Arogya Sanjeevani Policy | Treatments Covered | Eligibility

What is Arogya Sanjeevani Policy?

Looking for affordable and comprehensive health insurance? The Arogya Sanjeevani Policy might be just what you need. The Arogya Sanjeevani Policy is a standard health insurance plan introduced by the Insurance Regulatory and Development Authority of India (IRDAI) in 2020. It aims to offer comprehensive health coverage for individuals and families at affordable rates. This policy covers a range of medical expenses, including hospitalisation, treatments, surgeries, and alternative therapies such as Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH). It is designed to ensure that all segments of society have access to basic healthcare without getting overwhelmed by complex insurance terms.

Arogya Sanjeevani Health Insurance Policy Details

The Arogya Sanjeevani Health Insurance Policy offers coverage options ranging from Rs. 50,000 to Rs. 10 lakhs. This flexibility ensures that individuals from various economic backgrounds can find a policy that suits their needs. Available both as individual and family floater plans, the policy provides protection against medical emergencies. In a family floater plan, you can include dependents such as your spouse, children, parents, and parents-in-law under a single policy. The policy covers hospitalisation expenses, including room rent, doctor’s fees, ICU charges, nursing expenses, and much more. It also offers coverage for pre-hospitalisation expenses (30 days before hospitalisation) and post-hospitalisation costs (up to 60 days after discharge). Another feature is that it covers modern medical procedures and alternative treatments under AYUSH, making it a well-rounded health insurance product. With the Arogya Sanjeevani Policy, individuals and families have access to an affordable and comprehensive health insurance plan that covers a broad range of medical treatments and hospitalisations. Whether you are looking for individual coverage or a family plan, this policy provides financial protection against unexpected medical expenses while ensuring peace of mind.

How does Arogya Sanjeevani Policy work?

The Arogya Sanjeevani Policy is simple and straightforward. Upon purchasing the policy, the policyholder chooses the sum insured, which ranges from Rs. 50,000 to Rs. 10 lakhs. Premiums are calculated based on the sum insured and the age of the insured individuals. This policy comes with a co-payment clause where the policyholder must bear 5% of the claim settlement amount, and the insurance company covers the remaining 95%. If the insured person or any family member under the policy requires hospitalisation, they can access treatment through the cashless facility at network hospitals. The policyholder simply needs to provide their insurance details to the hospital, and the insurer will settle the bills directly with the healthcare provider. In the case of non-network hospitals, the policyholder pays the bills upfront and then submits them for reimbursement. Pre- and post-hospitalisation expenses, including doctor consultations, diagnostic tests, and medications, are also covered under this plan.

Inclusions of Arogya Sanjeevani Policy:

The Arogya Sanjeevani Policy is comprehensive, covering most medical expenses. Here are some of its main inclusions.

• In-Patient Hospitalisation: The policy covers hospitalisation expenses for illnesses and accidents, including room rent, ICU charges, and doctor’s fees. Room rent is capped at 2% of the sum insured or Rs. 5,000 per day, while ICU charges are capped at 5% of the sum insured or Rs. 10,000 per day.
• Pre- and Post-Hospitalisation: The policy covers medical expenses incurred 30 days before and 60 days after hospitalisation, ensuring that follow-up treatments are taken care of.
• Daycare Procedures: The policy covers certain medical treatments that do not require 24-hour hospitalisation, such as cataract surgery or dialysis.
• AYUSH Treatment: This policy covers treatments under alternative medicine systems like Ayurveda, Yoga, Unani, Siddha, and Homeopathy.
• Ambulance Charges: The policy provides coverage of up to Rs. 2,000 for ambulance services during hospitalisation.
• Modern Treatments: Policyholders are covered for treatments like robotic surgery, stem cell therapy, and oral chemotherapy, providing access to advanced healthcare options.

