% of the premium. This can be claimed and utilized to discount the renewal premium. 

Read more - Important Things to Know About No Claim Bonus in Health Insurance

7. Cashless Benefit

Arogya Sanjeevani policy offers the cashless hospitalization benefit at all the cashless network hospitals listed in the empanelled hospital list of the insurance company. Cashless hospitalization saves you from out-of-pocket expenses and helps you avail of quality treatment at the right time. 

Cons of Arogya Sanjeevani Health Insurance Policy

Like any health insurance plan, the Arogya Sanjeevani plan also comes with some cons. Let’s take a look at the cons of the policy:

1. Limited and Uniform Coverage

Arogya Sanjeevani policy comes with coverage limitations in comparison to other standalone health insurance policies available in the market. The policy excludes domiciliary hospitalization expenses, maternity expenses, etc. The policy limits the coverage for cataract surgery and other modern treatments. The maximum cap on cataract treatment is up to INR 40,000 and 50% of the coverage amount for modern treatments. There is also a higher cap on the room rent and ICU charges. 

2. Low Coverage

The sum insured offered under the Arogya Sanjeevani policy is only up to INR 10 lakhs which is quite low in comparison to other standalone health insurance policies available. The amount of coverage may not be sufficient for the expensive treatments considering the medical inflation.

3. No Additional Rider

The policy offers standard coverage without any frills or additional coverages offered. Hence, the Arogya Sanjeevani policy cannot be customized based on your specific healthcare needs.

To sum up, Arogya Sanjeevani is a standard health insurance plan that is designed to provide coverage for a wide range of healthcare needs at the lowest possible premium so that everyone can access and afford quality treatment for basic health problems. You can compare and weigh the benefits and costs of the policy to understand how ideal the Arogya Sanjeevani policy is for your health care needs. 

Read more -


1. What is the maximum coverage available in Arogya Sanjeevani Policy?

As per the guidelines issued by the Insurance Regulatory and Development Authority of India (IRDAI), the maximum coverage available in Arogya Sanjeevani health insurance policy is INR 5 lakhs. Anyone between 18 years to 65 years can avail of the policy for up to a coverage of INR 5 lakhs.

2. Can I increase the sum insured in Arogya Sanjeevani Policy?

The maximum sum insured offered under Arogya Sanjeevani health insurance is INR 10 lakhs. You cannot increase the sum insured above the maximum limit of INR 10 lakhs as the limit is set by the insurance regulator.

3. Is there a waiting period in Arogya Sanjeevani Policy?

Yes. There is a waiting period applicable in the Arogya Sanjeevani health insurance policy. Arogya Sanjeevani policy coverage has an initial waiting period of 30 days except for accident cases. The specific illnesses covered under the plan come with a waiting period of 24 months. Coverage for pre-existing illnesses starts after the completion of a 48 months waiting period.

4. What is co-pay? Is the co-payment clause applicable in Arogya Sanjeevani Policy?

Co-pay in health insurance refers to a set amount of claim amounts or the percentage of the claim amount that the policyholder needs to bear and the rest of the amount would be paid by the health insurance company. There is a minimum limit of 5% of the claim amount that is applicable as co-pay under the Arogya Sanjeevani Policy as per the guidelines by the Insurance Regulatory and Development Authority of India (IRDAI).

5. Can I port my existing health insurance policy to Arogya Sanjeevani Policy?

Yes. You can port your existing health insurance policy (that is valid as of date) to Arogya Sanjeevani health insurance policy with simple processes. The process of porting to Arogya Sanjeevani is easy and quite quick.

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