From April 2020, the Insurance Regulatory and Development Authority of India (IRDAI) has enforced that all insurance companies should sell Aarogya Sanjeevani Policy.
It is a standard health insurance policy that covers up to INR 5 lakh in essential hospitalisation-related costs. The IRDAI also prohibits insurers from charging deductibles or giving riders and variants with the insurance.
Such a policy, in the opinion of several experts in financial planning, is an excellent entry-level policy. However, others think a family of four needs more coverage than the policy offers. So, there’s a need to scan and find its suitability for all.
Defining Arogya Sanjeevani Policy
Arogya Sanjeevani Health Insurance Policy offers comprehensive medical coverage at a reasonable cost. It provides medical expenditure coverage with a sum insured that ranges from INR 50,000 to 10,00,000. The coverage includes expenses for pre and post-hospitalisation, room rental, intensive care unit (ICU), and alternative medicine treatments.
You can purchase Arogya Sanjeevani Policy by paying the premium payable on a monthly, quarterly or annual basis.
Highlighting Features of Arogya Sanjeevani Policy
Sum Insured Options - You can select a sum insured option between INR 1 lakh and 10 lakh.
Minimum Copay - A copayment of as low as 5% for Arogya Sanjeevani health insurance plan is inexpensive.
Affordable Premium - The premium is more affordable than other health insurance plans as it is a standard health insurance policy offered by insurers across India.
Option for Lifelong Renewal - Arogya Sanjeevani offers a lifelong renewal option.
Buying Options - There are two ways to purchase this policy: a family floater or an individual health insurance plan.
Cumulative Bonus - If you haven't filed any claims in the preceding year, you'll receive a 5% cumulative bonus when your plan is renewed.
Eligibility Criteria
- Anyone between 18 and 65 years may purchase the policy.
- Dependent children from the age of three months to twenty five.
- The family floater option includes in-law parents as well.
- Option for perpetual renewability is available.
- Coverage for osteoarthritis and osteoporosis brought on by ageing.
- Pre-existing conditions are covered
- Treatments for joint replacement are available.
- The coverage has a 48-month waiting term, a 30-day requirement following the purchase of health insurance, and a 24-month waiting period for certain conditions.
The Premium for Arogya Sanjeevani Insurance
Various insurers charge different premium amounts. For an individual, it might cost around INR 3,000, while a family floater plan might cost around INR 15,000.
New Age Treatments Covered Under Arogya Sanjeevani Policy
Modern medical procedures that need a specialised team of physicians and researchers are what new-age therapies are all about. You can get coverage for up to 50% of the insured amount with Arogya Sanjeevani Policy. Some of the treatments covered under the policy are as below-
- IONM - intra operative neuro monitoring
- Balloon sinuplasty
- Stereotactic radio surgeries
- Immunotherapy
- Intra vitreal treatment
- Deep brain stimulation
- Green laser treatment
- Bronchial thermoplasty
- Stem cell therapy and research
- Uterine artery embolization
- Holmium laser treatment
- Oral chemotherapy
- High-intensity focused ultrasound
What Does Arogya Sanjeevani Cover?
- Corona Cover - All hospitalisation costs associated with illnesses or accidents, including those associated with Covid-19.
- AYUSH - Coveres alternative medical practices, including Ayurveda, Yoga, Naturopathy, Unani, Siddha, and homoeopathy.
- Hospital Room Rent - If you or a family member needs hospitalisation, you can choose the type of room as long as the rental cost is less than INR 5,000 per day.
- Intensive Care Unit Costs - This plan covers ICU/ICCU-related costs up to INR 10,000 per day, or 5% of the total amount insured, for ICU/ICCU-related charges.
- Emergency Ambulance Services - Ambulance fees of up to INR 2,000 are included if you need emergency transportation services.
- Cataract Surgery - It covers cataract surgery costs of INR 40,000 or 25% of the insured amount.
- Plastic surgery or dental treatment - Covers only accidents that result in injuries that necessitate dental or plastic surgery.
- Pre and Post-Hospitalization - Covers 30 days before hospitalisation and 60 days following hospitalisation, costs associated with treatment.
Exclusions of the Policy
- Non-medical costs
- Medical claims-unrelated to hospital bills, as well as pre-and post-hospitalisation bills
- AIDS, venereal diseases, and STDs
- Expenses related to sterility, fertility, and maternity
- Hospitalisation for drug, alcohol, or substance abuse
- Costs for the outpatient department
- Domiciliary hospitalisation
- Cosmetic and plastic surgery performed on purpose
- Complications associated with obesity and weight
- Disease brought on by poor lifestyle
- Warlike circumstances
- Nutritional supplements
- Expenses related to pregnancy, delivery, and maternity
Conclusion
Arogya Sanjeevani Health Insurance Policy is designed to offer higher benefits at the most affordable price. The plan is best for those with modest medical needs and first-time purchasers unfamiliar with health insurance's intricacies. But Arogya Sanjeevani is not the right plan for you if you want a health insurance plan with a massive sum insured amount.
