Arogya Sanjeevani Policy

The costs related to quality healthcare are increasing with every passing day. In such a scenario, getting proper treatment for any kind of medical emergency becomes unaffordable for most of the people if a health insurance plan does not cover them. 

Arogya Sanjeevani policy is a standard health insurance that is meant for both individuals and families across India. This insurance scheme option provides coverage for necessary hospitalization-related expenses. The IRDAI has set up the terms and conditions, as well as the coverage of this Sanjeevani health policy. These elements subsequently remain unchanged across all the health insurance providers throughout the nation.

The IRDAI had essentially ordered all the standalone and general health insurance firms in India to develop a standard health plan by 1st April 2020. Since the terms and conditions of this standard health insurance scheme option are universal for all insurance providers of the nation, the insurance seekers are open to buy this from any of the insurance providers who offer this policy. The customer service and premium rates for this plan may vary from one insurance provider to another.

The Arogya Sanjeevani policy is known to have more affordable premium rates than most other comprehensive health insurance plans in India. People can easily opt to compare online policies for health insurance to check if the Arogya Sanjeevani policy is more cost-effective than their current health insurance plan.

What is Arogya Sanjeevani Policy?

While health insurance is incredibly vital for all people, more than 55% of Indians do not have coverage. The lack of knowledge about insurance policies and the confusion over the various insurance products available in the market are contributing to the low health insurance penetration level in India. Moreover, many people across the country also do not have enough spare funds to pay for health insurance premiums. Hence, the IRDAI mandated health insurers across the nation for a standard, uniform health insurance product on 1st April 2020 to address these issues.

Arogya Sanjeevani policy simply is a standard health insurance plan that is offered by several health insurance firms across India. This Arogya Sanjeevani health is sold according to the IRDAI directives for a health insurance coverage ranging from Rs 1 lakh to 5 lakh. The two types of policies that are available under this health insurance scheme option are:

• Individual Plan: A single policyholder would be the beneficiary of the Arogya Sanjeevani policy.
• Family Floater Plan: Multiple family members of the policyholder may end up becoming the beneficiaries of Arogya Sanjeevani Policy.

This Sanjeevani health insurance plan can be considered to be an all-in-one health insurance policy that would look after the financial requirements of the insurer in the scenarios of medical emergencies.

Features of Arogya Sanjeevani Policy

Some of the unique features of this policy are:

• Arogya Sanjeevani policy is a standard health insurance policy option that is meant for all people.
• The features of this Sanjeevani health insurance plan shall be uniform across every insurance firm that offers it.
• The premiums of this health insurance scheme option are the same across all the insurers present in diverse parts of the nation.
• Because the policy scheme of Arogya Sanjeevani health is standard across multiple insurance firms, it can be ported easily from one company to another.
• The coverage provided by Sanjeevani health policy is between Rs 1 lakh and Rs 5 lakh and would be available in multiples of Rs 50,000.
• In every claim-free year, the sum insured of Arogya Sanjeevani policy shall be stepped up by 5% for up to 50% of the sum insured, provided that the policy is renewed every year without a break.
• Arogya Sanjeevani policy is valid for one year, and its premiums are payable half-yearly, monthly, quarterly, as well as annually.
• This health insurance scheme plan can be availed both as an individual and family floater policy basis.
• People can invest in the Arogya Sanjeevani policy to cover themselves, their spouses, parents, dependent children aged between 3 months and 25 years, and even their parents-in-law.
• Any person between the age of 18 years and 65 years would be able to invest in the Sanjeevani health insurance policy option.
• In case a person is over the age of 65 and already have an existing policy, they can easily keep the health insurance scheme option extending so that it essentially ends up becoming a lifetime policy.
• Arogya Sanjeevani health insurance scheme plan provides coverage for plastic surgery and dental treatment undertaken due to any disease or injury, as well as for cataract surgery up to a limit of Rs 40,000 or 25% of the sum insured, whichever amount is lower.
• 5% co-payment on the total claims of Arogya Sanjeevani policy is mandatory.
• In the scenario of hospitalization, there is a room-rent cap of Rs 5,000 or 2 % of sum assured, whichever is lower, involved in this health insurance scheme option. ICU capping is 5% up to a maximum of Rs 10,000 per day. (This may vary from insurer to insurer)
• Insurance companies cannot offer any add-ons with Arogya Sanjeevani policy as the IRDAI has forbidden them from imposing any kind of deductibles or offer riders and variants on this scheme option.

