Arogya Sanjeevani Health Insurance Policy & Its Benefits

The Insurance Regulatory and Development Authority of India (IRDAI) has recently mandated 29 health insurance providers to offer a standardized health insurance policy that can take care of the basic healthcare needs of policyholders.This welcome move was announced with the goal to provide standardized health insurance to entire families, especially those in the lower-middle income groups. All general and health insurance providers in India are now required to offer a standard health insurance policy which will be called the Arogya Sanjeevani Policy, with coverage ranging from Rs. 1 Lakh to rs. 5 Lakh.Read on to find out about the features and benefits of the Arogya Sanjeevani Insurance.

All general and health insurance providers in India will now offer a standalone insurance product called the Arogya Sanjeevani Policy which will have an insured sum of Rs. 1 Lakh to Rs. 5 Lakh. The policy will be available from 1st April 2020 via all insurance providers across India. Insurers must offer the standard policy with the given name only, followed by their own company name, for eg. Arogya Sanjeevani Policy, Aditya Birla Health Insurance.The policy is aimed at providing affordable health insurance with basic mandatory coverage as specified by the guidelines issued by the IRDAI. The policy will have exactly the same features no matter which insurance provider is providing it, and it cannot be modified or combined with any other product.

As per the terms of the IRDAI, the Arogya Sanjeevani Policy offers basic indemnity based health insurance to policyholders. Let us take a look at the features and benefits of the standard health insurance.

Arogya Sanjeevani Health Insurance Premium:

The premium for standard insurance can be paid either in its entirety every year, or in monthly, half-yearly or quarterly installments.

Sum Insured In Arogya Sanjeevani Policy:

The sum insured in the standard health insurance policy can be a minimum of Rs. 1 lakh and a maximum of Rs. 5 lakh. Anything in between shall be in multiple of Rs. 50,000. Both individual plans that will cover one person, as well as floater plans that cover the entire family, will be available.

Policy Period

The tenure of the Arogya Sanjeevani Policy shall be for one year, and has to be renewed every year for the policyholder to claim its benefits.

Low Co-payment Option

The standard health insurance policy allows for a low co-payment of just 5%, which means the policyholder will have to pay a maximum of 5% of the total claimed amount, while the rest will be paid by the insurer.

Free Look Period

A Free Look Period of 15 days is available when you buy a standard health insurance. Within this period, you can review the terms and conditions of the policy and cancel it without facing any penalty charges.

Cumulative No-Claim Bonus

If you do not claim your policy in a year, a cumulative no-claim bonus of 5% of the total sum insured will be added to your coverage.

Renewability

Policyholders can renew the standard policy for their entire lifetime.

Available both as an individual policy and a family floater plan

Depending on the requirement, one can choose to buy an individual policy or a family floater plan.

Sub-limits

In the Arogya Insurance Policy, there are some sub limits or caps for certain expenses. They’re as follows:Room rent, boarding and nursing: 2% of insured sum, upto a maximum of Rs. 5000 per dayICU & ICCU charges: 5% or sum insured, maximum of Rs. 10,000 per dayCataract surgery: 25% of insured sum or Rs. 40,000, whichever is lower.

AYUSH Treatment

Unlike most other insurance policies, the standard health insurance will also provide coverage for alternative medicinal treatment like Ayurveda, Homeopathy, Unani and Siddha.

Waiting periods in Arogya Sanjeevani Policy

The Arogya Sanjeevani Policy has a waiting period for certain diseases and treatments.The waiting periods are:

24 months

Diseases related to sinuses, ENT disorders, cataract surgery, spinal diseases (except due to accidents), gastric ulcer, rheumatism, age related eye illness, non-infective arthritis, cysts, tympanoplasty, mastoidectomy and gout.

48 months

Age related osteoarthritis and osteoporosis and joint replacement surgery (except due to accidents)

Pre and post-hospitalization expenses

The Arogya Sanjeevani Policy covers expenses incurred 30 days prior hospitalization as well as upto 60 days after discharge from the hospital.

Arogya Sanjeevani Policy Eligibility:

Minimum Age: Adult 18 YearsChildren 3 MonthsMaximum Age: Adult 65 YearsChildren 25 YearsRenewability: Lifetime

Minimum and maximum Sum Insured

Under the Arogya Sanjeevani Standard Health Insurance policy, insured persons can choose from plans with a minimum insured sum of Rs. 1 lakh and a maximum of Rs. 5 lakh. Anything in between can be in multiples of Rs. 50,000.

Arogya Sanjeevani Health Insurance Availability

The standard health insurance policy will be available with all insurance providers in India from 1st April, 2020. It will be called the “Arogya Sanjeevani Policy”, followed by the insurance provider's name.

The premium rates for the standard health insurance will vary slightly from insurer to insurer. The premium rates are not fixed by the IRDAI, hence it may be necessary to contact the insurance providers directly to find out their rates.

Since the government has mandated all insurance providers in India to offer the Arogya Sanjeevani Policy, you can buy the policy from any general and health insurance provider across India.