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 - An Overview

Arogya Sanjeevani Policy is a basic Health Insurance plan that offers a host of coverage to protect you and your family from financial contingencies caused due to hospital expenses. The 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. Hence, this plan is offered by all the public and private General Health Insurers across India.

Arogya Sanjeevani Policy covers medical bills of 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 lac to Rs. 5 lacs. The plan also covers Hospitalization expenses incurred due to Coronavirus (COVID-19).

Key Features of Arogya Sanjeevani Policy

  • 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

  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

ParametersMinimumMaximum
Entry Age (Adults)18 years65 years
Entry Age (Dependent Children)3 months25 years
Waiting Period24 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

Few Health Insurance Companies That Offer Arogya Sanjeevani Policy

Company NamePlanClaim Support (within 3 months)Maximum Sum Insured (in Rs)Premium @ Sum Insured 5 Lakhs (in Rs.)
Star Health and Allied Insurance CompanyArogya Sanjeevani Policy99.9%10,00,0004921
ICICI LombardArogya Sanjeevani Policy96.93%5,00,0005449
Bajaj Allianz General Insurance CompanyBajaj Allianz Arogya Sanjeevani Policy98.61%25,00,0005320
Reliance General Insurance CompanyReliance Arogya Sanjeevani Insurance Plan98.16%5,00,0004495
SBI General Insurance CompanyArogya Sanjeevani Health Insurance97.84%5,00,0004501

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

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.

Insurance Calculator

Frequently Asked Questions (FAQs)

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

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

2. 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.

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

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

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

Cancellation Type% of Premium Refunded
Up to 30 days75%
31-90 days50%
3 months - 6 months25%
6 - 12 months0%

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

5. 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.

6. 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.

7. 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.

8. 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.

Find Out What the Customers Are Saying

(Showing latest 5 reviews only)

- 4.6/5 (1157 Total Rating)

1 days ago

Akhilesh Yadav

Ahmedabad

One of the best health care companies with the best team. They help you as their own brother and sister.

1 days ago

Amit Kumar

Mumbai

Nice company with helpful and supportive staff members. I am very happy with the way the company helps me with my claim settlement

2 days ago

Tania

Hyderabad

good decsion approaching this company...they are very knowlegeable with their suggestions! I am thnkful!

2 days ago

Simran C

Delhi

happy with the claim settling speed....they responded within no time and were super efficient during the whole process

2 days ago

Dilpreet Singh

Pune

very vast range of plans! the premiums are decent for anybody s budget. I would 1000% recommend the comapny

Last updated on September, 2021

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