Benefits of Arogya Sanjeevani Health Insurance Policy

Arogya Sanjeevani policy was launched with the prime aim of simplifying the system of health insurance in the nation by providing a basic plan that provides exact coverage by multiple insurance firms. This health insurance scheme policy was designed to offer basic indemnity insurance benefits to individuals and families across all income groups. There are multiple benefits of the Sanjeevani health policy. Here are a few of them:

• No More Confusion: Arogya Sanjeevani policy eliminates the scope of any kind of confusion that might be faced by the insurance buyer as the same terms and conditions, as well as coverage extent, is provided for this scheme option by all insurance providers.
• Lower Co-Payment Option: Sanjeevani health policy provides a co-payment option of just 5% of the sum of claim. This means that the insurance buyers shall have to pay only 5% of the total sum of the claim at the time of settlement. This co-payment option is much lower than the ones provided in most typical health insurance plans.
• Cumulative Bonus: A cumulative bonus amount that is 5% on the total sum insured is rewarded to Arogya Sanjeevani policyholders for every year where no claims have been made, much like many other health insurance policies.
• Ideal for Newbies: Sanjeevani health insurance scheme plan comes as a boon for first-time policy buyers. It provides the perfect stepping stone to people inexperienced in investing in a health insurance policy option. They can avail of expansive coverage at a cost-effective price range without understanding the various advantages and disadvantages of different health plans.
• Renewable for a Lifetime: Arogya Sanjeevani policy provides lifetime plan renewal People can easily renew this scheme option for as long as they are alive.
• Income Tax Benefit: People can claim tax benefits under section 80D of the Income Tax Act, 1961, for the premiums paid by them for Arogya Sanjeevani policy, as per the prevailing income tax rules. 

Who Should Invest in an Arogya Sanjeevani Policy?

Both individuals and families can invest in an Arogya Sanjeevani health insurance plan, as it is available on an individual and family floater basis. This plan is known to be best suited for people who are investing in a health insurance policy for the very first time.  

Most first-time insurance buyers tend to be unsure about the extent of coverage they need and what they should look for when planning to invest in a health insurance plan. This Sanjeevani health policy serves as a boon for such first type buyers as this plan can provide wider health insurance coverage, including several new-age treatments.

Owing to the rising healthcare-related expenses, almost all people across India have to invest in a good health insurance plan to acquire quality healthcare in times of need. However, not many can afford the high rate of premiums involved in most comprehensive health insurance plans. If they compare policy options of other types with Arogya Sanjeevani health plan, however, they would be able to observe that the premium rate of this policy is incredibly cost-effective.  Arogya Sanjeevani policy has 5% co-pay for all ages, which makes it affordable for all people.

The high affordability factor of the Sanjeevani health insurance policy makes it a perfect choice for people with lower incomes and those residing in smaller towns and villages.

