All you need to know about Arogya Sanjeevani Policy
2020 was the year that the world would remember for many years to come. It showed the world the difficult path and explained the true meaning of ‘survival of the fittest.’
There were very few things about the year 2020 that made us happy or gave us peace of mind. Two things that gave people little ease were buying a health insurance plan or term life insurance plan. Health plans helped people secure their loved ones against unexpected hospitalization expenses, and term life insurance secured them against unforeseen eventuality.
It is interesting to know that India’s health insurance penetration rate was just about 26 percent in Fy’18, and the projection is that it will reach around 30 percent by Fy’2025 and 32 percent by 2030. (Source: https://www.statista.com/). There is still a very high percentage of Indians who either do not prefer to spend on health insurance or ignore this product due to its complexities. However, the year 2020 year has made many of us aware that how untoward situations can knock on the door, and we should do whatever best we can to keep the problem under control. Therefore, you must keep some funds aside to contribute to your health insurance plans so that your family is always secured against hospital expenses.
Insurance Regulatory and Development Authority of India (IRDAI) recently has taken various steps to ensure ease of buying health insurance policies. Arogya Sanjeevani Health Insurance Policy is just one example of IRDAI intervention. It proves that the regulator wants to break the products’ complexities into standardisation and wants more and more people to invest in their security.
However, ongoing effort is required to make products and the insurance buying process more user-friendly and affordable. Recently IRDAI announced that it would be mandatory for all health care partners to offer monthly payment options. The annual premium amount is one of the biggest deterrents for health care policies, and the monthly payment option helps overcome this challenge for potential buyers. The monthly payment option is still not available with many insurance providers and would need a further nudge from the regulator for the proper execution of the plan.
This post will cover how health insurance can make a little difference in people’s lives. We will go through all features, exclusions, inclusions of Arogya Sanjeevani policy for better understanding and decision making. Difficult times are still prevailing; this post is a good read for people who have already invested in a health plan and others who plan to invest. Let us start with the essentials understanding first.
What Is a Health Insurance Policy?
A health insurance policy assures you against unexpected hospitalisation expenses. A health insurance policy covers hospital expenses, pre- and post-hospitalisation, and some policies that even cover OPD charges based on the plan you choose. These plans come with variants, and you can choose to buy an individual or a family floater policy. You can also get covered by default if you work for a company invested in a group policy. Many health insurance policies cover major critical illnesses like cancer or even significant surgeries. Therefore, you must go through the policy details carefully before investing in it. Generally, health insurance policy comes with a waiting period, and post the waiting period; many critical illnesses get covered. Since you invest money and time in the waiting period to ensure you get complete coverage, you should renew this policy every year; so that maximum coverage is available for you.
Why the need for a Standard Policy?
Health insurance products are complicated and difficult to understand. Until recently, the product was difficult to buy as only the annual premium mode was available. To address these issues, IRDAI issued guidelines to all health insurance partners to give a product with standard guidelines and introduced monthly payment options. Therefore, the Standard health insurance product, also known as Arogya Sanjeevani Policy, was introduced.
Features of Arogya Sanjeevani Policy
Arogya Sanjeevani Health Insurance Policy provides medical coverage from Rs 3 lakhs to 5 lakhs. Below are the detailed inclusions of the Arogya Sanjeevani Policy:
- Hospitalisation– Policyholders can claim the cost of treatment in case of hospitalisation. The following coverage is part of the hospitalization cover:
- Stay, Bed Charges
- Room Rent
- Nursing expenses
- Pre – and Post-hospitalisation–The cost of pre-hospitalisation is Based on policy terms, you can receive this benefit for about 30 days before hospitalisation. Likewise, some procedures of hospitalisation may also require continued treatment post-procedure. Standard health insurance or Arogya Sanjeevani policy also covers such expenses for about 60 days from the date of discharge.
- ICU and ICCU Expenses–If a patient faces a situation of intensive care, i.e., ICU or ICCU, 5 percent of the sum assured or Rs 10,000/- per day is the limit for claim.
- Option of plastic surgery and dental treatment expense claim limit to the policy’s sum insured limit.
- Ayush Treatment – Even the ayurvedic treatments under Ayush care are covered for claim limits up to the sum assured under Arogya Sanjeevani Health Insurance Policy.
- Cataract Treatment– As a part of the Arogya Sanjeevani health insurance policy expense up to 25 percent of sum assured or Rs 40,000 can be claimed from the insurance company. This is applicable for both eyes.
- Ambulance Charges–Ambulance cost cover limit for a maximum limit of Rs 2000 per hospitalisation.`
- Modern/New Age Treatment – Arogya Sanjeevani health insurance policy covers the cost of modern treatment for a limit of up to 50 percent of the total sum assured.
- Room Rent – Hospital rent limit available for a maximum of Rs 5000 per day.
- COVID 19 (Corona)Cover: COVID 19 protection and allows payment of expenses borne due to a patient’s hospitalisation due to COVID 19.
