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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:
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.
Explore top health insurance companies to buy the most suitable mediclaim policy for families.
Take a look below to explore more about Arogya Sanjeevani Policy, and then make an informed decision.
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:
The plan covers treatment expenses incurred due on the positive diagnosis of Covid- 19.
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.
The hospitalization expenses incurred on Ayurveda, Homoeopathy, Siddha, Unani related treatments are also covered under this plan.
The policy pays up to Rs.10,000 or 5% of the total sum insured for ICU/ICCU related expenses.
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.
The policy covers the expenses related to Daycare procedures which require less than 24 hours of hospitalization.
The policy covers all the Pre and Post-hospitalization expenses for a period of 30 days and 60 days respectively.
The policy covers Dental Treatment expenses incurred due to an unfortunate accident/ mishap.
Expenses incurred on Plastic Surgery due to accidents are covered under the policy.
Expenses incurred on Cataract surgery are also covered up to Rs. 40,000 or 25% of the sum insured.
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:
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 |
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:
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
Here is a list of exclusions that are not covered under the Arogya Sanjeevani Health Insurance Policy:
A standard health insurance policy, wherein you can choose coverage of up to Rs.1 lac to Rs.5 lacs.
Unique Benefits
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
It is a standard health insurance plan that mainly covers emergency hospitalization, alternative treatment, Inpatient Care and ICU expenses.
Unique Benefits
A standard comprehensive plan mandated by IRDAI that offers coverage for both Ayurvedic or Allopathic treatments.
Unique Benefits
A health insurance plan that offers standard benefits as directed by the IRDAI. The plan offers coverage up to INR 10 Lakhs.
Unique Features
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
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
A standard and affordable health plan that offers medical coverage to individual and their families with a coverage of up to 10 Lakhs.
Unique Features
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
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
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
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
Inform the Insurer about Hospitalization at the earliest.
Submit the requisite forms, Health Card, photo ID at the Hospital Desk.
On approval, the Insurer settles your claim directly with the hospital.
Reimbursement Claims
Inform the Insurer about Hospitalization at the earliest.
Submit original copies of bills to the Insurer within 15 days post discharge.
Once approved, the claim amount shall be transferred to your account.
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Arogya Sanjeevay Policy is available on an individual as well as family floater basis. One can cover the family members including:
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.
If Room/ICU/ICCU rent exceeds the specified limits, the claim shall be subject to the proportionate deduction.
The policy tenure of Arogya Sanjeevani is for 1 year only.
The Arogya Sanjeevani plan comes out with a 15 day free look period.
The policy covers 2 adults (self and spouse) and up to 3 dependent children.
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.
Yes, Arogya Sanjeevani policies cover COVID-19 related hospitalization charges. Refer to the plan brochures for more specificities regarding the plan.
Any person in the age bracket of 18-60 years is eligible to buy this policy.
Yes. If you receive treatment at a Network Hospital associated with your Insurance Provider, you can avail Cashless Hospitalization under Arogya Sanjeevani.
The policy covers the room rent up to a maximum of Rs. 5,000 per day, subject to the Sum Insured.
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.
No, the plan does not have any riders.
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September 29, 2023
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