All you need to know about the Arogya Sanjeevani plan

A standardized health insurance policy, Arogya Sanjeevani is an attempt to make health insurance affordable and accessible for all by IRDAI.

The Insurance Regulatory and Development Authority of India (IRDAI) seeks to make the insurance industry more competitive and relevant to changing consumer needs and preferences. To simplify the comparison process and allow essential coverage benefits to policyholders, the IRDAI introduced the concept of standardization in insurance. 

Under the concept of standardization, a list of life and health insurance plans was launched, and they directed all the insurance companies to offer standardized insurance plans to their customers. The USP of standardized insurance plans is the same benefit structure no matter which insurance company offers the policy. However, insurance companies are allowed the flexibility to charge the premiums as per their pricing policy in terms of premiums. So, while the standardized insurance plan would have the same scope of coverage, its premiums would differ depending on the insurer’s pricing policies.

Standardized health insurance plan–Arogya Sanjeevani

On 1st April 2020, the IRDAI launched the standardized health insurance policy, Arogya Sanjeevani. The purpose of introducing the policy-making health insurance is affordable and accessible by all!

After its launch, IRDAI allows insurance companies to offer Arogya Sanjeevani to their customers from July 2020. Today, the policy has become a popular choice among individuals looking for a basic health insurance plan for their entire family.

What does Arogya Sanjeevani offer?

Here are some of the salient features of the Arogya Sanjeevani policy offered by insurance companies –

  1. Eligibility terms

The Arogya Sanjeevani policy is available both on an individual and on a family floater basis. You can cover yourself, your spouse, dependent children, dependent parents, and your parents-in-law under the plan. The minimum and maximum entry ages are 18 and 65 years, and it covers dependent children from 91 days to 25 years. 

The sum insured allowed starts from Rs.50,000, and it can go up to Rs.10 lakhs depending on the insurance company you choose. The policy tenure is one year, and you can avail of lifelong coverage.

  1. Comprehensive scope of coverage

Arogya Sanjeevani allows a good scope of coverage to you and your family as it covers the following benefits –

  • Inpatient hospitalisation
  • Advanced medical treatments
  • AYUSH treatments
  • Pre and post hospitalization costs
  • Daycare procedures
  • Cataract 
  • Ambulance costs
  1. Other benefits

If you don’t make claims in a policy year, you can earn a no claim bonus of 5%, wherein the sum insured increases by 5% with no increase in the premium. You can enjoy this bonus cumulatively for every successive claim-free year up to a maximum of 50%.

Things to look out for

Here are some essential conditions of the coverage that you should know about –

  1. There are sub-limits on room rent and ICU room rent. These limits are as follows –
    1. Room rent–up to 2% of the sum insured subject to a maximum of Rs.5000/day
    2. ICU room rent–up to 5% of the sum insured subject to a maximum of Rs.10,000/day
  2. Listed modern and advanced medical treatments are covered for up to 50% of the sum insured
  3. Limits on cataract treatment are up to 25% of the sum insured subject to a maximum of Rs.40,000 per eye
  4. Pre-existing conditions coverage kicks in after a waiting period of 48 months
  5. There is a compulsory co-payment of 5% on every claim that you make under the policy
  6. Pre-entrance health check-ups might be needed depending on your age

Arogya Sanjeevani policy – What’s in it for you?

The Arogya Sanjeevani policy offers affordable health insurance coverage that includes all the basic coverage benefits. So, if you are not insured under an independent health insurance policy of your own, you can opt for this plan if affordability is an issue. In addition, you can insure all your family members and enjoy decent coverage against medical emergencies. 

One of the main benefits of this standardized health insurance policy is that you can easily compare it against other insurers. Since the coverage benefits are uniform, you can simply compare the premium rates and choose an insurer that offers the most affordable coverage. Moreover, there are no hidden clauses except for the ones mentioned earlier, and you can avail of suitable coverage without burning your pockets. In addition, the facility of instalment premiums makes the plan even more affordable.

So, understand what the Arogya Sanjeevani policy is all about, and then invest in one if it fulfils your coverage needs. 

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