Arogya Sanjeevani health insurance policy is a basic health insurance plan that offers coverage of up to Rs.5 lakh. It covers medical expenses like ICU services, hospital room rent, hospitalisation expenses, etc. Since its launch on 1st April, 2020, the Insurance Regulatory and Development Authority of India (IRDAI) has mandated 29 general and health insurance companies to market this product.
Read on to know the features, benefits, eligibility, how to claim insurance, documents required and cancellation/refund process of Arogya Sanjeevani Health Insurance Plan.
Follow these steps to buy Arogya Sanjeevani Health Insurance:
You can choose between two types of Arogya Sanjeevani Health Insurance Policy:
Take a look at the details of the Arogya Sanjeevani Health Insurance Policy:
|Health Insurance Company||Niva Bupa Health Insurance (Formerly known as Max Bupa Health Insurance)||Care Health Insurance (Formerly known as Religare Health Insurance)||Raheja QBE Health Insurance|
|Policy Name||Arogya Sanjeevani Niva Bupa Health Insurance||Care Health Arogya Sanjeevani Health Insurance||Arogya Sanjeevani Raheja QBE Health Insurance|
|Sum Insured (Rs.)||1-5 Lakhs||5 Lakhs||1-5 Lakhs|
|Premium (Rs.)||3,148 – 4,722 p.a.||6,013 p.a.||2,579 – 3764 p.a.|
|Coverage||Individual/Family Floater||Individual/Family Floater||Individual/Family Floater|
The Arogya Sanjeevani scheme covers medical expenses 30 days before and 60 days after hospitalisation.
Arogya Insurance also extends coverage benefits for hospitalisation expenses for COVID-19 treatment.
Arogya Sanjeevani Health insurance policy covers expenses for alternative treatments such as Ayurveda, homoeopathy, etc.
The policy covers 5% of the sum assured for ICU charges up to a limit of Rs. 10,000 per day.
Arogya Insurance policy covers room rent charges up to a maximum of Rs. 5000 daily.
Ambulance charges up to a limit of Rs. 2,000 per hospitalisation are covered under this policy.
It includes the expenses of any daycare procedure.
This policy includes expenses from any dental or plastic surgery availed due to any illness or injury.
It covers charges from cataract surgery for each eye up to a maximum cap of Rs.40,000 or 25% of the total sum assured, whichever is less.
Arogya Sanjeevani Health Insurance also includes expenses for modern or new-age treatments such as:
As Arogya insurance, this policy comes with several coverage benefits at minimal costs, first-time insurance buyers might want to consider this policy.
As the coverage benefits and terms and conditions are universal for all the insurance companies in India, members might find it easier to make their selection without any confusion.
For every claim-free year, insurers offer a cumulative bonus of 5% to policyholders of Arogya Sanjeevani.
At the time of claim settlement, this insurance option comes with a lower co-payment of only 5%.
Policyholders can avail lifetime renewability on their Arogya health insurance policy.
There are various ways to file a claim:
If the hospital is under the Network Hospitals list of Arogya Sanjeevani Health Insurance, you can claim cashless at the hospital insurance claim desk. Submit all the documents within 24 hours of hospitalisation. For planned hospitalization, send an intimation to your insurer 3 days prior with the name and address of the Hospital and the treatment required. For post hospitalisation insurance claims, submit all the required documents within 15 days.
Inform your insurer through email or fax about the hospitalisation within 72 hours in case of emergency hospitalisation. In case of planned hospitalisation, inform the insurer 72 hours in advance. Obtain claims from A and B from the hospital and mention the necessary details such as investigation reports and discharge summary and submit them to the TPA office within 15 days. You can claim pre and post-treatment expenses separately. For post hospitalisation, submit original documents within 15 days after completing treatment to claim insurance.
Policyholders of the arogya sanjeevani health insurance policy plan can avail of a 15-day free-look period wherein they can cancel their plans within 15 days without paying any cancellation charges. They will get back the paid premium amount as a refund other than the expenses incurred by the insurance company.
Further, individuals can cancel their plans even after a 15-day free-look period by giving a 15-days notice to the insurance provider. The premium refund amount will vary as per the cancellation time as follows:
|Cancellation time||Percentage of premium refund|
|Up to 30 days||75%|
|3 -6 months||25%|
For a comprehensive health insurance plan, you can download the Navi app and buy Navi Health Insurance. Benefits include cashless claims in 10,000+ network hospitals, no capping on room rent, up to 1 crore cover, and more! Check out the complete list of Navi Health Insurance below.
To conclude, Arogya Sanjeevani Health Insurance Policy is a low-cost premium health insurance that provides coverage for many medical expenses including COVID-19, certain surgeries and post-hospitalisation expenses. Claiming your insurance or cancelling and getting a refund can also be done easily. Check your eligibility and other details before applying for an Arogya Sanjeevani Health Insurance Policy.
Ans: Yes. You can opt for cashless claims on your Arogya Sanjeevani health insurance. With this facility, policyholders can get treatment from a network hospital without making any upfront payments.
Ans: The default policy tenure of Arogya Sanjeevani is one year. However, policyholders can continue receiving coverage benefits for a lifetime as there is no renewal cap on this health insurance policy.
Ans: You can get coverage for your family members with the second and third variants of the Arogya Sanjeevani insurance plan. It extends coverage benefits to all family members, including 2 adults and up to 3 dependent children.
Ans: Yes. There are three variants of this plan, including individual plan, non-floater family plan and family floater plan.
Ans: Yes, you can port your existing plan to Arogya Sanjeevani health insurance.
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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