This Health Plan Has It All: Arogya Sanjeevani Health Policy

The health insurance industry has developed by leaps and bounds in the last two decades. Earlier, people were less than enthused about the idea of buying insurance for themselves or their families. But there were others who saw the merit in buying health insurance plans in India to offset the rising costs of healthcare and modern treatments.

Today, there are comprehensive health insurance plans in India that offer a range of benefits to the policy holder. But you can also buy additional policies to enhance the overall coverage, one of them being the Arogya Sanjeevani Policy.

What is the Arogya Sanjeevani Policy?

It is a standard health insurance plan offered by all recognised health insurance providers in India. For the uninitiated, it is a universal health insurance plan in India which has the same outlook, benefits and features no matter which insurance provider you buy it from.

The plan has one of the most affordable premiums in Indian health insurance today. Also, it is possible to add the Arogya Sanjeevani policy coverage to your existing health insurance to enhance the overall coverage available to you. This is possible with both individual and family health plans. It has various sub-limits and co-payment clauses included at a nominal premium. When first floated, the policy had a maximum sum assured of Rs 5 lakh. As of May 2021, this limit has now been extended to Rs 10 lakh.

Thus, if you don’t have a super top up health plan and are worried about exhausting the entire sum assured on your health insurance in one year (following multiple hospitalisations for one or more family members) then you can choose to buy the Arogya Sanjeevani health plan as an added coverage.

Important facts about the plan

• Entry and maximum ages: The minimum entry age to buy this policy is 18 years, and maximum age is 65 years. You must be an Indian national resident in India to buy the plan. You may cover dependent children up to the age of 25 years, but not if they are majors and having their own source of income. The policy has a term of one year but is renewable every year.
• Coverage terms: This policy offers hospitalisation cover for 30 days before the date of admission to hospital, and 60 days from discharge. As mentioned above, the maximum sum assured in the plan is Rs 10 lakh.
• Treatments covered: The plan covers all day care treatments. These include any surgical or medical procedures performed under anaesthesia (local or general) in a hospital or clinic OT and which lasts less than 24 hours due to technology and which in the absence of that technology, would have resulted in hospitalisation over 24 hours. The doctor must certify this before you file the claim. Do note that OPD (Out Patient Department) consultation and treatment is not included in the coverage.
• Sub-limit clauses: There are sub-limits in the Arogya Sanjeevani policy that you should know about. In terms of room rent, the sub-limit is 2% of the total sum assured or maximum of Rs 5,000 per day. If admitted to ICU, the sub-limit is 5% of the sum assured or maximum Rs 10,000 per day. As far as ambulance charges go, the policy caps the costs at Rs 2,000 per hospitalisation. Further, the sub-limits on treatment costs for ‘simpler’ procedures like cataract surgery, for example, are up to 25% of the sum assured or maximum of Rs 40,000. The limits for complicated surgeries is 50% of the sum assured. There is a co-payment limit of 5% on the claim amount admissible under the policy.
• Bonuses: Under the terms of the policy, the sum assured but not the cumulative bonus, are increased by 5% for every No-Claim year, as long as the plan is renewed on or before due date every year without a break. The bonus is subject to 50% of the sum assured. The cumulative bonus is reduced if you claim in any year, at the same rate that it was previously accrued.

Premium payments: You can pay the policy premiums on annual, half-yearly, quarterly or monthly basis.

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