WHAT IS AROGYA SANJEEVANI POLICY YOJANA

The Government of India has introduced various policy, or "yojanas," aiming at a wide range of socio-economic development. One such initiative making significant strides in enhancing healthcare accessibility and affordability is the Arogya Sanjeevani policy. These governmental schemes will improve the lives of millions across the nation. On 1st April 2020, the IRDAI announced the top health insurance plan named the "Arogya Sanjeevani Policy," offering it to all premium Health Insurance Companies in India. Now, the Insurance Regulatory and Development Authority of India (IRDAI) has sanctioned all health insurance companies to include this yojana in the basic and standard health insurance plans for individuals and families.

What is Arogya Sanjeevani Policy?

Arogya Sanjeevani Policy yojna is a primary health insurance policy that provides coverage to suitable ages up to Rs. 5 Lakhs for medical/hospitalization expenses like ICU bed, medical consultation charge of doctor or Nursing charges, medicine which consuimg during hospital admission days. Additionally, it offers full coverage for pre- and post-hospitalization expenses.  protects you and your family through both individual health insurance and family insurance. Arogya Sanjeevani Health Insurance aims to alleviate your financial burden during any medical emergency.

How many Plans come under the Arogya Sanjeevani Insurance Policy?

There are two types of Arogya Sanjeevani Health Insurance:

1. Individual Plan:

This Plan will be beneficial for only 1 insurer.

2. Family Floater Plan:

Under this Arogya Sanjeevani Health Insurance plan will be beneficial for all the insured family members. It includes dependents as well such as children, parents & Parents in-laws, and spouses in a single-family floater policy under 3 month to 25 years age is cover. The person's age should between 18 to 65 years. 

Key features of the Arogya Sanjeevani Policy:

Arogya Sanjeevani policy offers the following benefits to insurer. 

• Standard Coverage:

The policy offers standardized coverage across all insurers from basic to top hospitals, ensuring consistency in benefits and terms. Additionally, Arogya Sanjeevani policy pays up to 5% charges of the ICU or ICCU treatment.

• Affordable Premiums:

Arogya Sanjeevani Policy aims to make health insurance more accessible and worthwhile by offering coverage at affordable premiums.

• Alternative Insurance Benefits:

Arogya Sanjeevani Health Policy provides coverage for approved hospitals with alternative medical treatments such as Ayurveda, homeopathy, and Siddha.

• Comprehensive Coverage:

The policy provides coverage for hospitalization expenses, including room rent, doctor's fees, medical tests, surgeries, and other related expenses.

• No Co-payment:

The policy does not require the policyholder to pay a percentage of the claim amount (co-payment) at the time of claim settlement.

• No Room Rent Capping:

Unlike some other health insurance policies, Arogya Sanjeevani Policy does not impose any capping on room rent charges during hospitalization. Arogya Sanjeevani health Insurance Policy covers the room rent up to Rs. 5000/- per day.

• Pre and Post-Hospitalization:

The policy covers pre- and post-hospitalization expenses for a specified period, ensuring comprehensive coverage for medical treatment. It covers the medical emergencies of illness, accidental injury plus Coronavirus (COVID-19)

• Family Floater Option:

Policyholders have the option to include their family members under a single policy through a family floater plan, providing coverage for the entire family.

• Tax Benefits:

Premiums paid towards the Arogya Sanjeevani Policy are eligible for tax deductions under Section 80D of the Income Tax Act, offering additional financial benefits.

• Cataract Surgery:

The cost basis of cataract surgery for each eye is set up to Rs. 40,000/- or 25% of the total sum insured amount in this Arogya Health policy.

• Modern medical surgeries and treatment :

Arogya Sanjeevani policy covers more expenses related to cancer treatment, including chemotherapy, robotic surgery, and major treatments like sinuplaty or themoplasty and Intra Vitreal injections with up to 50% of the sum insured being covered.

 

Exclusions of Arogya Sanjeevani Policy:

1. Pre-existing Conditions:

Arogya Sanjeevani Policy may exclude coverage for pre-existing medical conditions such as Diagnostics or investigative tests. These are health issues that existed before purchasing the policy.

2. Cosmetic Treatments:

Cosmetic procedures or treatments, such as plastic surgery for aesthetic purposes, are typically not covered under the Arogya Sanjeevani Policy.

3. Alternative Therapies:

Some alternative therapies, such as acupuncture, naturopathy, or homeopathy, may not be covered by the policy. Coverage for these therapies may vary depending on the insurer and the specific policy terms.

4. Specific Medical Conditions:

Certain medical conditions or treatments like infertility treatments, and weight loss procedures are excluded from coverage under the Arogya Sanjeevani Policy.

 

Eligibility Criteria for Arogya Sanjeevani Policy:

Below are the eligiility criteria  of Arogya Sanjeevani Policy are mentioned.

