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Explained: What is Arogya Sanjeevani Policy

By Vikas Chandra Das
21 July 2022, 11:46 AM

The Covid-19 pandemic has heightened the need for health insurance policies. The IRDA (Insurance Regulatory and Development Authority of India) has mandated all insurance providers to curate COVID-specific insurance policies in the interest of the people affected by the pandemic. Arogya Sanjeevani Policy is one such health insurance plan formulated to offer insurance coverage to people. Let us understand the policy details.

What is Arogya Sanjeevani Policy?

Arogya Sanjeevani Policy is a health insurance plan introduced on 01st April 2020 by the IRDA. The plan is available with all general insurance providers in India.  The Arogya Sanjeevani Policy offers health insurance coverage between INR 1 Lakh to INR 5 Lakhs. The biggest advantage of this health insurance plan is that it not only covers hospitalization expenses but also covers Covid-19 treatment costs.

The Arogya Sanjeevani Policy comes in two variants namely:

  • Individual Plan: Under this type, a single policyholder is covered
  • Family Floater Plan: Under this type, multiple family members can be covered

What is Covered Under the Arogya Sanjeevani Policy?

The Arogya Sanjeevani Plan is one of the best health insurance policies that offer all-in-one benefits to secure your financial needs. The following are some standard coverage offered under the plan.

  • Pre-hospitalization expense: 
    The policy offers to cover the pre-hospitalization expenses for 30 days i.e. all expenses incurred 30 days prior to the date of the hospitalization.
  • Post-hospitalization expense: 
    The policy extends benefits to cover post-hospitalization expenses for 60 days starting from the date of discharge from the hospital.
  • Hospitalization expense: 
    The policy covers the expenses incurred during the hospital stay. The hospitalization expense includes room rent, ICU charges, OT charges, Medicine and Drugs, Surgeons and nurses charges, etc will be covered under the Arogya Sanjeevani Policy.
  • Sub-limit: 
    Under the Arogya Sanjeevani Policy a sub-limit on Room Rent, Boarding and Nursing charges applies. The coverage has put a sub-limit on expenses up to 2% of the sum insured subject to a maximum of INR 5,000 per day. Additionally, a cap of 5% of the sum insured subject to a maximum of INR 10,000 per day has been put on the Intensive Care Unit (ICU) charges and Intensive Cardiac Care Unit charges.
  • Day-care treatment: 
    The policy provides up to 50% of the sum insured as coverage for day-care treatment. Insured can claim up to 50% of the sum insured for day-care treatments.
  • Cataract treatment: Insured can avail up to 25% of the sum insured or INR 40,000 (whichever is lower) per eye as coverage for cataract treatment.
  • AYUSH treatment: 
    All the treatment taken by In-patient care shall be covered under the plan. The policy shall cover the Ayush care treatment expense up to the sum insured.
  • Pre-existing medical disease: 
    All pre-existing medical diseases declared by the insured in the proposal form and accepted by the insurance provider shall be covered under the plan, however, after completing a waiting period of 4 years.

What are the Benefits of the Arogya Sanjeevani Policy?

Arogya Sanjeevani Policy is one unique health insurance plan that offers numerous benefits to the insured. The insured will receive the following benefits from the Arogya Sanjeevani Policy.

  • No Claim Bonus: 
    As the name suggests, in the event of no claim registered by the insured, the policy offers a 5% increase in the sum insured for every claim-free year subject to a maximum of 50% of the sum insured.
  • Free Lookup Period: 
    The plan offers a free lookup period wherein the insured can review the policy and decide whether to continue the coverage or get a refund from the health insurance provider.
  • Tax Benefit: 
    All premium payers can avail of income tax benefits under the Arogya Sanjeevani Policy. Tax Benefits can be availed under Section 80D of the Income Tax Act, 1961.
  • Ambulance Charges: 
    The Arogya Sanjeevani Policy covers Ambulance charges up to INR 2,000 per hospitalization.

What are Eligibility Conditions for Arogya Sanjeevani Policy?

To purchase the Arogya Sanjeevani policy prospective insured has to satisfy the following eligibility criteria.

Name of the PlanArogya Sanjeevani Policy
Nature of the PlanIndividual Plan, Family Floater Plan
Sum InsuredINR 1 Lakh to INR 5 Lakhs
Policy Period1 year
Sum Insured ApplicabilityUnder the Individual Plan, the entire Sum Insured shall apply to one single person.
Under Family Floater Health Insurance Plan, the entire Sum Insured shall apply to the entire family.
Age at EntryMinimum of 18 years
Maximum 65 years
The policy can be availed forSelf and Family (Spouse, Parents, Parents in-law, and dependent children (aged between 3 months to 25 years, however, if children aged above 18 years are financially independent then he/she is not eligible for coverage in subsequent renewals.

Who Should Opt for the Arogya Sanjeevani Policy?

Health insurance plans are the need of the hour so buying Arogya Sanjeevani Policy will be beneficial for customers from all walks of life. The health insurance premium is pocket-friendly. An individual plan starts from INR 3,000 approximately while a family floater plan starts from INR 15,000. It is best to get the exact premium chart from a preferred Insurance provider. 

Conclusion

The Arogya Sanjeevani Policy is the best-suited health insurance plan for individuals seeking health insurance cover up to INR 5 Lakhs. The benefits and features provided by the policy are unmatched and will help you meet financial needs during a medical emergency.

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