Arogya Sanjeevani Health Insurance Policy
Arogya Sanjeevani policy is a new, standard health insurance policy formulated by the IRDAI and will be offered by all health insurance companies in India starting from 1st April 2020 onwards. The name of the policy will be ‘Arogya Sanjeevani Policy – Insurance company name’.
The coverage and terms & conditions of this policy are universal for all twenty-nine health insurance companies. The buyer has the choice to purchase this policy from any insurer. However, the premium rates and customer service can vary from one insurance company to another. It is suitable for lower and middle-income group families who have no health insurance policy.
Some features of the Policy are as under:
| Feature | Terms and Conditions |
| Sum Assured | The minimum sum assured is Rs 1 Lac and maximum sum assured is Rs 5 Lacs (in the multiple of 50,000) |
| Premium Payment Frequency | Premiums can be paid on a monthly, quarterly, half-yearly, and on yearly basis. It will be a 1 yr policy renewable each year |
| Cashless Benefit | Yes, there is a cashless benefit under this policy |
| Renewability | Lifetime renewability is available in this policy. |
| Minimum & Maximum Age | The minimum entry age for the principal insured is 18 years and the maximum entry age is 65 years. |
| Waiting Period | 30 days of the waiting period. Hence no claim will be paid in the first 30 days after buying a policy |
| Co-payment | A fixed copay for 5% is applicable for all ages in this policy. |
| Portability | Yes, the policy offers the portability option to other health insurance companies |
| Ambulance Charges | Max Rs. 2000 per hospitalization |
| Pre & Post Hospitalization | 30 days Pre Hospitalization & 60 days Post Hospitalization expenses |
| Ayush Benefit | The medical expenses for in-patient treatment taken under Ayurveda, Unani, Siddha, and homeopathy are covered without sub-limits. |
| Day Care Procedures | Medical expenses incurred for daycare procedures taken at a hospital or daycare center. 24-hour mandatory hospitalization is not necessary for the daycare procedure. |
| NCB (No Claim Bonus) | NCB (No Claim Bonus) of 5% for each year up to 50% of the sum assured is covered. |
| Waiting Periods | There are 2 types of waiting periods, 24 months, and 48 months. Most of the illness have only 24 months of the waiting period, but two of them have 48 months of the waiting period |
| Riders | Not Available |
| Sub Limits | For hospitalization expenses like room, boarding, nursing expenses up to 2% of Sum Assured, or a maximum of Rs.5,000 per day. |
| Sub Limits | ICU/ICCU expenses will also be provided up to 5% of sum assured or a maximum of Rs.10,000 per day. |
| Sub Limits | Cataract treatment is covered op to 25% of Sum insured or Rs.40,000/-, whichever is lower, per eye, under one policy year |
| Main Exclusions | Maternity treatment expenses, treatments related to weight loss, change of gender, plastic surgery, hazardous adventure sports, breach of law, or due to war, etc are excluded from the policy. |
Sample Premium Chart for Sum Assured Rs 5 lakhs (Inclusive GST)
| Company | Individual (Age 30 years) | Family Floater (Age 40 yrs) (2+2) |
| Max Bupa | 4,722 | 11,998 |
| SBI General | 5,311 | 15,173 |
| Religare Health | 6,013 | 16,865 |
three comments
Very useful article!
Good information at the right time
Very very useful Article!