Arogya Sanjeevani Policy
  • Covers In- Patient Hospitalization Expenses
  • Protects against COVID-19 Hospital Bills
  • Cashless & Reimbursement Claim Settlement
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Arogya Sanjeevani Policy

To make health insurance accessible for all, Insurance Regulatory and Development Authority of India (IRDAI) has mandated a standard health insurance plan for all individuals and their families from 1st April 2020. The name of the mandated plan is Arogya Sanjeevani Policy.

Arogya Sanjeevani Policy is a basic health insurance plan that offers a broad spectrum of coverage to protect you and your family from financial contingencies caused due to hospital expenses. The plan is offered by all the public and private general health insurers across India.

Arogya Sanjeevani Policy is an affordable health insurance policy that covers the individual against the expenses incurred against Hospital Room Rent, ICU services, Nursing & Boarding charges, Pre & Post hospitalization, and even Modern Age treatments with a wide range of sum-insured options ranging between Rs. 1 lakhs to Rs. 10 lakhs. The plan also covers hospitalization expenses incurred due to Coronavirus (COVID-19).

To know more about Arogya Sanjeevani Policy Details, continue reading:

How is Arogya Sanjeevani Policy different from Health Insurance?

Nowadays, health Insurance companies ensure to provide health insurance to everyone. However, with high premiums, it is not possible for everyone to afford the same. Therefore, to help the general public, the Insurance Regulatory and Development Authority of India (IRDAI) launched the Arogya Sanjeevani Health Insurance Policy on April 1, 2020. Arogya Insurance is a standard and simplified health insurance policy that covers basic healthcare expenses in case of hospitalization.

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Key Features of Arogya Sanjeevani Policy

Take a look below to explore more about Arogya Sanjeevani Policy, and then make an informed decision.

  • Sum Insured
    The plan offers the sum insured ranging from Rs 1 Lakh to Rs. 5 Lakhs.
  • Lifetime Renewability
    The plan comes with an option of lifetime renewability.
  • Plan Option
    Available on an Individual as well as family floater basis
  • Individual Plan: Only 1 policyholder is the beneficiary.
  • Family Floater Plan: Entire family (spouse, children, parents, and parents-in-law) can be covered and avail the benefits of the Aarogya Sanjeevani policy.
  • In-patient Hospitalization Cover
    All the hospitalization expenses related to Medical treatments are covered under this plan.
  • Cumulative Bonus
    The plan offers a 5% Cumulative Bonus at the time of renewal, provided that the Insured has not made any claims in the last year.
  • Minimum Co-Pay
    The Arogya Sanjeevani Health Insurance policy comes with a minimum copay of 5% only.

Inclusions of Arogya Sanjeevani

Arogya Sanjeevani Health Insurance offers certain inclusions that make it one of the best health plans. Take a look at the below section to explore all the inclusions of the Arogya Sanjeevani Policy:

  1. COVID-19 Cover

    The plan covers treatment expenses incurred due on the positive diagnosis of Covid- 19.

  2. Hospital Room Rent Coverage

    If policyholder or his/her family member requires hospitalization, the plan covers Room Rent of the hospital up to a maximum limit of Rs. 5,000 per day.

  3. AYUSH Coverage

    The hospitalization expenses incurred on Ayurveda, Homoeopathy, Siddha, Unani related treatments are also covered under this plan.

  4. ICU/ICCU Charges

    The policy pays up to Rs.10,000 or 5% of the total sum insured for ICU/ICCU related expenses.

  5. Emergency Ambulance

    In case, the Insured or any of his/her family members require emergency transportation from one hospital to another, Ambulance Charges up to Rs. 2000 per hospitalization are included under this plan.

  6. Daycare Treatments

    The policy covers the expenses related to Daycare procedures which require less than 24 hours of hospitalization.

  7. Pre and Post hospitalization Expenses

    The policy covers all the Pre and Post-hospitalization expenses for a period of 30 days and 60 days respectively.

  8. Dental Treatment

    The policy covers Dental Treatment expenses incurred due to an unfortunate accident/ mishap.

  9. Plastic Surgery

    Expenses incurred on Plastic Surgery due to accidents are covered under the policy.

  10. Cataract Treatment

    Expenses incurred on Cataract surgery are also covered up to Rs. 40,000 or 25% of the sum insured.

  11. New Modern Age Treatments

    The cost of Advanced Medical Treatments is also covered under this plan up to a maximum of 50% of the total sum insured amount.

