You must be thinking about how a basic health insurance policy like Arogya Sanjeevani can fulfil all your health goals. But only let this thought sink in when you read this page further. Acko Arogya Sanjeevani Policy is an indemnity insurance plan that provides an allowance for your healthcare needs at an affordable charge. The Arogya Sanjeevani policy by Acko is suitable for an individual buyer and a family. The sum insured by this plan goes from INR 50,000 to 10 Lakhs (in multiples of INR 50,000) which is sufficient to cover the primary members of your family like your spouse, children, parents, and parents-in-law.
This insurance plan serves standardly in times of emergency, the incurred medical expenses due to hospitalisation including pre & post-hospitalisation, ICU charges, and room rent with the sub-limit of 2% of the SI subject to INR 5,000 on a per-day basis. Acko Arogya Sanjeevani policy provides support for COVID-19 treatment or any medical expenses related to AYUSH treatment or alternative therapies, specified daycare procedures, and so on.
This plan is curated to ensure the all-around health interest of the policyholders across every section of society. Additionally, the Acko Arogya Sanjeevani policy is a good choice for those who are beginners in buying health policy as it comes with a co-payment clause of 5% on every claim raised during a policy tenure.
Read further to know more about Acko Arogya Sanjeevani policy, its eligibility criteria, specific benefits, and the process for getting a claim settlement.
Eligibility Criteria for Acko Arogya Sanjeevani Policy
Know here the eligibility criteria, sum insured, waiting period and other important features of the Arogya Sanjeevani Policy by Acko:-
Entry Age
3 Months - 25 Years
Adult Entry Age
18 - 65 Years
Plan Type
Individual/ Family floater (Indemnity plan)
Policy Tenure
1 year
Sum Insured
50,000 - 10 Lakhs (Maximum)
Initial Waiting Period*
30 Days
*The Initial Waiting Period is the period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
To know more about the plan, read the policy details provided below:
Benefits of Acko Arogya Sanjeevani Policy
Below are some of the notable benefits of the Arogya Sanjeevani Policy of Acko:
Family coverage
Arogya Sanjeevani plan ensures the safety of your family members first (with a floater plan). It provides medical support to the policyholder, legally married spouse, children, parents, and parents-in-law - all under a single plan.
COVID-19 treatment cover
You need no other plans especially for COVID-19 coverage, as the Acko Arogya Sanjeevani policy is sufficient to provide you with the hospital cost for coronavirus treatment.
Lifelong renewability
Acko Arogya Sanjeevani's policy ensures you're protected until you live. Hence, this plan's lifelong renewability is a feature you can utilise to get lifelong healthcare support.
Daycare procedure covers
The plan offers specified daycare procedures that require hospitalisation for less than or equal to 24 hours. The procedures for daycare cover are mentioned during the policy commencement.
Modern treatment coverage
The plan covers a new-age treatment like robotic surgeries and oral chemotherapy along with others.
Grace period
If you pay your premiums once for one policy year (annually), you get facilitated with a grace period of 30 days. However, by choosing any other mode of payment, the policy gives you a grace period of 15 days.
Tax benefits
All the premiums paid towards the Acko Arogya Sanjeevani Policy are eligible for tax benefits under Section 80D of the Income Tax Act, 1961.
Specifications of Acko Arogya Sanjeevani Policy
Here are the specifications of Acko Arogya Sanjeevani Policy:
In-patient & Out-patient coverage
Room Rent
Covered
ICU Charges
Covered
Pre-Hospitalization
Covered
Post-Hospitalization
Covered
Domiciliary Hospitalization
Not covered
Daycare Treatment
Covered
OPD Charges
Not Covered
Coverage Terms
COVID-19 Treatment
Covered
Cataract
Covered
No Claim Bonus
Applicable
Automatic Restoration
Not Applicable
Daily Hospital Cash
Not Covered
Organ Donor
Not Covered
Maternity Cover
Not Covered
New Born Baby Cover
Not Covered
Alternative Treatments
AYUSH Treatment
Covered
IVF Treatment
Not Applicable
Modern Treatment
Covered
Emergency Coverage
Ambulance
Covered
Air Ambulance
Not Covered
Compassionate Travel
Not Applicable
Global Coverage
Not Applicable
Wellness Programmes
E-Consultation
Not Applicable
Health Check-Up
Not Applicable
Second Medical Opinion
Not Applicable
Vaccination
Not Applicable
Limitations
Co-payment
Applicable
Sub-limits
Applicable
What is Room Rent?