Know about the waiting period
When you decide to buy a health policy, it is imperative to understand the waiting period associated with the policy. Here are the details of the waiting period:
|Post buying the policy||30 Days|
|Pre-Existing Diseases||48 Months|
|Joint Replacement Procedure||40 Months|
|Listed Diseases||24 Months|
|Age-associated Osteoarthritis & Osteoporosis||48 Months|
What is new age Modern treatment?
Since Arogya Sanjeevani Policy has been created keeping ease of people in mind, IRDAI has made sure that it also covers new-age modern treatments. Below are some of them
- Robotic Surgeries: These are surgeries performed through robotic systems. Robotic processes serve complex procedures with more accuracy and flexibility than old surgical procedures.
- Deep Brain Stimulation: A neurological procedure for treating a disorder related to Parkinson’s disease, tremor, dystonia, and other neurological conditions. Electrical stimulation and implanted electrodes are in use for deep brain stimulation.
- Oral Chemotherapy: It is a cancer-treating drug taken in a capsule, liquid, or pills and considered very useful to kill cancer cells.
- Stereotactic Radio Surgeries: It is a non-surgical radiation therapy that helps treat functional abnormalities and brain tumors. Focused radiation beams treat tumors and concerns related to the liver, spine, brain, neck, etc.
- Intravitreal injections: These are injection shots for the eyes. It is a procedure where a fluid is filled in the eye.
- Bronchial Thermoplasty: It is a procedure for patients with severe asthma. This procedure is known to be useful for asthma as it reduces asthma attacks for about five years.
- Uterine Artery Embolization and HIFU: It is a treatment of uterine fibroids and adenomyosis. High-intensity focused ultrasound is a non-invasive therapeutic procedure to increase blood flow or destroy tissue using mechanical/thermal techniques.
Why Arogya Sanjeevani Policy?
The main objective of launching the Arogya Sanjeevani policy was to simplify health insurance by establishing a standard health insurance plan with the best features of different health insurance plans. Health insurance plans are generally tricky to understand for a non-specialist to understand. Therefore, an innovative and easy-to-understand standard product was introduced to make it easy for a potential buyer to decide.
Benefits of Arogya Sanjeevani Health Insurance Policy
Besides standardisation of complex terms of health insurance, the Arogya Sanjeevani health insurance policy also offers many benefits. Here are few services that make this product lucrative:
|Lower Co-Payment Option||Only 5 percent co-payment as compared to other plans which can have co-payments of up to 20 percent.|
|Cumulative Bonus||In case there is no claim in a year, your cover will increase by 5 percent.|
|Lifetime Renewability||Once bought, the insured can renew the policy every till he wants.|
|Ease for first-time buyers||There is no upper limit to renew this policy. One must buy this policy between 18 and 65 years, and post buying, you can continue it for a lifetime.|
|Individual and family floater plans available.||An individual can take a stand-alone cover or can take a family floater plan to cover the beneficiaries.|
|Tax Benefits||Tax Benefits under section 80D.|
|Broad coverage||Arogya Sanjeevani Health Insurance policy has all primary inclusions like hospitalization, treatments of cataracts, hernia, ENT concerns, etc.|
Exclusions of Arogya Sanjeevani Policy
While there are a lot of benefits of the Standard health insurance policy, but when you make a decision, you must also understand the exclusions of the policy:
- Cosmetic Surgery or Obesity Treatment
- Maternity Expenses
- Treatment due to an act of breaking the law
- Cost of diagnostics and evaluation
- Accidents while participating in defense operations
- Sexually transmitted diseases
- Medical treatment outside India
- Adventure Sports injuries
- Treatment due to excessive use of intoxicating substances
- Gender change treatments
- Claim due to wars
- Self-perpetrated injuries
Eligibility norms of Arogya Sanjeevani Health Insurance Policy
An individual between the age of 18 and 65 years can buy this policy. For family floaters, dependent children can between 3 months and 25 years be covered.
Once children above 18 years become independent, they are not covered under the family floater policy. They can buy their individual policy as per their wish.
Here is a quick summary of features to decide on the Arogya Sanjeevani Health Insurance Policy:
– Pre & Post Hospitalization
– ICU and ICCU Expenses
– Plastic Surgery and Dental Treatment
– Ayush Treatment
– Cataract Treatment
– Ambulance Charges
– Modern/New Age Treatment
– Room Rent
– COVID 19 (Corona)Cover
How to buy Arogya Sanjeevani Health Insurance Policy?
Buying an Arogya Sanjeevani Health Insurance Policy is as easy as other health plans. There are various web aggregators like BimaKaro.in, offering health policies from multiple insurers. In the case of Arogya Sanjeevani policy, you will not find much difference as this is supposed to be a standard health care plan. You can log on to BimaKaro.in to find out about different health plans available with various insurance providers and opt for the right one for yourself and your family.