The Arogya Sanjeevani Policy from HDFC ERGO is a basic plan that is designed for individual or family floater coverage. It provides you with the precise medical support of health insurance including, hospitalization, pre and post-hospitalization, doctor’s consultation, AYUSH treatment, preventive health check-ups, etc.
With a sum insured of up to 10 Lakhs, the plan is sufficient for your alternate medical requirements. Also, as a policyholder, you need not worry about the hefty monthly premiums. It comes with an affordable range and seamless, all-time customer support for everyone.
Read further about the benefits and specifications of the plan in this article.
Eligibility criteria for HDFC ERGO Arogya Sanjeevani Policy
Know here the eligibility criteria, sum insured, waiting period, etc of Arogya Sanjeevani Policy by HDFC ERGO:-
Entry Age
3 Months - 25 Years
Entry Age Max.
18 - 65 Years
Policy Tenure
1 year
Plan Type
Individual/ Family Floater
Sum Insured
INR 50,000 - 10 Lakhs
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.
Read more specifications in the brochure.
Choose your Arogya Sanjeevani Policy by HDFC ERGO
Here are the specifications of Arogya Sanjeevani Policy by HDFC ERGO:
Coverage for SI: 50,000 - 10 Lakh
In-patient & Out-patient Coverage
Room Rent
2% of the sum insured (maximum of Rs.5000 per day)
ICU Charges
5% of the sum insured (maximum of Rs.13,000 per day)
Pre-Hospitalization
From 30 days before hospitalization
Post-Hospitalization
Upto 60 days after hospitalisation
Domiciliary Hospitalization
Not Covered
Daycare Treatment
Covered
OPD Charges
Not covered
Coverage Terms
COVID-19 Treatment
covered
Cataract
Covered
No Claim Bonus
5% for each claim-free year (up to 50% of the SI)
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 up to SI
IVF Treatment
Not Applicable
Modern Treatment
Not Applicable
Emergency Coverage
Ambulance
Maximum of INR 2,000 per hospitalisation
Air Ambulance
Not Covered
Compassionate Travel
Not Applicable
Global Coverage
Not Applicable
Wellness Programmes
E-Consultation
Not Applicable
Health Check-Up
Applicable
Second Medical Opinion
Not Applicable
Vaccination
Not Applicable
Limitations
Co-payment
Applicable, 5% on all claims
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 HDFC ERGO Arogya Sanjeevani Policy
Under HDFC ERGO Arogya Sanjeevani Policy, the room rent is covered by 2% of the sum insured (maximum of Rs.5000 per day)
What are ICU charges?
It is a special department in the hospitals where patients with serious medical conditions are treated.
Coverage status under HDFC ERGO Arogya Sanjeevani Policy
Under the HDFC ERGO Arogya Sanjeevani Policy, ICU charges are covered by 5% of the sum insured (maximum of Rs.13,000 per day)
What is Pre-Hospitalization?
Medical expenses incurred before the hospitalization of the policyholder.
Coverage status under HDFC ERGO Arogya Sanjeevani Policy
Covered from 30 days before hospitalization.
What is Post Hospitalization?
Medical expenses incurred after the discharge of the policyholder from the hospital.
Coverage status under HDFC ERGO Arogya Sanjeevani Policy
Covered up to 60 days after hospitalisation
What is Domiciliary Hospitalization?
Home hospitalization arrangements for the insured person due to the unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get financial coverage.
Coverage status under HDFC ERGO 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 HDFC ERGO Arogya Sanjeevani Policy
Specific conditionals are covered after a 24-month waiting period.
What are OPD charges?
Covers the cost of doctor consultations and prescribed medical tests that may not require hospitalization.
Coverage status under HDFC ERGO 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. approved Centre.
Coverage status under HDFC ERGO Arogya Sanjeevani Policy
Covid-19 Covered.
What is Cataract Treatment?
A common eye condition in which your vision gets blurred.
Coverage status under HDFC ERGO Arogya Sanjeevani Policy
Covered after a waiting period of 24 months.
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 HDFC ERGO Arogya Sanjeevani Policy
A cumulative bonus of 5% for each claim-free year (up to 50% of the SI) is applicable.
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 HDFC ERGO 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 HDFC ERGO 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 HDFC ERGO Arogya Sanjeevani Policy
Not applicable.
What is a Maternity Cover?
It refers to the cover that includes expenses for normal and c-section procedure deliveries.
