Arogya Sanjeevani Policy

Arogya Sanjeevani policy is a basic health insurance policy introduced by the IRDAI on 1st April, 2020. Under this health insurance policy, insured person can avail policy coverage ranging from Rs 1 lakh to 5 lakh. An Arogya Sanjeevani policy comes as an Individual Health Plan & Family Floater Health Insurance Policy offered by all health insurance companies in India.

The IRDAI or the Insurance Regulatory and Development Authority of India had ordered all general and standalone health insurance companies to come up with a standard health insurance policy by 1^st April 2020. This policy is known as the ‘Arogya Sanjeevani Policy’, suffixed by the name of the insurance company. For example, the Arogya Sanjeevani policy by Religare Health Insurance is called the ‘Arogya Sanjeevani Policy, Religare Health Insurance’.

As the coverage and the terms & conditions of the Arogya Sanjeevani health policy are universal for all insurance providers, the buyer has the liberty to purchase this policy from any insurer. However, the premium rates and customer service can vary from one insurance provider to another.

Arogya Sanjeevani Policy Details at a Glance

Features of Arogya Sanjeevani Policy

There are several features that differentiate an Arogya Sanjeevani plan from other health insurance plans available in India. Take a look at some of the most attractive features of Arogya Sanjeevani policy below:

• More economical than other health plans
• Universal coverage, terms & conditions across all health insurers
• Sum insured ranging from Rs. 1 lakh to Rs. 5 lakh
• Available in individual as well as family floater basis
• Covers hospitalization expenses related to COVID-19
• Online issuance of the policy

Arogya Sanjeevani Health Insurance Plans

Benefits of Arogya Sanjeevani Health Insurance Policy

The Arogya Sanjeevani policy has been launched with an aim to simplify health insurance in India by offering a basic policy with the exact same coverage by all insurance companies. It strives to provide basic indemnity insurance benefits to people across all income groups in India. To understand this policy better, take a look through the list of benefits that a policyholder can access under this policy:

• No More Confusion - This policy eliminates the scope of any confusion that may arise in the minds of a health insurance buyer as the same level of coverage and the terms & conditions is offered by all insurance companies.
• Lower Co-payment option - This policy offers a lower co-payment option of only 5% of the claim amount, which means the applicant will have to pay the only 5% of the total claim amount at the time of settlement.
• Cumulative Bonus - Just like many health insurance policies, the Arogya Sanjeevani health insurance policy also rewards a cumulative bonus of 5% on the total sum insured amount for every claim-free year
• Boon for First-Time Buyers - This policy is the perfect stepping stone for a first-time health insurance buyer as he will be able to get a wide range of coverage at minimum cost without the hassles of understanding the pros and cons of different kinds of health plans.
• Lifetime Renewability - It comes with lifetime renewability that allows policyholders to renew their policies for as long as they live.

Eligibility Criteria for Arogya Sanjeevani Policy

The following table mentions the age of eligibility for buying Arogya Sanjeevani health insurance policy:

The policyholder can include dependents, such as their legally-married spouse, parents, dependent children (including legally adopted children) and parents-in-law, in the Arogya Sanjeevani health policy.

Inclusions of Arogya Sanjeevani Policy

An Arogya Sanjeevani health insurance policy comes with the following inclusions:

