National Arogya Sanjeevani Policy
  • Understand the plan's features
  • Learn about its eligibility criteria
  • Know more about its exclusions
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National Arogya Sanjeevani Policy

National Arogya Sanjeevani Policy is a standard indemnity health insurance product, having Sum Insured up to 10 Lakhs available in both individuals as well as floater type which covers spouse, dependent legitimate or legally adopted children, parents, parents-in-law, new born from 3 months age. National Arogya Sanjeevani Policy provides coverage up to the age of 65 years. National Arogya Sanjeevani Policy includes expenses the policy holder is billed for Day Care Treatment or In-Patient Care due to an illness or injury during the policy period. The policy also covers Pre Hospitalisation (30 days) & Post Hospitalisation (60 days) expenses along with Ambulance Charges. Read below to understand more in detail about the benefits of this plan.

National Arogya Sanjeevani Policy Specifications

Entry Age

Min: 18 Years, Max: 65 Years, Dependent children: 3 months to 25 years

Sum Insured

50,000 to 10 Lakh

Plan Type

Individual/Family Floater

Policy Term

1 Year

Initial Waiting Period

30 DaysChildren- 91 days to 25 years*

Premium Payment

Half Yearly/ Quarterly/ Monthly

*Initial Waiting Period is the time 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.

Choose your National Arogya Sanjeevani Policy

With wide coverage options, National Arogya Sanjeevani Policy lets you customize your health insurance plan as per your needs and requirements:

In-patient & Out-patient coverage

Room Rent

2% of SI

ICU Charges

5% of SI

Pre-Hospitalization

Covered up to 30 days

Post-Hospitalization

Covered up to 60 days

Domiciliary Hospitalization

Not Covered

Daycare Treatment

Covered

OPD Charges

Not Covered

Coverage Terms

COVID-19 Treatment

Not Covered

Cataract

Covered

No Claim Bonus

Available up to 50% of SI

Automatic Restoration

Not Available

Daily Hospital Cash

Not available

Organ Donor

Not Covered

Maternity Cover

Not Available

New Born Baby Cover

Not available

Alternative Treatments

AYUSH Treatment

Available

IVF Treatment

Not Available

Modern Treatment

50% of SI

Emergency Coverage

Ambulance

Covered up to 2k

Air Ambulance

Not covered

Compassionate Travel

Not Available

Global Coverage

Not Available

Wellness Programmes

E-Consultation

Not Available

Health Check-Up

Not Available

Second Medical Opinion

Not Available

Vaccination

Not Covered

Limitations

Co-payment

5% applicable

Sub-limits

Not 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 National Arogya Sanjeevani Policy?

Under National Arogya Sanjeevani Policy, the room rent is covered by up to 2% of the SI subject to a maximum of Rs. 5000/- 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 National Arogya Sanjeevani Policy?

Under this plan, ICU charge coverage is available up to 5% of the SI subject to a maximum of Rs. 10000/- per day.

What is Pre Hospitalization?

Medical expenses incurred before the hospitalization of the policyholder.

Coverage status under National Arogya Sanjeevani Policy?

This plan covers medical expenses incurred during pre-hospitalization for up to 30 days.

What is Post Hospitalization?

Medical expenses incurred after the discharge of the policyholder from the hospital.

Coverage status under National Arogya Sanjeevani Policy?

This plan covers medical expenses incurred during post-hospitalization for up to 60 days.

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 National Arogya Sanjeevani Policy?

Under the National Arogya Sanjeevani Plan, domiciliary hospitalizations is 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 National Arogya Sanjeevani Policy?

This plan covers expenses of all daycare procedures up to 50% of the Sum Insured.

What are OPD charges?

Covers the cost of doctor consultation and prescribed medical tests that may not require hospitalization.

Coverage status under National Arogya Sanjeevani Policy?

Not covered under the plan.

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 National Arogya Sanjeevani Policy?

COVID-19 treatment cover is available under this plan.

What is Cataract Treatment?

A common eye condition in which your vision gets blurred.

Coverage status under National Arogya Sanjeevani Policy?

The plan covers Cataract Treatment subject to a limit of 25% of the Sum Insured or INR 40,000 per eye, whichever is lower, 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 National Arogya Sanjeevani Policy?

The plan offers an additional 5% to the sum insured as a No Claim Bonus for each claim-free year, a maximum of up to 50% of the sum insured.

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 National Arogya Sanjeevani Policy?

Automatic Restoration under National Arogya Sanjeevani Policy is not available

What is Daily Hospital Cash?

It is a cash amount that you receive each day during the time of hospitalization.

Coverage status under National Arogya Sanjeevani Policy?

The daily hospital cash is not available under the plan.

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 National Arogya Sanjeevani Policy?

Under the plan, Organ Donor expenses are not covered.

What is a Maternity Cover?

It refers to the cover that includes expenses for normal and c-section procedures deliveries.

Coverage status under National Arogya Sanjeevani Policy?

Not covered

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 National Arogya Sanjeevani Policy?

Not covered

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 National Arogya Sanjeevani Policy?

AYUSH treatment is covered under this plan.

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 National Arogya Sanjeevani Policy?

Not available

What is a Modern Treatment?

Medical treatments that demand modern technology such as robotic surgeries, stem cell therapy, etc.

