Arogya Sanjeevani Health insurance Plan
In time of any health
issue , a basic Health insurance is better than nothing .
Insurance regulator IRDAI introduced a Basic health
insurance policy, named "Arogya Sanjeevani" to not overpower
a first time health insurance plan buyer
.
The policy is the same whether bought from a private or
public sector insurer. It will include the name "Arogya Sanjeevani"
followed by the name of that insurer. A policyholder can avail of the cashless
facility across the network hospitals of an insurer and get can get his or her medical
expenses reimbursed. Between the insurance companies offering Arogya Sanjeevani,
the only differentiating factor is in the premium and the process of on-boarding
a customer. The buyer has to make a decision on the basis of the goodwill and
brand of insurer and the cost, instead of comparing a long list of riders
across different products.
Govenments main aim of launching Arogya Sanjeevani is to
take care of the basic healthcare expenditure of the public ,like in some countries
it is compulsory for citizens to have a health Insurance. Arogya Sanjeevani has
basic mandatory covers such as hospitalisation, including for Covid-19,
day-care treatment, pre- and post-hospitalisation expenses, and offers tax
benefits under sec 80(C).
The idea behind the introduction of Arogya Sanjeevani policy
was to provide a simple and basic level health insurance product to consumers
with a cover of up to Rs 5 lakh for hospitalisation in case of injuries or illnesses. Arogya Sanjeevani was
introduced to encourage more people in India to opt for health insurance
products to cover basic hospitalisation charges without being confused by the
endless number of health policies offered by insurance companies.
IRDAI has banned insurers to impose deductibles or offer
riders and variants with this policy.
Features of Arogya Sanjeevani
It covers basic hospitalisation expenses like day-care
treatment, pre and post-hospitalisation expenses.
The policy terms under Aarogya Sanjeevani are the same
irrespective of the insurance company you buy from.
Available for both individual and on family basis.
Minimum sum insured is Rs 1 lakh and the maximum is Rs 5
lakh.
Minimum entry age: 18 years, maximum entry age: 65 years.
For children under 'Family Floater' policies, the entry age: 3 months, exit: 25
years.
It is annually renewable with a grace period of 30 days,
with a lifelong renewability option.
No add-ons and optional covers available.
Room rent, boarding and nursing expenses are capped up to
2 per cent of the sum insured and maximum Rs 5,000 per day. Intensive Care Unit
(ICU) / Intensive Cardiac Care Unit (ICCU) expenses are capped up to 5 per cent
of the sum insured and maximum Rs 10,000 per day. The maximum ambulance covered
under this policy is Rs 2,000 per hospitalisation.
As a special benefit, plastic surgery and dental cover in
case of injury or illness are provided.
Cumulative bonus facility is available, that is, an
additional increase in sum insured (up to a maximum of 5 percent) without any
increase in existing premium payment.
Portability has been allowed in health insurance.
No claim rejection after 8 years
Cooling and waiting period -Except accident no other
ailments will be covered in the first 30 days of the Arogya Sanjeevani policy.
For any pre-existing diseases the insured person will have to wait for 48
months to get coverage under the policy.
Which insurance company is best to purchase Arogya Sanjeevani?
Under the Arogya Sanjeevani health insurance policy,
coverage, exclusions and aspects of the policy such as co-payment (cost-sharing
arrangement that is, a certain percentage of claim amount that the customer has
to compulsorily pay from his/her pocket) and sub-limits (cap on coverage for a
particular treatment), are the same across insurers.
However, premium and process of on-boarding a customer will
vary between the insurance companies. Therefore, the decision of which insurer
should one choose will rest on the credentials of their insurer, the cost of
premium offered, their network of hospitals for the cashless facility (or
reimbursement of incurred expenses) and their customer service.
You could also look at the convenience of their online services
to purchase insurance as well as pay the premium, if that is important to you. Further,
due to the standardisation, a customer can seamlessly port between insurers if
he/she is not happy with their existing insurer's service.
As mentioned in upper paragraphs, the Arogya Sanjeevani
policy is a simple health plan with a cover of up to Rs 5 lakh. It will
probably suit those who do not have a good health insurance cover from their
employer, are young and new to the health insurance buying terms. Its kind of Cheap and best health insurance.
However, if you have dependents (parents or children), Rs 1
to 5 lakh cover may not be sufficient considering the high costs of
hospitalisation in private hospitals based in metro and urban areas. You can
search for some other insurance policies for better coverage of your and your
family needs.
Arogya sanjeevani - IRDAI GUIDELINES
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