Care Arogya Sanjeevani Policy (Formerlly known as Religare Arogya Sanjeevani Policy)

Arogya Sanjeevani policy by Care Health is a standardised product that offers basic hospitalisation cover to the customers.  The policy was commenced from April 01, 2020 and is provided by all the insurers including Care Arogya Sanjeevani Policy (Formerlly known as Religare Arogya Sanjeevani Policy) provider. The policy is ideal for those who cannot afford a higher premium and the coverage amount is between Rs 1 lakh and Rs 5 lakh. Check out what the Care Health Arogya Sanjeevani Policy has to offer:

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Care Arogya Sanjeevani Policy (Formerlly known as Religare Arogya Sanjeevani Policy)

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    Features of Care Health Arogya Sanjeevani Policy

    Some of the prominent features of this policy are given below:

    • People above the age of 65 years can buy the policy for their family members if not self
    • The coverage amount ranges from Rs 1 lakh to Rs 5 lakh
    • Arogya Sanjeevani plan offers coverage on both individual and on family floater basis
    • If you are between the age group of 18 and 65 years, then you can buy this plan
    • And your children between the age group of 3 months and 25 years are also eligible to be covered under the same plan
    • Care Health provides a grace period of 30 days to renew the Arogya Sanjeevani policy, which needs to be renewed on an annual basis
    • A co-payment of 5% applies to all the claims, which means that the policyholder needs to pay an amount equal to 5% of the medical expenses
    • Arogya Sanjeevani Policy does not provide an add-on or optional covers
    • However, Care Health Arogya Sanjeevani plan offers a special cover for dental expenses and plastic surgery due to an illness or injury

    Eligibility Criteria for Care Health Arogya Sanjeevani Policy

    Sum Insured

    Rs 1 Lakh – Rs 5 Lakh

    Entry Age Minimum

    Individual- 5 years

    Floater- 1 member to be 18 years and 3 months for a child

    Entry Age Maximum

    Children: 24 years

    Adult: 65 years

    Policy Term

    1 Year

    Coverage

    Individual/Family Floater

    Members Covered

    Self, spouse, parents, children, parents-in-law

    Renewability

    Lifelong

     No Claim Bonus

    5-50%

    Inclusions of Care Health Arogya Sanjeevani Policy

    Care Health Arogya Sanjeevani offers compensation for the following medical expenses:

    • The policy offers in-patient hospitalization cover including Ayush treatment up to the sum insured limit
    • Pre and post hospitalization expenses are covered for 30 days and 60 days respectively
    • The policy also covers expenses incurred on cataract treatment up to the specified limit
    • Ambulance expenses are also covered up to a limit of Rs 2000
    • Care Health Arogya Sanjeevani plan covers all day-care treatments
    • Cumulative bonus of 5% is offered for every claim-free year

    Exclusions of Care Health Arogya Sanjeevani Policy

     Care Health Arogya Sanjeevani health scheme does not cover the following medical expenses:

    • Pre-existing diseases are not covered until the completion of the waiting period
    • Any disease or illness that is contracted in the initial 30 days of the policy purchase date, only accidental cases are covered
    • HIV/AIDS treatment is not considered
    • Treatment and illnesses due to the overdose of alcohol and drugs are not covered
    • Self-inflicted injuries, suicidal attempts and symptoms of depression and mental disorders are not eligible for insurance claim
    • Any type of congenital and inherited diseases are not paid by the insurer

    Care Health Arogya Sanjeevani Policy Renewal

    To ensure continuous comprehensive health insurance coverage for yourself and your family, make sure to renew your Arogya Sanjeevani policy on time. Policy renewal can be done online through Policy Bazaar’s website. Renewal premium payment can also be paid online using net banking, credit card, or debit card.  And the three simple renewal steps are given below:

    • Click on the click on renew tab available on the top right- hand corner of the page
    • Enter your policy number and date of birth to initiate the renewal process
    • Before renewal, it is suggested that you compare different plans and go through Care Health Insurance (Formerly known as Care Health Health Insurance) reviews online and then make an informed decision
    • Once you select the plan and pay the premium, you receive your policy wording on email and via courier

    Policy Terms

    • Pre-existing diseases are covered after a waiting period of 48 months
    • 30-days initial waiting period shall apply for all illnesses except for injuries
    • Some of the diseases can only be covered after a waiting period of 24 months
    • 5% co-payment clause is applicable on all the claims

    Care Health Arogya Sanjeevani Health Insurance Claim Process

    The claim procedure is usually the same as most of the health insurance companies, but sometimes it may vary. Aforementioned is the claim process for Care Health Arogya Sanjeevani Mediclaim policy –

    Immediately intimate your insurer by sending a claim request. You need to inform within 24 hours in case of emergency hospitalization and for planned hospitalization, you need to intimate within 48 hours.

    Cashless Treatment in Network Hospitals

    For cashless request for pre-authorization, follow the below mentioned process:

    • Email or fax the pre-authorization form, which you can find at the TPA or insurance desk of the
    • You can download it from the insurer’s site as well.
    • The claim management team will send you the letter of approval if the claim request is
    • approved
    • If there is any query regarding your claim, then the insurance company will contact the hospital
    • for the same
    • If it’s not approved, you will need to request for reimbursement claim

    Reimbursement claim Process in Non-network Hospitals:

    • Submit the claim form along with other required documents as mentioned at the time of policy purchase
    • You need to address the queries raised by the claim management team of the insurance company
    • Either you will receive a letter of approval or rejection after submitting the form

    Documents Required for Claim

    For claim reimbursement following documents needs to be submitted:

    • Duly filled and signed claim form
    • Patient’s photo id proof
    • Doctor’s prescription advising hospitalization
    • Bills/ receipts/discharge summary
    • Diagnostic reports
    • OT Reports
    • MLR/FIR as per the case
    • KYC for claims above Rs 1 Lakh
    • Any other document as required after case assessment

    Care Health Arogya Sanjeevani Policy FAQs

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