Digit Arogya Sanjeevani Policy

The policy covers COVID-19 treatment and other illnesses cost effectively. Not only this, but new-age modern treatments also a part of the coverage benefits.  Arogya Sanjeevani plan is basic and affordable and helps the policyholders in availing the best healthcare services during the Coronavirus pandemic.

Eligibility Criteria

Key Features of the Digit Arogya Sanjeevani Policy

Digit Arogya Sanjeevani Policy offers a range of features and benefits:

• The sum insured options under the Digit Sanjeevani policy range from Rs 3 lakh to Rs 5 lakh
• The policy covers all the daycare procedures as well
• Pre and post hospitalization expenses are claimable for 30 days and 60 days respectively
• 5% cumulative bonus is provided for all the claim-free years
• Hernia, varicose veins, fissures, congenital anomalies, sinus, benign tumors, polyps, cysts, and some other specific disease treatment/ surgery are payable after completion of 24 months of the policy term
• The insured has an option to pay the premium in installments

Inclusions of Digit Arogya Sanjeevani Policy

Digit Arogya Sanjeevani policy includes the following medical expenses:

• Coverage is provided for pre and post-hospitalization expenses including doctor fees, diagnostics, doctor charges, operation costs, hospital stay, medicines, etc.
• COVID-19 treatment and hospitalization is also covered
• Alternative treatments like Ayush hospitalization cover for Unani, Ayurveda, Siddha, and Homeopathy are provided
• Room Rent Capping up to Rs 5000 or 2% of the sum insured
• ICU and ICCU expenses are covered and the limit is Rs 1000 per day or up to 5% of the coverage amount
• You can avail ambulance cover up to Rs 2000
• Plastic Surgery and Dental Treatment cover for an illness or injury
• New Age/Modern treatments like Stem Cell Therapy are covered and the limit is 50% of the sum insured

Arogya Sanjeevani Policy Premium Chart and Calculator

Arogya Sanjeevani Policy Premium chart for Rs 3 Lakh and Rs 5 Lakh Sum Insured is given in the table below-

                                (Source: Go Digit)

Exclusions of Digit Arogya Sanjeevani Policy

Digit Arogya Sanjeevani Policy does not cover the following claims:

• Obesity or weight control related treatment
• Gender treatments are not claimable
• The policy does not cover maternity-related expenses
• Any type of cosmetic and plastic surgeries are excluded
• Illness resulting from substance abuse shall not be claimed
• Sterility and fertility treatments are not covered
• Treatments without a doctor’s prescription
• OPD expense or domiciliary care charges are also not covered

How to file Health Insurance Claim for Digit Arogya Sanjeevani Policy?

You can file both cashless and reimbursement claims under the Digit Arogya Sanjeevani Policy:

Cashless Claims

• For cashless claims the treatment needs to be availed in a network hospital
• Fill the cashless claim form  that is available with the TPA and network hospitals
• It will be then sent to the Company/TPA for authorization then a pre-authorization letter will be issued to the hospital by TPA after verification
• You need to verify and sign the discharge papers at the time of getting discharged and the Insurer / TPA holds the right to deny pre-authorization if all the required medical details are not provided
• ln case of denial of cashless access, you can file a reimbursement claim

Reimbursement Claims

Inform the insurer regarding claim reimbursement within 24 hours of the emergency hospitalization

• You need to file reimbursement of pre-hospitalization, daycare, and hospitalization within 30 days of getting discharged from the hospital
• For post-hospitalization expenses file your reimbursement claim within 15 days of treatment

Documents Required

• Duly completed Arogya Sanjeevani claim form
• Patients’ Photo ID Proof
• Doctor’s medical prescription
• Payment receipts and original bills with break-up
• Discharge summary, patients’ medical history, medical investigation/diagnostic test reports
• Sticker/Invoice of the Implants, if required
• Surgery details on the OT notes

FAQs