Arogya Sanjeevani Insurance Policy: Know Eligibility, Sum Insured and Other Details
- The plan covers all pre and post hospitalization costs
- Ambulance costs with a maximum ceiling of Rs 2,000 per hospitalization are included in the policy.
- ICU / ICCU fees are covered up to 5% of the maximum SI up to Rs 10,000 per day
New Delhi: The Insurance Regulatory and Development Authority of India (IRDAI) on April 1 launched the Arogya Sanjeevani, a standard health insurance policy for individuals and families. The regulator has mandated all insurance companies to offer this policy which covers up to Rs 5 lakh for basic expenses related to hospitalization.
The IRDAI website said: âIn the context of the COVID 19 pandemic outbreak, it is clear to the public that compensation-based health insurance products that cover the costs of treating hospitalization offered by all general and health insurance companies cover the costs of hospitalization treatment due to COVID -19. All insurers have been notified by the circular of the Authority of March 30, 2020 to insurers to accelerate the settlement of COVID 19 claims.
The authority had issued guidelines on the standard health insurance policy called Arogya Sanjeevani and had authorized 29 general and health insurance companies to market this product. Those interested can benefit from this standard health insurance policy by contacting listed insurance companies.
List of insurers authorized to market this product:
Note that although the coverage and terms and conditions of this policy are universal for all insurers, the purchaser has the option of purchasing this policy from any insurer. However, premium rates and customer service may vary from insurer to insurer.
Characteristics of Arogya Sanjeevani’s health policy:
- It offers a standardized product that covers the basic hospitalization needs of clients.
- This policy comes with a minimum sum insured of Rs 1 lakh and a maximum of Rs 5 lakh.
- These are available for individuals and families.
- The minimum and maximum entry age is 18 and 65 years old. For children under the âFamily Floaterâ policies, the entry age is 3 months and the exit is 25 years.
- This policy is renewable annually with a grace period of 30 days.
- A 5 percent co-payment is applicable at all ages, which means that the policyholder is obligated to pay 5 percent of the invoice amount.
- No add-ons or optional coverage is available in the Arogya Sanjeevani policy.
What is covered in this policy:
- All pre and post hospitalization costs, which could arise due to illness or accident. Treatment and hospitalization for Covid-19 too.
- Alternative treatments performed as a non-eligible hospital for inpatients.
- The room rent covered up to 2% of the SI maximum up to Rs 5,000 per day.
- The ICU / ICCU fees covered up to 5% of the SI maximum up to Rs 10,000 per day.
- Ambulance costs with a maximum ceiling of Rs 2,000 per hospitalization included.
- Plastic surgery or dental treatment made necessary because of injury or illness.
- For expenses incurred for the treatment of cataracts for each eye, policyholders can benefit from coverage of up to Rs 40,000 or 25% of the total sum insured, whichever is lower.
- Modern treatments including balloon sinuplasty, immunotherapy and stem cell therapy, among many other treatments, are covered up to 50% of the total sum insured.
According to most financial experts, this insurance policy is a good entry-level product. However, some experts believe that the insurance coverage of Rs 5 lakh is not enough to cover a family of four. One of the advantages of this policy is that it is relatively cheaper.