Arogya Sanjeevani Health Insurance Explained

By | April 7, 2020

The IRDAI, India’s insurance regulator, has introduced an affordable, standard Health Insurance policy that must be offered by all general and standalone health insurance companies. Here’s all you need to know about the Arogya Sanjeevani Policy.

Lesser-Known Features Of Health Insurance Plans That You Should Take Advantage Of

Are you looking to buy a Health Insurance policy amid the COVID-19 pandemic? You are not alone. Ever since the pandemic broke out, insurers are seeing keen interest in Health Insurance policies in India – a country that has thus far had dismally low Health Insurance penetration with over 55% of Indians not having coverage.

Health Insurance is a bit of a grey area for most people given the lack of knowledge and confusion over the number of products available in the market. Further, affordability too is another factor as lots of people do not have adequate spare funds to pay for Health Insurance premiums.

To address these issues, on April 1, 2020, the Insurance Regulatory Authority of India (IRDAI) mandated health insurers to roll out a standard, uniform product called the Arogya Sanjeevani Policy which offers basic coverage and is suitable for first-time Health Insurance buyers.

Several insurance companies, including HDFC Ergo, SBI General and Manipal Cigna, have rolled out the policy, which is named Arogya Sanjeevani Policy followed by the name of the respective insurer.

Additional Reading: COVID-19 Insurance Policies That You Need To Know About

Top Features

 This is a standard Health Insurance policy for all and the features will be uniform across all insurance companies offering it.

  • The premiums are the same across all insurers and areas of the country.
  • Since the product is standard across all insurance companies, it can be easily ported from one company to another.
  • The insurance policy offers coverage of between Rs. 1 lakh and Rs. 5 lakhs and is available in multiples of Rs. 50,000.
  • The sum insured will be stepped up by 5% for every claim-free year, up to 50% of the sum assured provided that the policy is renewed every year without a break.
  • The policy term is one year with premiums payable monthly, quarterly, half yearly or annually.
  • The policy can be availed individually and as a family floater plan.
  • You can take a policy to cover yourself, your spouse, dependent children aged between 3 months and 25 years, parents and parents-in-law.
  • The policy will not cover children over the age of 18 who are financially independent.
  • Anyone aged between 18 years and 65 years of age can purchase this policy.
  • Over the age of 65, if you already have an existing policy, you can keep extending it so it essentially becomes a lifetime policy.
  • The policy covers plastic surgery and dental treatment caused by disease or injury as well as cataract surgery up to a limit of 25% of the sum assured or Rs. 40,000, whichever is lower.
  • 5% co-payment on the total claim amount is mandatory.
  • There is a room-rent cap of 2% of sum assured or Rs. 5,000, whichever is lower, in case of hospitalisation. ICU capping is 5% up to a maximum of Rs. 10,000 per day.
  • Insurers cannot offer any add-ons with this policy as the IRDAI has forbidden them from imposing deductibles or offer riders and variants.

Additional Reading: 4 Ways To Get Your Finances In Order During The Lockdown

Should You Opt For This?

Considering that the prohibitive cost of Health Insurance premiums deters a number of Indians who cannot really afford it, this insurance cover is better than having none at all amid a rickety public-health system. Premiums are low as there is 5% co-pay for all ages.

If you are earning decently well and can afford Health Insurance, it is better to get health cover of more than Rs. 5 lakhs. Given that healthcare costs are spiraling rapidly upward, Rs. 5 lakh cover may not be adequate. So look for products beyond this.

However, for people with lower incomes and in smaller towns and villages, especially first-time buyers, this is a simple, no-frills standard Health Insurance policy that could help you meet any unexpected medical emergency costs.

Pro tip: Remember to automate your Health Insurance premium payments with a Credit Card so that you never miss a payment and your policy remains in force.

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