Arogya Sanjeevani policy is a new, standard health insurance policy
set by the IRDAI and will be offered by all health insurance companies
in India. This policy provides for a basic health insurance cover.
Key Highlights
The plan covers all pre and post hospitalization expenses
Ambulance charges with a maximum cap of Rs 2,000 per hospitalization are included in the policy.
ICU/ICCU charges are covered up to 5% of the SI maximum upto Rs 10,000 per day
The Insurance Regulatory and Development Authority of India (IRDAI)
on April 1 launched the Arogya Sanjeevani -- a standard health insurance
policy for individuals and families. The regulator mandated all
insurance companies to offer this policy which provides coverage of up
to Rs 5 lakh for basic hospitalisation-related expenses.
The IRDAI website said, "In the context of outbreak of COVID 19
pandemic, it is clarified to the Public, that indemnity based health
insurance products that cover the treatment costs of hospitalization
offered by all general and health insurance companies cover the costs of
hospitalization treatment on account of COVID -19. All insurers have
been advised by the Authority vide Circular dated 30th March, 2020
insurers to expedite settlement of COVID 19 related claims."
The authority had issued guidelines on Standard Health Insurance
Policy called Arogya Sanjeevani and had issued clearance to 29 General
and Health Insurance companies to market this product. Interested people
can avail of this Standard Health Insurance policy by approaching the
listed insurance companies. List of insurers allowed to market this product:
Note that while the coverage and terms & conditions of this
policy are universal for all insurance providers, the buyer has the
choice to purchase this policy from any insurer. However, the premium
rates and customer service can vary from one insurance provider to
another. Features of Arogya Sanjeevani health policy:
It offers a standardised product that covers basic hospitalisation needs of customers.
This policy comes with minimum sum insured of Rs 1 lakh and maximum of Rs 5 lakh.
These are available for both individual and family.
The minimum and maximum entry age are 18 and 65 years. For children
under 'Family Floater' policies, the entry age is 3 months and exit is
25 years.
This policy is annually renewable with a grace period of 30 days.
A co-payment of 5 per cent is applicable across all ages meaning
the policyholder is required to pay 5 per cent of the bill amount
compulsorily.
No add-ons and optional covers are available in Arogya Sanjeevani Policy.
What is covered in this policy:
All pre and post hospitalization expenses, that could occur due to
an illness or accident. Treatment and hospitalization for the Covid-19
too.
Alternative treatments done as an inpatient ineligible hospital.
Room rent covered up to 2% of the SI maximum up to Rs 5,000 per day.
ICU/ICCU charges covered up to 5% of the SI maximum up to Rs 10,000 per day.
Ambulance charges with a maximum cap of Rs 2,000 per hospitalization included.
Plastic surgery or dental treatments necessitated owing to an injury or a disease.
For expenses incurred towards the treatment of cataract for each
eye, policyholders can avail coverage of up to Rs 40,000 or 25% of the
total sum insured, whichever is lower.
Modern treatments, including Balloon Sinuplasty, Immunotherapy and
Stem Cell Therapy, amongst many other treatments covered to up to 50% of
the total sum insured.
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