Medical expenses may spoil your future financial planning. Therefore, it is recommended by Funds Instructor to secure your medical expenses with a health insurance plan that maintain your financial planning and secure your future.
The IRDA (Insurance Regulatory and Development Authority of India) is to urge insurance companies to create products that are affordable or easy to understand for people.
Thus, the name Standard Health Insurance plan is a policy offered by across all health insurance companies. And Arogya Sanjeevani Policy is the first example of standard health insurance in India that provides for a basic health insurance cover of between ₹ 3 lakh to ₹ 5 lakh.
What is Covered under Arogya Sanjeevani Policy?
1. Hospitalization Expenses
Coverage for all pre and post hospitalization expenses, that could occur due to an illness or accident. Treatment and hospitalization for the COVID-19 also are covered under this.
You can receive this benefit for 30 days before hospitalization and Post Hospitalization costs are covered for 60 days after discharge.
2. AYUSH Care
The expenses related to AYUSH treatment in a hospital offering these services are covered up to the sum insured limit.
3. Room Rent
Room rent in Arogya Sanjeevani Policy is covered up to 2% of the sum insured maximum up to ₹ 5,000 per day.
4. ICU and ICCU Expenses
In the case of intensive Care Unit (ICU) charges are covered up to 5% of the sum insured maximum up to ₹ 10,000 per day.
5. Ambulance Services
Ambulance service charges are including with a maximum cap of 2,000 per hospitalization during the policy.
6. Dental Treatment and Plastic Surgery
The expenses related to Dental treatment and Plastic surgery is covered up to the limit of sum insured of the policy.
7. Stem Cell Therapy
This comes under out-patient treatment and therefore it has a cap of 50% of the sum insured during the policy period.
8. New Age Treatments
Modern treatments such as Uterine Artery Embolization and HIFU (High intensity focused ultrasound), Balloon Sinuplasty, Deep Brain stimulation, Oral Chemotherapy, Immunotherapy-Monoclonal Antibody to be given as an injection, Intravitreal injections, Robotic surgeries, Stereotactic radio surgeries, Bronchial Thermoplasty, Vaporisation of the prostrate (Green laser treatment or holmium laser treatment), IONM: Intra Operative Neuro Monitoring, Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions are covered up to 50% of the total sum insured.
9. Cataract Surgery
The expenses of this treatment are covered up to 25% of the sum insured or ₹ 40,000/- (whichever is lower) by the insurance company for each eye.
10. Cumulative Bonus
For every claim-free year, you and your family get rewarded with 5% as a bonus in your sum insured.
Benefits of the Arogya Sanjeevani policy
A) Income Tax Benefit
When you buy this health insurance policy you can claim a tax benefit under section 80D of the Income Tax Act, 1961.
B) Low Premium
The Arogya Sanjeevani policy premium for the same is comparatively lower than other health insurance policies in the market.
C) No Claim Bonus (NCB)
No claim bonus is offered by the insurance company when no claims are raised during a policy period. You and your family get rewarded with 5% as a bonus in your sum insured and this discount can reach a maximum of 50%.
D) Minimum Co-payment
Every health insurance company comes with its own set of co-payment limitations. Where some at least have a 10% to 20% co-payment involved, while some come with no co-payment at all. Thus, in this case, this policy comes with a minimum co-payment of 5% only. It means during claims you will have to 5% of the expenses from your pocket.
E) Different types of policies available
The Arogya Sanjeevani Policy comes with two plans available:
a) an Individual Health Policy (One policy each for a family member) and
b) a Family Floater Health Insurance (One policy for the entire family).
Arogya Sanjeevani Policy Premium Rates
As mentioned before that in India this policy is a standard health insurance product available across multiple insurance companies. The premium amount of Arogya Sanjeevani Policy may be varying as for each plan.
The price of Individual policies starts approximately at ₹ 3000 and while the other side Family Floaters start approximately at ₹ 15000.
You will find the exact policy premium chart and rates at your preferred insurer’s website, and with your insurance agents along with various details related to your Arogya Sanjeevani Policy.
What is Not Covered under Arogya Sanjeevani?
1. Broke the Law
The insurance companies are not liable to settle a claim if the insured person requires medical treatment due to an action that broke the law.
2. Diagnostics & Evaluation
The cost of diagnostics and evaluation procedures is not covered under this policy.
3. Change of Gender Treatments
Treatments such as changing the characteristics of the body to resemble the opposite sex shall not be covered under this policy.
4. Cosmetic or Plastic Surgery
The cost of cosmetic or plastic surgery treatments will not be covered unless a need arises as a result of an accident, burns, or cancer. In this case, by the attending doctor, the requirement of cosmetic surgery should be certified.
5. Infertility or Sterility
Treatment-related to IVF, ZIFT, GIFT, ICSI, sterilization, surrogacy, sterilization, and reversal of sterilization.
Any injuries related to a war-like situation in the country are not covered. This includes Nuclear, chemical, or biological war.
7. Maternity Expenses
Expenses related to voluntary termination of pregnancy are also not covered.
8. Eyesight Correction
Treatment-related to the correction of eyesight due to refractive error that is less than 7.5 dioptres.
9. Geographical Limits
Any medical treatment taken outside India will not be covered under the plan.