The room rent limit is the maximum amount of bed charge that you can claim if you are hospitalized.
Common room categories covered under room rent are:
Private Single AC Room
Twin Sharing
General Ward
Coverage status under Acko Arogya Sanjeevani Policy
Room rent, boarding, and nursing expenses all inclusive as provided by the hospital/ nursing home, doctors' fees up to 2% of the sum insured subject to a maximum of Rs.5,000/- per day.
What are ICU Charges?
The Intensive Care Unit (ICU) is a hospital special department where patients with severe medical conditions are treated.
Coverage status under Acko Arogya Sanjeevani Policy
Intensive Care Unit (ICU) charges/ Intensive Cardiac Care Unit (ICCU) charges all inclusive as provided by the hospital/nursing home up to 5% of the sum insured subject to a maximum of INR 10,000 per day.
What is Pre Hospitalization?
Medical expenses incurred before the hospitalization of the policyholder.
Coverage status under Acko Arogya Sanjeevani Policy
Covered from 30 days before hospitalisation.
What is Post Hospitalization?
Medical expenses incurred after the discharge of the policyholder from the hospital.
Coverage status under Acko Arogya Sanjeevani Policy
Covered up to 60 days after hospitalisation
What is Domiciliary Hospitalization?
Home hospitalization arrangement for the insured person due to unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get financial coverage.
Coverage status under Acko Arogya Sanjeevani Policy
Not covered.
What is Daycare Treatment?
Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.
Coverage status under Acko Arogya Sanjeevani Policy
Covered.
What are OPD charges?
Covers the cost of doctor consultation and prescribed medical tests that may not require hospitalization.
Coverage status under Acko Arogya Sanjeevani Policy
Not covered.
What is COVID-19 Treatment?
COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. an approved center.
Coverage status under Acko Arogya Sanjeevani Policy
Covered.
What is Cataract Treatment?
A common eye condition in which your vision gets blurred.
Coverage status under Acko Arogya Sanjeevani Policy
The company shall indemnify medical expenses incurred for treatment of Cataract, subject to a limit of 25% of the Sum Insured or INR.40,000, whichever is lower, per each eye in one policy year.
What is a No-Claim Bonus?
For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as a no-claim bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain percentage that varies from plan to plan.
Coverage status under Acko Arogya Sanjeevani Policy
A cumulative bonus of 5% for each claim-free year (up to 50% of the SI) is applicable. In the event of a claim, the cumulative bonus shall be reduced at the same rate.
What is Automatic Restoration?
Automatic restoration is a benefit in which an insurance company restores the sum insured amount completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from plan to plan.
Coverage status under Acko Arogya Sanjeevani Policy
Not applicable.
What is Daily Hospital Cash?
It is a cash amount that you receive each day during the time of hospitalization.
Coverage status under Acko Arogya Sanjeevani Policy
Not covered.
What is an Organ Donor Cover?
It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body.
Coverage status under Acko Arogya Sanjeevani Policy
Not applicable.
What is a Maternity Cover?
It refers to the cover that includes expenses for normal and c-section procedures deliveries.
Coverage status under Acko Arogya Sanjeevani Policy
Not available.
What is a New Born Baby Cover?
It takes care of the medical expenses that arise due to the hospitalization of the newborn baby in case of unforeseen circumstances. Some of the common treatments that are covered under the newborn cover are listed below and these common treatments can vary from plan to plan:
Congenital anomaly (conditions since birth)
Acute condition
Chronic condition
Premature delivery
Birth asphyxia
Day care treatment
Coverage status under Acko Arogya Sanjeevani Policy
New Born Baby cover or related expenses are not available
What is AYUSH Treatment?
Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.
Coverage status under Acko Arogya Sanjeevani Policy
Covered up to the specified limit of the sum insured.
What is IVF Treatment?
In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:
Full infertility
No fertility
Infertility diagnosis
Infertility diagnosis and limited fertility treatment
Medication (which may or may not include fertility drug prescriptions)
Coverage status under Acko Arogya Sanjeevani Policy
Not covered.
What is a Modern Treatment?
Medical treatments that demand modern technology such as robotic surgeries, stem cell therapy, etc.
Coverage status under Acko Arogya Sanjeevani Policy
New-age treatments such as Robotic surgeries, Oral Chemotherapy, etc., are covered under this plan.
What is an Ambulance Cover?
An ambulance is used to move the patient from home to hospital, transfer to another hospital, and take them for different tests outside the hospitals.
Coverage status under Acko Arogya Sanjeevani Policy
Covered up to INR 2,000 against ambulance charges for every hospitalisation.
What is an Air Ambulance?
Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.
Coverage status under Acko Arogya Sanjeevani Policy
Not applicable
What is Compassionate Travel?
Refers to the traveling expenses of a family member of the insured person in case the policyholders get admitted to a hospital outside his/her residential city.
Coverage status under Acko Arogya Sanjeevani Policy
Not available
What is Global Coverage?
Any kind of medical/health emergency when you are outside of India.
Coverage status under Acko Arogya Sanjeevani Policy
Not covered
What is E-Consultation?
If a policy offers E-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.
Coverage status under Acko Arogya Sanjeevani Policy
Not applicable.
What is a Health Checkup?
A facility where the policyholder can avail free health check-ups after fulfilling the company's policies.
Coverage status under Acko Arogya Sanjeevani Policy
Not applicable
What is a Second Medical Opinion?
If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company's network of medical practitioners.
Coverage status under Acko Arogya Sanjeevani Policy
Not applicable.
What is Vaccination cover?
Coverage against the expenses incurred on vaccinations is provided by the insurance companies.
Coverage status under Acko Arogya Sanjeevani Policy
Not covered.
What is Co-payment?
In the co-payment clause, policyholders have to pay a portion of the hospitalization expense on their own and the insurer will pay the rest of the amount.
Coverage status under Acko Arogya Sanjeevani Policy
Applicable, 5% on all claims
What is the Sub limit?
Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder.
Coverage status under Acko Arogya Sanjeevani Policy
Available.
What is not covered (Exclusions) under the Acko Arogya Sanjeevani Plan
This policy schedule has some exclusions that are mentioned below:
Any kind of external congenital illnesses or voluntary treatments like cosmetic therapies/beautification/plastic surgery, etc
OPD and home care treatments
Unproven treatments, rest care, rehabilitation, etc
Sterility and infertility, birth control, gender change treatments, etc
Maternity expenses like childbirth, miscarriage, and lawful medical termination of pregnancy during the policy period
Hypertension, diabetes, cardiac arrests, organ transplants, donor expenses, etc
Breach of the law, alcoholism, drug, or substance abuse cases, etc
How to claim Acko Arogya Sanjeevani Policy?
To avail of the claim settlement or reimbursement services of Acko Arogya Sanjeevani policy, the policyholder needs to follow the process given below:
For cashless claim settlement
Inform your TPA about your hospitalisation before getting admitted
Get admission at any of the networking hospitals available under the company
Submit your E-card and UHID number to the hospital authority
Your TPA will send the application of hospitalisation request to the company for authorisation
Upon getting the details of the claim request, your insurer and hospital will settle all the medical bills without your interference
If you're admitted without any pre-authorisation, you can send all the related documents to your insurer and the expenses would be reimbursed.
Got more questions? Contact the insurer at their toll-free number 1800 266 2256 or send them an email at hello@acko.com
If you still have anything to ask, reach out to PolicyX.com for further assistance.