    List of New Age Treatments which are covered under Arogya Sanjeevani Policy:

    • Immunotherapy
    • Balloon Sinuplasty
    • Deep Brain Stimulation
    • Bronchial Thermoplasty
    • Oral Chemotherapy
    • Uterine Artery Embolization
    • High Intensity focused ultrasound
    • Holmium laser treatment
    • Intra Operative Neuro Monitoring (IONM)
    • Stereotactic radio surgeries
    • Intra vitreal treatment
    • Bronchial Thermoplasty
    • Green laser treatment
    • Robotic Surgeries
    • Stem cell therapy

Eligibility Criteria

Below mentioned is the eligibility criteria of the Arogya Insurance policy:

Parameters Minimum Maximum
Entry Age (Adults) 18 years 65 years
Entry Age (Dependent Children) 3 months 25 years
Waiting Period 24 months for specific illnesses (mentioned on the company's brochure) and 48 months for:
Osteoarthritis and osteoporosis (Age-related)
Pre-existing disease
Joint Replacement therapies

Arogya Sanjeevani Policy Premium

The below-mentioned graph represents the Arogya Sanjeevani Policy Premium which is to be paid by a healthy male of 30 years at the Sum Assured amount of Rs. 5 lakhs. The premium has been calculated for the above-mentioned companies. Take a look and get an idea of how much you need to pay for your Arogya Sanjeevani Health Insurance policy:

Few Health Insurance Companies That Offer Arogya Sanjeevani Policy

Company Name Plan Claim Support (within 3 months) Maximum Sum Insured (in Rs) Premium @ Sum Insured 5 Lakhs (in Rs.)
Star Health and Allied Insurance Company Arogya Sanjeevani Policy 99.9% 10,00,000 4921
ICICI Lombard Arogya Sanjeevani Policy 96.93% 5,00,000 5449
Bajaj Allianz General Insurance Company Bajaj Allianz Arogya Sanjeevani Policy 98.61% 25,00,000 5320
Reliance General Insurance Company Reliance Arogya Sanjeevani Insurance Plan 98.16% 5,00,000 4495
SBI General Insurance Company Arogya Sanjeevani Health Insurance 97.84% 5,00,000 4501

Let's understand the premium rates with the help of a graph.

The belowmentioned graph represents the Premium which is to be paid by a healthy male of 30 years at the Sum Assured amount of Rs. 5 lakhs (for different companies).

Premium payable by an individual under Arogya Sanjeevani Policy

Premium payable by an individual under Arogya Sanjeevani Policy

Exclusions

Here is a list of exclusions that are not covered under the Arogya Sanjeevani Health Insurance Policy:

  • Gender change treatments
  • Obesity and weight control programs
  • Nuclear attack or Invasion or warlike activities
  • Intentional cosmetic or plastic surgery
  • Domiciliary hospitalization
  • STDs/ AIDS/ Venereal diseases
  • Pregnancy, maternity, and childbirth-related expenses
  • Drug/Alcohol/Substance abuse
  • Dietary Supplements
  • Injury is due to adventurous/hazardous sports such as rock climbing, deep-sea diving, mountaineering, etc.
  • OPD or out-patient treatment

Arogya Sanjeevani Plans of 2022

Aditya Birla Arogya Sanjeevani

A standard health insurance policy, wherein you can choose coverage of up to Rs.1 lac to Rs.5 lacs.

Unique Benefits

  • Avail 5% cumulative bonus
  • Cataract treatment covered
  • All daycare treatments covered

A robust policy that takes care of 360-degree health needs for you and your family with a maximum sum assured up to INR 25 lakh.

Unique Features

  • Modern Treatment covered
  • Avail AYUSH treatment
  • Avail cumulative bonus

Digit Arogya Sanjeevani Policy

A standard health insurance policy that covers your healthcare expenses up to 2 crores and includes new-age treatments and much more.

Unique Benefits

  • Lifelong Renewability
  • 5% of copayment applicable
  • Plastic Surgery & Dental Treatments

Care Arogya Sanjeevani

A standard comprehensive plan mandated by IRDAI that offers coverage for both Ayurvedic or Allopathic treatments.

Unique Benefits

  • AYUSH Treatment
  • Pre and Post hospitalization
  • 5% cumulative bonus

Future Generali Arogya Sanjeevani

A health insurance plan that offers standard benefits as directed by the IRDAI. The plan offers coverage up to INR 10 Lakhs.

Unique Features

  • Cataract Treatments covered
  • Coverage for Modern Treatments
  • Avail up to 50% increase in SI

Icici Arogya Sanjeevani Policy

A standard Health plan that offers coverage up to 5 lakhs to the insured & his family. The plan offers you everything you need under a health insurance plan.

Unique Features

  • 5% increase in SI as Cumulative Bonus
  • Coverage against Cataract Treatments
  • Modern Procedures covered

Kotak Arogya Sanjeevani Policy

It is a standard health insurance plan that offers medical coverage of up to 10 Lakhs. Also, a fixed co-pay of 5% is applicable for all claims and ages in this policy

Unique Features

  • Coverage for cataract treatment
  • Modern treatments covered
  • Cumulative bonus of 5%

A standard and affordable health plan that offers medical coverage to individuals and their families. The plan covers inpatient hospitalisation with a coverage of up to 10 Lakhs.