• Pre & Post Hospitalization Expenses - This mediclaim policy will cover all the pre-hospitalization and post-hospitalization expenses following an emergency illness or accidental injury
• COVID-19 expenses - It covers any expenses incurred on hospitalization due to contracting COVID-19 or coronavirus disease
• AYUSH Benefit - It includes hospitalization expenses incurred on obtaining alternative treatments, such as Ayurveda, homeopathy, Siddha, etc, at an approved hospital
• ICU/ ICCU Charges - The Arogya Sanjeevani policy pays the charges of treatment taken in the ICU (Intensive Care Unit) or ICCU (Intensive Coronary Care Unit)
• Room Rent - It covers the room rent of the hospital to up to a maximum of Rs. 5,000 per day
• Ambulance Services - It covers the cost of ambulance services up to a maximum of Rs. 2000 per hospitalization
• Daycare Treatment - It covers the expenses arising out of any daycare treatment procedures
• Plastic Surgery and Dental Treatment - The cost of any dental or plastic surgery treatment taken as a result of an illness or injury is also covered
• Cataract Surgery - It also covers the cost of cataract surgery for each eye up to a maximum of Rs. 40,000 or 25% of the sum insured amount, whichever is less
• New Age/ Modern Treatment - This policy also covers the cost of modern/ new age treatment up to a maximum of 50% of the sum insured amount.

New-Age/ Modern Treatments Covered Under Arogya Sanjeevani Health Insurance Policy

The Arogya Sanjeevani health policy covers the following modern or new-age treatments:

• Balloon Sinuplasty
• Bronchial Thermoplasty
• Deep Brain Stimulation
• Immunotherapy - Monoclonal Antibody Injections
• Intraoperative Neuromonitoring (IONM)
• Intravitreal Injections
• Oral Chemotherapy
• Robotic Surgeries
• Stem Cell Therapy (Bone marrow transplant through Hematopoietic stem cells for hematological conditions)
• Stereotactic Radio Surgeries
• Uterine Artery Embolization and High Intensity Focussed Ultrasound (HIFU)
• Vaporisation of the Prostate (Green Laser/ Holmium Laser treatment)

Exclusions of Arogya Sanjeevani Policy

The Arogya Sanjeevani health insurance policy does not include the following treatments or situations:

• Diagnostic or Investigative Tests - It will not cover the expenses incurred on getting any diagnostic or investigative tests done
• Bed Rest or Rehabilitation Expenses - This policy will not cover any expenses incurred due to enforced bed rest in the absence of treatment. It will also not cover any expenses arising out of rehabilitation needs
• Weight Control/ Obesity Treatment - Any expenses arising out of the treatment taken for obesity or weight management will not be covered
• Gender-change Treatment - It will not cover the cost of taking any treatment for changing the gender
• Cosmetic or Plastic Surgery - Any expenses incurred on cosmetic or plastic surgery which is not required as a result of an accident, cancer, burn injury or medically necessary treatment will not be covered
• Maternity Expenses - The Arogya Sanjeevani health insurance policy will not cover the cost of any treatment related to pregnancy and childbirth
• OPD Treatment - It will not cover the cost of any OPD or out-patient treatment taken by the policyholder
• Adventure/ Hazardous Sports - This policy does not cover any medical treatment expenses arising due to participation in a hazardous or adventure sports, such as rock climbing, sky diving, para-jumping, deep-sea diving, mountaineering, etc, as a professional
• Breach of Law - It will not cover any expenses incurred due to breaching the law with a criminal intention
• Alcohol/ Drug addiction- Any expenses arising out of the treatment for addiction of alcohol or drug or substance abuse will not be covered
• Dietary Supplements - It will not cover the cost of purchasing any dietary substance or supplements, such as minerals, vitamins, etc., without a prescription.
• Unproven Treatment - This policy will not cover the cost of any unproven treatment taken by the policyholder
• Infertility and Sterility - It will not cover any expenses arising out of infertility or sterility
• Domiciliary hospitalization - Any expenses arising out of domiciliary hospitalization will not be covered
• Nuclear attack or War - This policy will not cover any claims arising out of a nuclear attack or a war/ war-like situation
• Treatment outside India - It will not cover the expenses incurred on receiving any outside India

The Arogya Sanjeevani health policy comes with the following waiting periods:

• Initial Waiting Period - An initial waiting period of 30 days from the date of policy commencement for all claims except accidental claims
• Pre-Existing Disease - A waiting period of 4 years for coverage of pre-existing disease or medical condition
• Specific Illness/ Treatment - A waiting period of 2/ 4 years for coverage of specific treatments such as tonsillectomy, benign prostate hypertrophy, hernia, cataract, internal congenital anomalies, age-related osteoporosis/ osteoarthritis, joint replacement treatment, etc.

