Arogya Sanjeevani health insurance policy has been introduced by IRDIA. This is a uniform health insurance policy which means the features and the benefits provided under this policy will remain the same no matter who is your insurance company.

Choosing the right Health Insurance policy is a mammoth task. You come across multiple options offering more or less the same benefits. All of these companies have different features. So it’s become difficult for the common man to choose the health insurance policy.

Most of us are getting confused between the available policies and we tend to follow our family or friend’s choice. Insurance is a personal thing and cannot be imitated. So you should choose the policy which is best suitable for your needs.

To help you, IRDIA has introduced a standard health insurance policy named “Arogya Sanjeevani”. The features and benefits will remain the same across the insurance providers.

Features of Arogya Sanjeevani Health Insurance Policy

Let’s have a look at the standard features and benefits of the Arogya Sanjeevani health insurance policy.

  • The minimum age for buying this policy is 18 years
  • The maximum age for buying this policy is 65 years
  • This policy is available as an individual as well as family floater
  • Here family = spouse, father, mother, parents in law and child up to an age of 18 years
  • The policy will be available from the 1st of April 2020 through most of the leading insurance provider companies.
  • The sum assured under this policy is from 1 lakh to 5 lakh at the max
  • The validity of the policy is life long. You just have to renew the policy every year the same as you do for other policies.
  • The policy does not offer any rider like critical illness etc
  • You can get the cashless benefit under this policy
  • Available premium payment options are monthly, quarterly, half-yearly or yearly
  • A waiting period of 30 days is applicable
  • Most of the illness has only one year of the waiting period
  • A fix 5% of co-payment clause is applicable irrespective of the age
  • You will get a ₹. 2000 as an ambulance charges
  • This plan offers 30 days pre-hospitalization and 60 days post hospitalization coverage.
  • Sub limit is applicable as 2% of the total sum assured or a maximum of ₹. 5000 per day for room and nursing expense
  • No claim bonus is 5% for each year up to 50% of the sum assured
  • If you cancel this policy within 30 days, you will get 75% of the premium amount back
  • The policy offers the portability option to other health insurance companies
  • For a yearly premium payment, 30 days grace period is allowed and for other modes of premium payment 15 days grace period is allowed

Drawbacks of Arogya Sanjeevani Insurance Policy

  • Maternity treatment expenses are excluded from the policy
  • The maximum sum assured is capped at ₹ 5 lakhs only
  • Sub limit on room rent
  • 5% co-payment terms are applicable (you have to pay 5% of the total expense)
  • Children above 18 years are not included in a family floater plan
  • There are no riders available in this plan (plain-vanilla health insurance policy)

Read Also: Best Term Insurance Policy

FAQs of Arogya Sanjeevni Policy

What is the age limit of purchasing the Arogya Sanjeevani policy?

The maximum age limit of purchasing the Arogya sanjeevani policy is 65 years.

What is the validity of the policy?

The policy comes with lifetime validity, you just have to renew the policy by paying the applicable premium every year.

What are the riders available on the policy?

There are no riders available for this policy. It’s a plain vanilla insurance policy.

What is the waiting period applicable?

There are 2 types of waiting periods, 24 months and 48 months.
Most of the illness has only 24 months of the waiting period, but two of them have 48 months of the waiting period.

Are pre and post hospitalization expenses covered?

30 days Pre Hospitalization & 60 days Post Hospitalization expenses are covered.

Is cashless benefit available for this policy?

Yes, the cashless benefit is available for this policy.

What are the premium payment options available?

Premiums can be paid on a monthly, quarterly, half-yearly and on a yearly basis. It will be a 1 yr policy renewable each year.

Is Arogya Sanjeevani policy is portable to other insurance company?

Yes, the policy offers the portability option to other health insurance companies.

Is the Ayush treatment covered under this policy?

Yes, it’s Available.
AYUSH means all treatments related to:

Yoga & Naturopathy

Are there any no claim bonus available under this policy?

No Claim Bonus of 5% for each year up to 50% of the sum assured is covered.

Can I get a refund of the premium if I cancel the policy?

The refund policy is as below.
If you cancel within 30 days, you will get 75% premiums back
If you cancel from 31 to 90 days, then you get 50% premiums back
If you cancel between 3 months to 6 months, then you get 25% premiums back
After 6 months, you get NO refund

When the policy will be available?

The policy will be available from 1st April 2020 through leading insurance companies.

Are there any sub-limits applicable?

For hospitalization expenses like room, boarding, nursing expenses up to 2% of Sum Assured or a maximum of Rs.5,000 per day.
ICU/ICCU expenses will also be provided up to 5% of sum assured or a maximum of Rs.10,000 per day.
Sub-limits of cataract surgery are equal to actual expenses i.e. 25% sum assured or Rs 4 lakhs, whichever is lower.

Are daycare treatment covered under this policy?

yes, all daycare treatments are covered under this policy.

Is the premium differ from city to city?

No, the premium will be the same across India.

What is the policy premium for Arogya Sanjeevani?

Individual policies could start at ₹5,000, whereas those for family floater plans could start at ₹15,000.

Arogya Sanjeevani – Policy Review

The main funda of introducing Arogya Sanjeevani insurance policy is its uniformity across the insurance company. Thus making it simpler for the layman like you and me. You just need to understand the policy thoroughly and then you can buy it from any insurance company. The features and benefits will remain the same.

The only difference is the premium amount decided by the insurance company. So you will have to find the lowest premium provider insurance company.

As I mentioned above, there are few drawbacks to the policy. It offers only 5 lakhs of sum assured, which is I think not enough looking at the medical expenses shooting through the roof. Who among us wants to pay 5% co-payment where there are policies available with full coverage. Another main drawback is the non-coverage of maternity treatment expenses. If you are planning for the family floater policy, then this expense must be covered. But here it is not covered.

Sub-limit on the room rent and ICU and ICCU is another thing you need to keep in mind before taking this policy.

None the less, there are few good points of the policy as well, which makes this policy among the best ones.

Same features and same premium amount across the country is a best thing one can get in the policy.

So if you are a first-time buyer or cannot afford to pay the higher premium, you should try this policy. It is a budgeted health insurance policy for middle to lower-middle-class segments in India.

Let the premium amount finalized by the insurance company and then only take the decision after comparing it with the existing health insurance policy.


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