The Insurance Regulatory and Development Authority of India has formulated a new standard health insurance policy. It is called the Arogya Sanjeevani Policy. It was introduced amidst the Covid-19 pandemic on 1st April 2020. In this article, we will cover this newly formulated policy.
Arogya Sanjeevani is a basic health insurance policy that provides medical/hospitalization expenses up to 5 lakh rupees. This health insurance policy comes as an individual plan and family floater plan that covers the hospitalization expenses arising due to Coronavirus.
It may be noted that this health policy is universal for all general and health insurance companies in India and comes with various benefits as well. It covers pre as well as post hospitalization expenses that include bed and nursing charges, ICU and doctor consultation charges etc.
There are two types of plan under this policy. They are:
This health insurance policy comes with following inclusions:
As stated earlier this policy covers expenses due to Pre and Post Hospitalization in case of any medical emergency due to any illness or an accidental injury. It will also cover medical and hospitalization expenses due to coronavirus.
It shall also offer corona insurance protection and shall pay for any expenses due to hospitalization on contracting coronavirus.
It shall cover hospitalization expenses incurred due to obtaining alternative treatments like ayurveda, homeopathy etc at an approved hospital.
In case of treatment taken in ICU (Intensive Care Unit) and ICCU (Intensive Coronary Care Unit), the policy shall pay up to 5% charges of such treatment of the total sum insured up to a maximum of 10000 rupees per day.
This policy shall cover the room rent of the hospital as well up to a maximum of 5000 rupees per day.
It shall cover the cost of ambulance service up to a maximum 2000 rupees per hospitalization.
The expenses of any dental or plastic surgery treatment that is taken due to an illness or injury will also be covered.
This policy shall cover the expenses incurred due to any daycare treatment procedures. Daycare treatment means medical treatment/surgical procedure which are undertaken under general or local anesthesia in a hospital in less than 24 hours and which would have required a hospitalization of more than 24 hours.
It shall cover the cost of cataract surgery for each eye up to a maximum of 40000 rupees or 25% of the total sum insured amount, whichever is lower.
This health insurance policy shall also cover the cost of modern/new age treatment up to a maximum of 50%.
The exclusions of this policy are as mentioned blow:
Any expense due to treatment for obesity or weight management shall not be covered.
This policy shall not cover any cost associated with the treatment for changing the gender.
Expenses arising out of cosmetic or plastic surgery which is not needed as a result of an accident, cancer, or burn injury or medical required treatment shall not be covered.
This policy shall not cover the treatment cost of pregnancy and child birth.
It shall also not cover the expenses due to any diagnostic or investigative tests.
Any expense incurred due to Infertility and sterility shall not be covered.
The policy will not cover any claims from nuclear attack or war.
The features of this new health insurance policy separate it from other health insurance plans. Some of its attractive features are as follows:
The eligibility requirements are:
This policy aims to simplify the health insurance in India.
There are many benefits that can be availed by a policy holder such as:
It provides lower co-payment option that means the applicant shall require paying only 5% of the total claim amount.
This policy just like any other health insurance plan also rewards a 5%
Cumulative bonus on the total sum insured amount for every claim-free year.
A first time health insurance buyer can get a wide range of coverage at minimum cost without the need to know the advantages and disadvantages of various health plans.
It comes with renewability of lifetime that permits policyholders to renew their policies for their lifetime.
Read our article:Regulatory Compliances of IRDA for Insurance Companies