Insurance Companies Offering Arogya Sanjeevani Policy

According to IRDA, all insurance providers offering health insurance products across India were supposed to introduce Arogya Sanjeevani policy by 1^st April 2020; few of them have not launched it yet. Nevertheless, there are still multiple health insurance providers operating across India through which people may invest in the Arogya Sanjeevani health plan. Some of them are:

• Aditya Birla Health Insurance
• Bajaj Allianz Health Insurance
• Bharti AXA Health Insurance
• Care Health Insurance (formerly known as Religare Health Insurance)
• Cholamandalam Health Insurance
• Edelweiss Health Insurance
• Future Generali Health Insurance
• Go Digit Health Insurance
• IFFCO Tokio Health Insurance
• Kotak Mahindra Health Insurance
• Liberty Health Insurance
• ManipalCigna Health Insurance
• Max Bupa Health Insurance
• National Health Insurance
• New India Health Insurance
• Oriental Health Insurance
• Raheja QBE Health Insurance
• Royal Sundaram Health Insurance
• SBI Health Insurance
• Star Health Insurance
• Tata AIG Health Insurance
• United Health Insurance
• Universal Sompo Health Insurance

Disclaimer: Paisawiki does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

Arogya Sanjeevani Policy Comparison Table

Inclusions of Arogya Sanjeevani Policy

Arogya Sanjeevani health insurance plan comes with several inclusions. This includes: 

• Pre and Post Hospitalization Expenses: This Sanjeevani health insurance plan provides coverage with all the pre-hospitalization and post-hospitalization expenses incurred by any kind of emergency illness accidental injury.
• COVID-19 expenses: Arogya Sanjeevani policy shall provide coverage on any most expenses that are incurred on hospitalization that can occur due to the COVID-19 or coronavirus disease.
• AYUSH Benefit–This health insurance scheme option also includes hospitalization expenses incurred by obtaining various types of alternative treatments, like Ayurveda, homeopathy, Siddha, etc. These treatments, however, should be undertaken at an approved hospital.
• ICU/ ICCU Charges–Sanjeevani health policy provides payment for the expenses incurred due to the treatment taken in the ICCU (Intensive Coronary Care Unit) or the ICU (Intensive Care Unit).
• Room Rent: This policy option provides coverage for the hospital room rent to a maximum amount of Rs 5,000 each day.
• Ambulance Services–Arogya Sanjeevani health plan effectively covers the expenses related to ambulance services up to a maximum amount of Rs 2000 every hospitalization.
• Daycare Treatment- The Sanjeevani health policy covers coverage for any kind of expense that arises due to diverse daycare treatment procedures.
• Plastic Surgery and Dental Treatment–This health insurance policy option also covers any dental or plastic surgery treatment expenses that are taken as a result of any kind of illness or injury.
• Cataract Surgery–Arogya Sanjeevani policy provides coverage for the expenses related to cataract surgery for each eye up to25% of the sum insured amount or a maximum of Rs. 40,000, whichever sum is lesser.
• New Age/ Modern Treatment–Several modern/ new age treatments are covered by Sanjeevani health policy up to a maximum of 50% of the sum insured amount. These new-age treatments include the following:
• Balloon Sinuplasty
• Bronchial Thermoplasty
• Deep Brain Stimulation
• Immunotherapy - Monoclonal Antibody Injections
• Intraoperative Neuromonitoring (IONM)
• Intravitreal Injections
• Oral Chemotherapy
• Robotic Surgeries
• Stem Cell Therapy
• Stereotactic Radio Surgeries
• Uterine Artery Embolization and High Intensity Focused Ultrasound (HIFU) V
• Vaporization of the Prostate (Green Laser/ Holmium Laser treatment)

Exclusions of Arogya Sanjeevani Policy

Arogya Sanjeevani policy does not provide coverage for the following situations or treatments:

• Diagnostic or Investigative Tests – The Sanjeevani health policy does not cover the expenses incurred on undertaking any type of diagnostic or investigative tests.
• Bed Rest or Rehabilitation Expenses –Arogya Sanjeevani health plan does not cover any cost incurred by enforced bed rest in the absence of treatment. This policy also does not provide coverage for the expenses incurred due to rehabilitation requirements.
• Weight Control/ Obesity Treatment – The expenses that arise due to treatments undertaken for weight management or obesity is not covered by Sanjeevani health insurance.
• Treatment for Gender Change– Arogya Sanjeevani policy does not cover the expenses arising from the treatments involved in gender reassignment.
• Cosmetic or Plastic Surgery– The costs taking place on going through any cosmetic or plastic surgery that is not needed as a result of an accident, burn injury, cancer, or treatment that is medically necessary will not be covered under Arogya Sanjeevani health
• Maternity Expenses–The expenses involved in any treatment related to pregnancy and childbirth shall not be covered by the Sanjeevani health insurance
• OPD Treatment – This health insurance policy option shall not provide coverage for expenses of any kind of OPD or out-patient treatment that is taken by the policyholder.
• Adventure/ Hazardous Sports – Arogya Sanjeevani policy shall not cover any medical treatment cost that arises due to participation in any kind of hazardous or adventure sports as a professional. These sports may include the following:
• Rock climbing
• Sky diving
• Para-jumping
• deep-sea diving
• Mountaineering
• Breach of Law – Arogya Sanjeevani policy shall not cover any expenses incurred by the breach of law while having a criminal intention.
• Alcohol/ drug addiction- Any type of expense that arises due to the treatment of addiction to drugs, alcohol, or some other type of substance abuse shall not be provided coverage by Sanjeevani health policy.
• Dietary Supplements– Arogya Sanjeevani health plan will not cover the expenses involved in the purchase of any type of dietary substance, as well as supplements without a prescription. These items can include minerals and vitamins as well.
• Unproven Treatment – Sanjeevani health policy will not cover the expenses incurred due to an unproven treatment in nature.
• Infertility and Sterility – Arogya Sanjeevani policy will provide coverage for any expenses taking place due to the issues of infertility or sterility.
• Domiciliary Hospitalization – The expenses that arise out of domiciliary hospitalization that would not be provided coverage under the Arogya Sanjeevani policy.
• Nuclear Attack or War– Such a health insurance scheme option shall not provide coverage for any claims arising from a nuclear attack or a war/ war-like situation.
• Treatment Outside India–Sanjeevani health insurance will not cover the costs that are incurred on receiving any treatment outside India.

Arogya Sanjeevani Policy Waiting Period

Sanjeevani health policy comes with certain waiting periods. They include: 

• Initial Waiting Period– For all types of claims except accidental claims, there is a waiting period of the first 30 days involved in the Arogya Sanjeevani policy, from the date of policy commencement.
• Pre-Existing Disease–A 4 years waiting period is involved in this health insurance policy scheme for any kind of pre-existing disease or medical condition.
• Specific Illness/ Treatment: A 2/ 4 years waiting period is involved in the coverage of certain specific treatments under Sanjeevani health policy. Some of these treatments include:
• Tonsillectomy
• Hernia
• Benign prostate hypertrophy
• Cataract
• Internal congenital anomalies
• Age-related osteoarthritis / osteoporosis
• Joint replacement treatment 

Eligibility Criteria for Arogya Sanjeevani Policy

The table provided below mentions the age of eligibility involved in investing in the Arogya Sanjeevani health insurance policy.

Policyholders can include their dependents in the Arogya Sanjeevani policy. Their dependents can involve their parents, spouse (legally married), parents-in-law, as well as adopted children (legal).

Claim Process of Arogya Sanjeevani Policy

The claim process for the Arogya Sanjeevani Policy is similar to other health insurance policies, which facilitates claiming the policy for availing cashless or reimbursement benefits.

Cashless Claim Process – Only applicable for network hospitals

• Get the pre-authorization request form filled and signed
• The network hospital shall inform the insurance company about the Arogya Sanjeevani policy claim
• The insurer shall examine the pre-authorization request form and accept/deny the availability of a cashless facility based on the policy guidelines.

Reimbursement Claim Process

• Inform the insurance company about the hospitalization
• Submit the necessary documents to the insurer, along with the claim form
• The insurer shall examine the documents and the claim form and accept/deny the availability of a cashless facility based on the policy guidelines.

As multiple insurers offer the Arogya Sanjeevani Policy, the specific details about its claim process may differ from one company to the other. 

