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AROGYA SANJEEVANI

Q1. What is Arogya Sanjeevani ?

The Arogya Sanjeevani plan is a newly-launched standard health insurance policy for individuals and families that provides coverage for basic hospitalization-related expenses.

Insurance Regulatory and Development Authority of India (IRDAI), the country’s insurance regulator, has introduced a standard health cover policy that must be offered by all general and standalone health insurers. This standard health policy is Arogya Sanjeevani.

Q2. Which age group does this policy cover ?

The policy covers anyone between 5 months and 65 years with a variable sum insured up to 5 lakhs. Arogya Sanjeevani Policy comes with several advantages such as covering all day care procedures, lifelong renewals, cumulative bonus, Cataract treatment and Ayush Treatment up to the limit of sum insured.

Q3. What are the specification of Arogya Sanjeevani ?

Features Specification
Sum Insured 1 lakh - 5 lakhs
Policy Term 1 Year
Co-Pay 5% of Sum Insured
Eligibility Criteria Adult: 18-65 Years
Dependent Children: 3 months - 25 Years
Special Benefits Plastic Surgery and Dental Cover in case of injury or illness
No-Claim Bonus 5% - 50%
Policy type Individual/Family Floater

Q4. What are key features of Arogya Sanjeevani ?

  • No medical check-up up to the age of 45 years for people with no medical history.
  • AYUSH coverage.
  • Family Floater: one plan, full family.
  • Road Ambulance Cover.
  • Cumulative Bonus: 5% of SI for each claim-free year, up to 50%.
  • Coverage from Rs 100,000 to Rs 500,000.
  • Life-long renewability.
  • Tax Deduction: Under Sec 80D

Q5. What will be covered in Arogya Sanjeevani ?

  • Your hospital room rent, boarding expenses and doctor fees.
  • Nursing expenses, Operation theatre and ICU charges.
  • Medicines that you consume during the hospital stay.
  • Road Ambulance charges.
  • Pre and Post hospitalization expenses up to 30 and 60 days respectively.
  • AYUSH Treatment.

Q6. What exclusions will be in Arogya Sanjeevani ?

  • Pre-existing diseases from inception of the policy up to 4 years of this policy being in force continuously.
  • Treatment taken outside India.
  • Admission primarily for investigation & evaluation.
  • Admission primarily for rest cure, rehabilitation and respite care.
  • Expenses related to surgical treatment of obesity that do not fulfill certain conditions.
  • Change-of-Gender treatments.
  • Expenses for cosmetic surgery.
  • Expenses related to treatments resulting from hazardous or adventure sports.
  • Maternity Expenses.
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