Treatments Covered Under Arogya Sanjeevani Policy:

One of the major advantages of the Arogya Sanjeevani Policy is its broad coverage of both traditional and modern treatments. The policy covers essential medical treatments, surgeries, and hospitalisations, reducing the policyholder's financial burden. Additionally, it includes AYUSH treatments, which are alternative therapies recognised by the Indian government. This allows policyholders to choose between modern medicine and traditional treatments, depending on their preferences. Moreover, the policy covers modern procedures such as robotic surgeries and balloon sinuplasty, providing access to advanced medical technologies.

Key Benefits of Arogya Sanjeevani Policy:

The Arogya Sanjeevani Policy is designed with simplicity and affordability in mind. Here are some of its key Arogya Sanjeevani Policy benefits.

• Lifelong Renewability: The policy comes with the option of lifelong renewability, allowing policyholders to continue their coverage without any age restrictions.
• No Claim Bonus: For each claim-free year, the policyholder’s sum insured increases by 5%, up to a maximum of 50% of the sum insured. This rewards policyholders for maintaining good health and not needing to make any claims.
• Affordable Premiums: Compared to other health insurance plans in the market, the Arogya Sanjeevani Policy offers relatively lower premiums, making it accessible to a wider population.
• Family Floater Option: With the family floater plan, you can cover your entire family, ensuring everyone gets the health coverage they need under a single policy.
• Wide Range of Coverage: From pre-hospitalisation to post-hospitalisation, modern treatments to alternative therapies, the policy covers an extensive range of medical needs, making it a comprehensive solution for individuals and families alike.

What are the Exclusions of the Arogya Sanjeevani Policy:

While the Arogya Sanjeevani Policy offers extensive coverage, it does have certain exclusions. These include the following: The policy does not cover expenses for diagnostic tests unless they result in hospitalisation or treatment. Treatments related to obesity, weight control, and bariatric surgery are excluded from the policy. Cosmetic procedures not required due to accidents or illness are not covered. The policy does not provide coverage for maternity-related expenses, including childbirth. Treatments for alcohol or drug addiction, as well as self-inflicted injuries, are not covered.

Check Your Eligibility For Arogya Sanjeevani Policy:

To be eligible for the Arogya Sanjeevani Policy, the individual must be between 18 and 65 years of age. For family floater plans, dependent children between 3 months and 25 years are covered. The policy also allows coverage for parents and parents-in-law, making it a comprehensive option for families. Children over 18 years old who are financially independent are ineligible for the family floater plan and would require individual coverage. Policyholders also benefit from a rural discount, which makes the policy more affordable for people living in rural areas.

Arogya Sanjeevani Policy Renewal:

Renewing the Arogya Sanjeevani Policy is a simple process and can be done online. Policyholders can renew their policy annually, and the insurance provider typically sends reminders before the renewal date. It is crucial to renew the policy on time to avoid any lapse in coverage. The policy also has a grace period of 30 days, during which the policyholder can still renew without losing coverage. In terms of cost, the renewal premium is determined by the sum insured, the age of the policyholder, and the number of dependents covered under the plan. Policyholders can choose to pay the premium annually, half-yearly, or quarterly, offering flexibility in managing finances.

FAQs:

How to Buy Arogya Sanjeevani Policy?

Purchasing the Arogya Sanjeevani Policy is easy. You can buy the policy online from the insurer’s website or through an agent. You'll receive a premium quote after providing basic details like age, sum insured, and family members to be covered. Once the payment is made, the policy is issued instantly, and the policyholder receives the documents via email.

What is the Policy Tenure of Arogya Sanjeevani Policy?

The policy tenure for Arogya Sanjeevani is one year. Policyholders must renew the policy annually to continue coverage.

What are Sum Insured in Arogya Sanjeevani Policy?

The Arogya Sanjeevani Policy offers sum insured options ranging from Rs. 50,000 to Rs. 10 lakhs. Policyholders can choose a sum insured that fits their healthcare needs and budget.