For Reimbursement claim settlement
Intimate the insurer about your hospitalisation at health@acko.com
After treatment, pay the incurred medical bills on your own
Submit all the documents that are asked for (mentioned below) by the executives of Acko
After verification of all the details, the insurer will send you confirmation of reimbursement approval
Reimbursement will be initiated by the company as per the terms mentioned under the policy's schedule
Documents to be submitted while raising a claim
Original medical bills and payment receipts/invoice
Doctor's prescription or reports that suggest hospitalisation
Photo identity card
A copy of the Medico-Legal Report (MLR) (If required)
FIR copy in original (If required)
Hospital discharge summary
Investigation or diagnostics reports backed by the doctor
NEFT details and cancelled cheque/ or bank details
Other documents asked by the insurer
Explore Other Health Insurance Plans by ACKO Health Insurance Company
ACKO Health Insurance offers health insurance plans to help stay financially protected in medical emergencies. Let's have an overview of these plans.
Acko Group Health Insurance Plan
Plan providing coverage for medical expenses arising out of hospitalization for a group of employees/workers of a particular organization.
Unique Features
Maternity benefit Available
Coverage for disabled children
Injuries due to Terrorism
A Final Note
Acko Arogya Sanjeevani Policy is a health insurance plan that affordably provides basic healthcare coverage. Within the base policy, the policyholder is covered for medical expenses related to pre and post-hospitalisation, AYUSH treatment, daycare procedures, COVID-19 care, etc. There are no high premiums, no hassle in getting benefits against the policy, and even anyone who's a beginner to purchase health insurance policy can buy it easily.
Want to know more? Contact our customer care executives on 18003450330 or visit the official website of PolicyX.com.
Acko Arogya Sanjeevani Policy: FAQs
1. What is the total amount of sum insured for the Acko Arogya Sanjeevani Policy?
The maximum sum insured under this plan is up to INR 50,000 to a maximum of 10 Lakhs.
2. Is there any coverage for COVID-19 under this plan?
Yes, the Acko Arogya Sanjeevani Policy covers the treatment for COVID-19.
3. Can I buy the Acko Arogya Sanjeevani Policy for my family?
Yes, this plan is designed for all. Either you want an individual policy for you and your family separately. Or all the family members can be covered under the same family floater plan.
4. How many members can be covered under this policy?
It offers family floater plan benefits to your spouse, parents/ in-laws and children (3 months-25 years) can be covered under the same policy.
5. Is there any variant under Acko Arogya Sanjeevani's plan?
No, there is no variant of Arogya Sanjeevani's policy of Acko.
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Bengaluru
June 3, 2023
The company has some of the best health plans from low budget to high. The company provides support 24/7 and does not bother with spam calls.
Tarun
Ludhiana
February 21, 2023
I got payment with in 3 working days. I am glad how Vomitha ma am who s the executive, listen me carefully and release the payment directly to my account. Thanks Acko
Sachin abhyankar
Pune
September 16, 2022
Very affordable Acko plans. Provide coverage for every health issue and are ready to help anytime any day.
nandini
Dehradun
February 21, 2022
ACKO is no 1 insurance company. made process very easy for me when my nani fell sick and i was only with her but the insurance company arranged everything.
Sheersha Kundra
Bengaluru
October 28, 2021
The company has various affordable plans also they have an amazing customer care team that helps their customer in their time of need.
Mahaveer Singh
Delhi
September 6, 2021
Very good company, with best customer services. Health Insurance plans offered by the company are also very good.
Kavita Kumari
Guwahati
September 6, 2021
impressive work done by Acko Health Insurance, and its customer suppost. Keep serving us like this. well done
Simran has an experience of 3 years in insurance content writing. She transitioned from hospitality to the insurance industry after her emerging interest in how vast insurance is. With her ability to write complex insurance concepts in a simple, relatable manner she keeps her audience hooked and solves their doubts smoothly.