1. The Arogya Sanjeevani Policy has a minimum of 18 and maximum 65-year age limits for eligibility.
2. Applicants may be required to disclose their medical history, including pre-existing conditions, during the application process. Insurers use this information to assess the applicant's risk profile and determine eligibility.
3. The policy may be available only to residents of India. Applicants may need to provide proof of residency, such as a valid address proof, to qualify for coverage under the Arogya Sanjeevani Policy.

 

Arogya Sanjeevani Policy Renewal:

1. Renewal Process:

Policyholders can renew their Arogya Sanjeevani Policy upon its expiry by paying the renewal premium before the due date.

2. Continuous Coverage:

It's essential to renew the policy before the expiry date to avoid a lapse in coverage.

3. Benefits of Renewal:

Renewing the Arogya Sanjeevani Policy allows policyholders to retain their existing coverage benefits and continue enjoying the security of health insurance.

 

Refund of Arogya Sanjeevani Policy Premium:

1. All insurers of the Arogya Sanjeevani Policy offer a 15-day free cancellation period where a policyholder can cancel their insurance within that 15 days without cancellation charges.
2. Additionally, policyholders can cancel his/her policy by writing a cancellation note to the Arogya Sanjeevani Policy provider.
3. The paid premiums will be refunded after cancellation by deducting the incurred expenses. The refund percentage may decrease as the policy term progresses.

• Up to 30 days: 75% refund
• 31 days to 90 days: 50% refund
• 3 months to 6 months: 25% refund
• 6 to 12 months: 0% refund

 

How to Buy Arogya Sanjeevani Policy:

Step 1:

Arogya Sanjeevani Policies can be purchased online through insurers' websites or offline through insurance agents or branches. Online health inurance platforms offer the convenience of comparing policies and purchasing them digitally.

Step 2:

You can compare the insurance quotes using Arogya Sanjeevani Policy. Compare coverage options, premiums, exclusions, and additional benefits Calculate everything on Arogya Sanjeevani Policy Premium Calculator.

Step 3:

Fill out the application and provide accurate personal information, disclose any pre-existing conditions, and choose the desired coverage options.

Step 4:

Pay the premium for the selected Arogya Sanjeevani Policy. Premiums can usually be paid online using various payment methods, including debit/credit cards, net banking, or mobile wallets.

Step 5:

Once the application and premium payment are processed, the insurer will issue the Arogya Sanjeevani Policy document.

Note: Review the policy terms and conditions carefully to understand the coverage, exclusions, and renewal procedures.

Arogya Sanjeevani Policy Refund and Cancelation Process 

Aarogya Sanjeevani Yojana offers a 15-day free look period, in which policyholders can cancel the policy without any cancellation charges and get their money back if no claim has been made. Even after the free look period, policy holders can cancel the policy, but for this they have to give 15 days prior written notice to the insurance company.

 

Conclusion:

If you are seeking the ideal policy that offers comprehensive coverage and benefits for individuals of all ages, then the Arogya Sanjeevani Health Policy is the perfect choice. It provides standardized coverage for hospitalization expenses, including room rent, doctor's fees, medical tests, surgeries, and related costs. Additionally, pre and post-hospitalization expenses are covered for a specified period, ensuring thorough coverage for medical treatment. Buy your Health Insurance today!

Compare and secure lower premiums, ensuring continuous coverage for you and your family throughout your lives with us.

 

FAQs

Q1. Who is eligible for the Arogya Sanjeevani Policy?

Ans: Individuals between the ages of 18 to 65 (or as specified by the insurer) are typically eligible for the Arogya Sanjeevani Policy. It is available to Indian residents and offers coverage for self, spouse, dependent children, and parents.

Q2. Are there any age-wise benefits under the Arogya Sanjeevani Policy?

Ans: Premiums and coverage may vary based on the age of the insured. Younger individuals may benefit from lower premiums, while older individuals may see slight increases due to age-related health risks.

Q3. Are there any tax benefits associated with the Arogya Sanjeevani Policy?

Ans: Premiums paid towards the Arogya Sanjeevani Policy are eligible for tax deductions under Section 80D of the Income Tax Act, providing additional financial benefits to policyholders.

Q4. What should I do if I need to file a claim under the Arogya Sanjeevani Policy?

Ans: Policyholders can file a claim by contacting their insurance company or agent and providing the necessary documentation, such as medical bills and reports. The insurer will then assess the claim and process it accordingly.

Q5. Does Arogya Sanjeevani Policy cover  treatment  taken outside the country?

Ans: No, outide country treatment is excluded from this policy.

Q6.  Does sbi arogya sanjeevani policy covers AYUSH treatment ?

Ans: Yes, the SBI Arogya Sanjeevani Health Insurance covers Ayurveda, Unani, Naturopathy, Siddha, and Homeopathy treatments.

Last Updated : 09-10-2024