Who Should Buy Arogya Sanjeevani Policy?

The Arogya Sanjeevani health insurance policy can be purchased by individuals as well as by families. It is available as an individual policy as well as on family floater basis health insurance policy.

However, Arogya Sanjeevani plan is best suited to first-time health insurance buyers. This is because new buyers are usually about what coverage they need and what should they look for while buying health insurance. It may lead to a lot of confusion, given the ocean full of health insurance policies available in the market.

The Arogya Sanjeevani health policy will serve as a boon for first-time buyers as they will get all the required coverage under their health insurance policy, right from basic hospitalization expenses to coverage for new-age treatments.

How to buy Arogya Sanjeevani Policy?

An Arogya Sanjeevani health insurance policy can be purchased online. The IRDAI has permitted insurance companies to issue the Arogya Sanjeevani policy online or electronically to the policyholders. This further reduces the operating/ serving cost of the insurance company making it more economical for the buyers.

In order to buy Arogya Sanjeevani policy, the policyholder will need to compare the premium quotes using the Arogya Sanjeevani policy premium calculator. After comparing premium and choosing an Arogya Sanjeevani plan, the policyholder will have to fill up the proposal form and pay the premium online. The Arogya Sanjeevani health insurance policy will be issued online.

However, it is mandatory for insurance providers to issue the policy document in physical form even if it has been purchased online. Moreover, the IRDAI has also directed all health insurance companies to offer a certificate of insurance to the policyholders specifying the Arogya Sanjeevani policy details including the terms and conditions.

Arogya Sanjeevani Policy Cancellation and Refunds

All policyholders of the Arogya Sanjeevani health policy offer a 15-day free-look period. This means the policyholder can cancel his policy within the first 15 days without paying any cancellation charges. The paid premium will be refunded to the policyholder minus any expenses incurred by the insurance company, provided no claims were made during this period.

Please note that the free-look period is not applicable at the time policy renewals.

However, if the 15-day free-look period gets over, the policyholder can still cancel his Arogya Sanjeevani health insurance policy. He will be required to give a 15-days written notice to the insurance provider for cancelling the policy. The premium for the remaining policy period will be refunded to the policyholder as  per the rates given below:

Arogya Sanjeevani Policy Renewal

The Arogya Sanjeevani policy comes with lifetime renewals. This means that a policyholder can renew his Arogya Sanjeevani health policy for as long as he is alive. However, he should make sure to renew his policy before its date of expiry. If the policy is not cancelled even after the grace period of 30 days, it will be get terminated.

The Arogya Sanjeevani health insurance policy can be renewed online by entering the required details and paying the Arogya Sanjeevani policy premium.

Insurance Companies Offering Arogya Sanjeevani Policy

Although all insurance companies offering health insurance products are supposed to introduce the Arogya Sanjeevani policy IRDA by 1 April 2020, few insurance companies are yet to launch it.

Nonetheless, following is the list of health insurance providers in India who are currently offering  the Arogya Sanjeevani health insurance policy:

• Bajaj Allianz General Insurance
• Digit General Insurance
• Edelweiss General Insurance
• Future Generali India Insurance
• HDFC ERGO General Insurance
• HDFC ERGO Health Insurance
• Kotak General Insurance
• Magma HDI General Insurance
• ManipalCigna Health Insurance
• Max Bupa Health Insurance
• Navi General Insurance
• Religare Health Insurance
• Royal Sundaram General Insurance
• Tata AIG General Insurance
• United India Insurance
• Universal Sompo General Insurance

Arogya Sanjeevani Health Insurance Policy - FAQs