Coverage status under HDFC ERGO 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 and these common treatments
can vary from plan to plan:
Congenital anomaly (conditions since birth)
Acute condition
Chronic condition
Premature delivery
Birth asphyxia
Daycare treatment
Coverage status under HDFC ERGO 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 HDFC ERGO Arogya Sanjeevani Policy
Covered up to SI.
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 HDFC ERGO Arogya Sanjeevani Policy
Not covered.
What is a Modern Treatment?
Medical treatments that demand the use of modern technology such as robotic surgeries, stem cell therapy, etc.
Coverage status under HDFC ERGO Arogya Sanjeevani Policy
Not available.
What is an Ambulance Cover?
An ambulance is used to move the patient from home to the hospital, transfer to another hospital, and take them for different tests outside the hospital.
Coverage status under HDFC ERGO Arogya Sanjeevani Policy
Road ambulance is covered up to a maximum of INR 2,000 per hospitalization
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 HDFC ERGO 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 policyholder gets admitted to a hospital outside his/her residential city.
Coverage status under HDFC ERGO Arogya Sanjeevani Policy
Not available
What is Global Coverage?
Any kind of medical/health emergency when you are outside of India.
Coverage status under HDFC ERGO 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 HDFC ERGO Arogya Sanjeevani Policy
Not applicable.
What is a Health Checkup?
A facility where the policyholder can avail of free health check-ups after fulfilling the company's policies.
Coverage status under HDFC ERGO Arogya Sanjeevani Policy
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 HDFC ERGO 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 HDFC ERGO 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.
Status under HDFC ERGO 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.
Status under HDFC ERGO Arogya Sanjeevani Policy
Applicable.
Benefits of Arogya Sanjeevani Policy by HDFC ERGO
Below are some of the notable benefits of Arogya Sanjeevani Policy by HDFC ERGO:-
Easy policy buying process
The online policy-buying process allows you to secure the mental, physical and financial well-being of you and your family from the comfort of your couch.
Dental treatment & plastic surgery
This plan gives you the additional benefit of getting cashless and hassle-free treatment for any dental problem and plastic surgery. The only condition here is, the injury must be caused due to a disease or an accidental mishap.
Good customer support
The insurer provides its customers with an easy and hassle-free policy-buying and claim procedure. The 24*7 customer support is one of the impressive features that ensures that you enjoy the maximum benefits of your policy.
Tax benefits
All the premiums paid towards HDFC ERGO Arogya Sanjeevani Policy are eligible for tax benefits under Section 80D of the Income Tax Act.
What is not covered (Exclusions) under Arogya Sanjeevani Policy by HDFC ERGO
This policy schedule has some exclusions that are mentioned below:
Pre-existing conditions are covered only after the 48th month of the waiting period from the policy commencement date.
Daycare procedures like cataract treatment, hernia, varicose veins, etc are covered after a 24-month waiting period
Any kind of external congenital illnesses or voluntary treatments like cosmetic/beautification/plastic surgery, etc
Breach of the law, alcoholism, drug, or substance abuse cases, etc
Unproven treatments, rest care, rehabilitation, etc
Sterility and infertility, birth control, gender change treatments, etc
Hypertension, diabetes, cardiac arrests, organ transplants, donor expenses, etc
Maternity expenses like childbirth (complicated deliveries and caesarean sections, except ectopic pregnancy), miscarriage (except an accident) and lawful medical termination of pregnancy during the policy period
HDFC Ergo entails a wide network of cashless Hospitals that impact millions of lives PAN India. A well connected network of over 13,000+ cashless hospitals, HDFC Ergo ensures that you are medically secured, irrespective of the city you reside
in.
To avail of claim settlement services, the insured individual must follow the process below:-
Visit the official website of HDFC ERGO General Insurance.
Click on the ‘Claim’ button on the header of the official website and go to the claim process > Health insurance.
For claim intimation, the official website has a pre-authorized form that you can fill in with your contact number/policy number/email and ‘Proceed’
Individuals can call the toll-free number 022 6234 6234 or email their details to healthclaims@hdfcergo.com and get their claim settlement procedure info.
Reach out to PolicyX.com for further assistance.
For Reimbursement of the Arogya Sanjeevani Policy:
Get treatment at a networking hospital with a pre-authorization of the HDFC ERGO concerned executives
After receiving the authorization form, the company will verify and issue the authorized letter to the hospital
On the discharging day, you must verify and undersign the form against the claim of your medical or non-medical expenses.