How to Buy Arogya Sanjeevani Policy?

Arogya Sanjeevani policy can easily be purchased online. The IRDAI has provided permission to diverse insurance companies to issue the Sanjeevani health insurance plan electronically or online to the discerning policyholders. This factor further minimalizes the serving/ operating expenses of the insurance company, thereby making this health insurance policy option more economical for the buyers. When making an online policy comparison of health plans, people shall observe that the Arogya Sanjeevani policy is among the most affordable health insurance scheme options available in the market. People can easily use an insurance policy calculator to make such comparisons. 

To invest in the Sanjeevani health policy, people first have to use the Arogya Sanjeevani policy premium calculator to compare the premium quotes. After comparing the premiums, they have to orderly fill up the relevant proposal form and pay the premium amount online.  Arogya Sanjeevani policy shall be issued to the buyer after they have made their premium payment.

However, all insurance companies must issue Arogya Sanjeevani policy documents in physical form, even if it has been purchased online. IRDAI has additionally directed all health insurance firms to provide a certificate of insurance to the policyholders that specify the details of this Sanjeevani health policy, including its terms and conditions.

Documents Required to Buy Arogya Sanjeevani Policy

• Age proof, such as:
• Voter ID Card
• Pan Card
• Aadhaar Card
• Driving License
• Passport
• Birth certificate
• Identity proof, such as:
• Voter ID Card
• Passport
• Aadhaar Card
• Driving License
• Address Proof, such as:
• Ration card
• Driving license
• Passport
• Rent agreement if applicable
• PAN Card
• Aadhaar Card
• Utility bills like electricity bill, telephone bill, etc.
• Passport-size photographs (if demanded by the insurer)
• Medical reports (if demanded by the insurer)
• Proposal form duly filled in and signed 

Arogya Sanjeevani Policy Cancellation and Refunds

All Arogya Sanjeevani health insurance policyholders are provided with a 15-day free-look period. This implies that they would be able to cancel their policy within the first 15 days without paying any cancellation expenses. The premium amount paid for the Arogya Sanjeevani policy shall then be refunded to the policyholder minus any type of expenses incurred by the insurance company if there are no claims that were made during this period.

It is imperative to note that the free look period is not applicable at the time of policy renewal. However, in the scenario that a 15-day free-look period gets over, the policyholder still may cancel their Arogya Sanjeevani health plan. They would simply be required to provide a 15-days written notice to the insurance company for canceling the plan. The premium amount for the remaining policy term shall be refunded to the policyholder according to the rates mentioned below.

Arogya Sanjeevani Policy Renewal

The option of lifetime policy renewal is available in the case of the Arogya Sanjeevani policy. This implies that the policyholder would be able to renew their Sanjeevani health policy for as long as they are alive.  They, however, must remember to make their plan renewal before its expiry.  If the Arogya Sanjeevani policy is not canceled after the grace period of 30 days, it would be terminated. People can easily renew this health insurance scheme plan online by entering the relevant details and paying the policy premium. The online renewal steps are as follows:

• Visit the insurer’s official website
• Go to the ‘Renewal’ option
• Provide necessary information such as policy number, coverage amount etc.
• Calculate the premium online and proceed to the payment window
• Pay the premium online through net banking, credit or debit card

Arogya Sanjeevani Policy Premium Rates

IRDAI has provided various insurance companies with the freedom to orderly determine the premiums for the Arogya Sanjeevani policy, taking into the mandatory covers prescribed under it by a regulatory body into consideration. The insurance providers typically consider the factors of estimated claims, consumer behavior, risk assessment, as well as the sustainability of Sanjeevani health policy in the long term, when it comes to determining the premium amount.

The prices involved in investing in individual Sanjeevani health insurance scheme plans start at approximately Rs 3000, while the family floater policy options begin approximately Rs 15000. People can visit the insurance companies' websites offering Sanjeevani health policy to find their exact policy premium chart and rates.

Frequently Asked Questions