Unique Features

  • Coverage against special treatments
  • Daycare treatments covered
  • Dental Treatment and Plastic Surgery covered

A standard health insurance plan that comes with a coverage of 10 Lakhs. Moreover, the plan comes with a 5% Co-pay, applicable on all the admissible claims.

Unique Features

  • Advanced Procedures covered
  • Lifelong renewals
  • Cumulative Bonus of 5%

Star Health Arogya Sanjeevani Policy

A standard health plan mandated by IRDAI that covers all essential healthcare benefits including Ayush treatment, day care procedures, etc. for individuals and families.

Unique Features

  • Room rent up to 5K/day
  • Modern treatments covered up to 50% of SI
  • 20% rural discount available

How to Buy Arogya Sanjeevani Policy?

I. Directly through the Insurer's Website

1

Calculate Premium with Arogya Sanjeevani Premium Calculator

2

Choose the plan as per your requirements

3

Fill the proposal form with the required information

4

Pay the premium online via debit/credit card

5

Arogya Sanjeevani Policy will be issued online

Note: The procedure of buying Arogya Sanjeevani policy varies from company to company. Refer to the company's brochure for more information.

II. From PolicyX.com

1

Fill in all the required details in the 'Calculate Premium' section

2

The next page will show all the available plans

3

Choose the most suitable Health Plan and click on 'Buy Now'

4

Pay the premium online

5

Details will be shared at your registered email address

What is the Claim Process of Arogya Sanjeevani Policy?

Claims can be settled in two ways:

Cashless Claim - When you're admitted to a Network Hospital

Reimbursement Claim - When you're admitted to a Non Network Hospital

Cashless Claims

Claim Intimation

Inform the Insurer about Hospitalization at the earliest.

Documents Submission

Submit the requisite forms, Health Card, photo ID at the Hospital Desk.

Claim Settlement

On approval, the Insurer settles your claim directly with the hospital.

Reimbursement Claims

Claim Registration

Inform the Insurer about Hospitalization at the earliest.

Documents Submission

Submit original copies of bills to the Insurer within 15 days post discharge.

Claim Settlement

Once approved, the claim amount shall be transferred to your account.

Documents Required

  • Original reports of diagnostic tests, radiology reports, and payment receipts.
  • Original hospital bills and discharge certificate signed by a medical practitioner.
  • Valid ID Proof.
  • Medical practitioner's prescription for consultation, medicine, and medical tests.
  • Post Mortem Report (if applicable).
  • Others requested by the company.

Health Insurance Articles

Arogya Sanjeevani Policy: FAQs

1. I want to cover my entire family including my parents, wife, 2 daughters & 3 sisters. Can I do so?

Arogya Sanjeevay Policy is available on an individual as well as family floater basis. One can cover the family members including:

  1. Legally wedded spouse.
  2. Parents and Parents-in-law.
  3. Dependent Children (i.e. natural or legally adopted).

2. Is there any limit on the number of claims one can make under the Arogya Sanjeevani policy?

No, there is no limit on the number of claims one can make under this plan. However, the claims will be admissible only until your coverage is not exhausted.

3. If the room rent / ICU rent exceeds the mentioned limits, what will happen then?

If Room/ICU/ICCU rent exceeds the specified limits, the claim shall be subject to the proportionate deduction.

4. What is the policy tenure of Arogya Sanjeevani Policy?

The policy tenure of Arogya Sanjeevani is for 1 year only.

5. Can I get an option of a Free Look Period under this plan?

The Arogya Sanjeevani plan comes out with a 15 day free look period.

6. How many family members are covered under Arogya Sanjeevani Policy?

The policy covers 2 adults (self and spouse) and up to 3 dependent children.

7. What is the criteria for refunding the amount incurred on Arogya Sanjeevani Policy?

Cancellation Type % of Premium Refunded
Up to 30 days 75%
31-90 days 50%
3 months - 6 months 25%
6 - 12 months 0%

The policy covers 2 adults (self and spouse) and up to 3 dependent children.

8. Does my Arogya Sanjeevani policy cover COVID treatment?

Yes, Arogya Sanjeevani policies cover COVID-19 related hospitalization charges. Refer to the plan brochures for more specificities regarding the plan.

9. Am I eligible to purchase the Arogya Sanjeevani Policy?

Any person in the age bracket of 18-60 years is eligible to buy this policy.

10. Can I avail Cashless Hospitalization under this policy?

Yes. If you receive treatment at a Network Hospital associated with your Insurance Provider, you can avail Cashless Hospitalization under Arogya Sanjeevani.

11. Does Arogya Sanjeevani cover hospital room rent charges?

The policy covers the room rent up to a maximum of Rs. 5,000 per day, subject to the Sum Insured.

12. Can NRI's get access to Arogya Sanjeevani Scheme?

Yes, an NRI can buy Arogya Sanjeevani Insurance. However, before choosing one, you need to contact your insurer as every company comes with different terms & conditions.

13. Does Arogya Sanjeevani Insurance offer any riders for enhanced protection?

No, the plan does not have any riders.

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