You need to pay the medical expenses on your own first and attach all the necessary details of medical relevance in the claim submission form
Later, submit all the required documents to your insurer for claiming reimbursement for the total of your medical bills, which gets settled upon verification.
Documents to be submitted while raising a claim:
Completed claim form with the policyholder’s photographs
Doctor’s prescription for admission of treatment
All the original medical bills and payment receipts
Discharge summary and all the related details of the policyholder
KYC documents along with the bank’s cancelled cheque or NEFT details
Other documents the company asks to submit at the time of claim settlement.
Wrapping it up
Not having health insurance can sometimes drain all your emergency savings and even impact your financial stability. We often get sceptical about paying hefty premiums for a health insurance policy. This plan is the solution to your worries related to an affordable and specific health insurance policy. The Arogya Sanjeevani Policy of HDFC ERGO ensures you basic health support at a pocket-friendly premium. Additionally, it provides coverage for you and your family including daycare procedures and financial support against 12 listed treatment expenses.
Want to know more? Contact our customer care executives on 18003450330 or visit the official website of PolicyX.com.
HDFC ERGO provides myriads health plans to cater to the different needs of different customers. You can read about HDFC ERGO health plans for individuals, families, senior citizens, etc, below:
Designed especially for people with pre-existing diabetes or hypertension. Get coverage for diabetes and hypertension from Day 1 without any waiting period.
Covers all types of cancer at all stages with lifelong renewability option. If diagnosed with IV stage cancer or relapse, this plan pays 100% of SI as a lump sum.
An ideal health plan for people with a pre-existing critical illness or a family history of critical illnesses. Get comprehensive coverage for 15 critical illnesses.
A flexible and comprehensive health plan, securing your today & tomorrow. With 'Reserve Benefit' features, this plan grows unused policy amount @6% interest rate.*
Women-oriented health plan providing comprehensive medical insurance with major illnesses cover, and cancer cover all under a single plan but different variants.
This plan covers the policyholder with basic to advanced healthcare benefits not only within the Indian subcontinents but globally as well.
Unique Features
Global healthcare coverage
Multiple wellness services
Unlimited restore add-on
Optima Secure Global Plan (Pros)
In-patient hospitalisation
Daycare treatment
Domiciliary hospitalisation
Sum insured restoration
Organ donor expense cover
Optima Secure Global Plan (Cons)
COVID-19 care not covered
Modern treatment not covered
OPD not covered
Sub-limits not applicable
Optima Secure Global Plan (Other Benefits)
Individual, multi-individual & family floater plan
Trusted insurance provider
Unlimited benefits up to SI
Cashless claim settlemen
AYUSH treatment coverd
Optima Secure Global Plan (Eligibility Criteria)
Entry age - Child - 91 days - 25 Years
Adult - 18 - 65 Years
SI - INR 1 -2 Crore/s
Waiting Period - 30 days
Comprehensive
HDFC Ergo Personal Accident Insurance
Safeguard your financial savings with HDFC Personal Accident Insurance as it covers you against accidental medical expenditures.
Unique Features
Worldwide Coverage
Tax Benefits
Lifelong Renewability
Personal Accident Insurance (Pros)
No medical check-ups
Family cover available
Accidental Death
Permanent Total Disability
Broken Bone Coverage
Personal Accident Insurance (Cons)
Pre-existing injuries not covered
Suicide not covered
Adventure sport injuries not covered
Claims related to mental illness
Individuals working with explosives
Personal Accident Insurance (Other Benefits)
Hospital Cash Cover
Coverage For Burns
Long term discounts
24/7 coverage
High Sum Insured
Personal Accident Insurance (Eligibility Criteria)
Entry Age - 18 years
Max Entry Age - 65 years
SI - 2.5 to 15 L
Waiting Period - 30 Days
Hdfc Ergo Arogya Sanjeevani Policy : FAQs
1. What is the total amount of sum insured for the Arogya Sanjeevani Policy?
The maximum sum insured under this plan is up to INR 10 Lakhs in the multiple of INR 50,000.
2. Is there any coverage for senior citizens under this plan?
Seniors till the age of 65 years can buy this plan and the benefits of coverage work almost the same way as an adult. However, this plan is not specifically designed for senior citizens.
3. Can I buy HDFC ERGO 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 also offers a family floater plan benefit so your spouse, parents/ in-laws/ children (3 months-25 years) or all can be covered under a separate or the same policy.
5. Is there any variant under HDFC’s Arogya Sanjeevani plan?
No, there is no variant of Arogya Sanjeevani's policy of HDFC ERGO.
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.
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