Coverage status under National Arogya Sanjeevani Policy?

It is covered under the condition that the expense is shared with the policyholder.

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 National Arogya Sanjeevani Policy?

This plan covers Ambulance charges up to INR 2000.

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 National Arogya Sanjeevani Plan?

The plan does not cover the Domestic Emergency Assistance Services (including Air Ambulance) & International Emergency Assistance Services (including Air Ambulance).

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 National Arogya Sanjeevani Policy?

Not available

What is Global Coverage?

Any kind of medical/health emergency when you are outside of India.

Coverage status under National Arogya Sanjeevani Policy?

Not available

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 National Arogya Sanjeevani Policy?

The plan does not cover the expenses for E-consultation.

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 National Arogya Sanjeevani Policy?

The plan offers no Annual Health Check-up benefit.

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 National Arogya Sanjeevani Policy?

Not available

What is Vaccination cover?

Coverage against the expenses incurred on vaccinations is provided by the insurance companies.

Coverage status under National Arogya Sanjeevani Policy?

The plan does not cover vaccination cover.

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 National Arogya Sanjeevani Policy?

Co-payment is only applicable, 5% co-pay 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 National Arogya Sanjeevani Policy?

No sub-limits are available

National Arogya Sanjeevani Policy Benefits

Tax Benefits

Get tax relief under section 80D

Discounts

Avail 10% discount

Installment Benefit

Avail Premium Payment Installments

Tax Benefits

Amount paid towards the premium of this plan is eligible for tax relief under Section 80D of the Income Tax Act, 1961.

Discounts

If the new policy is issued through Customer Portal or renewed through Customer Portal then policyholders can avail 10% discount.

Installment Benefit

Premium for the Policy may be paid in installments of Monthly, Quarterly, Half Yearly as well as Yearly.

National Arogya Sanjeevani Policy Exclusions

National Arogya Sanjeevani Policy has certain limitations and exclusions involved. Read below to know more:

Surgery/procedures for weight control

Cosmetic/Plastic surgery unless required after an accident, burns or cancer

Adventure Sports

Maternity Cover

Infertility and In vitro fertilization

Coverage after Waiting Period

Certain diseases and treatments are covered under this plan after a certain time period. Read the details below:

Listed ailments after 24 Months

Pre-existing diseases after 48 Months

Explore National Health Insurance

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A unique benefit policy that covers expenses in the event of the insured person being affected with any of the listed critical illnesses.

Unique Features

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National Arogya Sanjeevani Policy: FAQ's

1. Is it allowed to cancel Arogya Sanjeevani Policy and receive a refund?

You will get a free-look period of 15-30 days under the Arogya Sanjeevani Policy. If you cancel your plan within this period, you would receive the entire amount after a few nominal deductions. The table below shows the amount of refund provided to the cancellation timing of the policy.

Refund of Premium (basis Policy Period)
Timing of Cancellation1 year
Up to 30 days75.00%
31 to 90 days50.00%
3 to 6 months25.00%
6 to 12 months0.00%

2. Does the plan offer portability benefit?

Yes, the plan comes with the portability benefit. As per the IRDAI guidelines, customers can port their plan from one insurer to another.

3. Can I migrate this policy with any other health insurance product of the National Insurance company?

Yes, the National Insurance company allows customers to migrate their policy to any of its other health insurance products/plans.

4. I want to increase the sum insured of my Arogya Sanjeevani Policy. Is that possible, what should I do?

If you are already insured under Arogya Sanjeevani Policy, you can easily increase the sum insured at the time of renewal in case you want it.

5. What is the copayment clause in this policy?

The plan has a copayment clause of 5% that is applicable to claim amount admissible and payable as per the terms and conditions of the policy.

6. Who is eligible for National Arogya Sanjeevani Policy?

The eligibility criteria for National Arogya Sanjeevani Policy is 18 to 65 years for individuals, whereas for a family floater plan you can purchase this policy for dependent children between 3 months & 25 years.

7. What are the benefits of the Arogya Sanjeevani Policy?

Arogya Sanjeevani is a standard health insurance policy provided by all general insurance providers across the country. It offers basic health insurance of INR 50k to 10 lakhs and covers hospitalization expenses, daycare procedures, COVID-19 treatment, AYUSH treatment, and much more.

8. How much sum assured does Arogya Sanjeevani Policy provide?

National Arogya Sanjeevani Policy is a standard indemnity health insurance product, that provides a sum insured of up to 10 Lakhs and the policy tenure is of 1 year.

9. Are maternity expenses covered in Arogya Sanjeevani Policy?

No, maternity cover is not available in Arogya Sanjeevani Policy.

10. Will I be able to access modern treatments if I buy Arogya Sanjeevani Policy?

You can avail of modern treatments under this policy with a limitation wherein the policy requires you to share the cost and only 50% of SI is covered.

11. Is National Arogya Sanjeevani Policy economical?

National Arogya Sanjeevani Policy is an affordable plan and offered as an individual as well as a family floater. The plan lets the policyholders choose from a sum insured ranging up to Rs. 10 Lakhs.

12. Does National Arogya Sanjeevani Policy cover Ayurvedic treatments?

Yes, the National Arogya Sanjeevani Policy covers Ayurvedic and homeopathy treatments.

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