Health Insurance is a crucial matter – especially after times like Covid 19. In simple words, Health Insurance is insurance that provides cover against medical emergency expenses. It should cover almost all the diseases whether critical or common depending upon features of the policy. Being affordable is one of the features most look for. So here comes – Analysis of Arogya Sanjeevani Policy.
Different health insurance policy has different features according to its plan. Each feature makes it costly and out of reach of the common man. Most of the business, private & unorganized sector employees do not get benefits of health from their employers or state. Hence the need for Sanjeevani Arogya Policy is felt.
Keeping this in mind Government of India & IRDAI (Insurance Regulatory and Development Authority of India) has asked all the companies to offer the product with the name of “Arogya Sanjeevani” from 01st of April, 2020.
Interesting thing is that this policy will offer the same features which are directed by the authority, across the insurance industry.
Analysis of Arogya Sanjeevani Policy
Every Arogya Sanjeevani policy will have the same feature, but its issuing company may differ. By making it a universal name, one can easily find out the features unique. So if HDFC Ergo offers this product then its name would be Arogya Sanjeevani Policy HDFC Ergo.
So, the policy is not company-specific but the features are standardized. The regulator has not issued any specific guideline about its premium amount so as per our knowledge, so its insurance premium amount may vary as it’s fixed by the insurance company.
Features & Benefits of Arogya Sanjeevani Policy
|
Basic Covered Features |
Details |
| Entry Age Limit – Individual Policy | 18 To 65 Years |
| Entry Age Limit – Family Floater Plan | 18 To 65 Years for the adult members & 03 months to 18 years of the dependent child |
| Family | Spouse, Parents, Parents in law, the dependent children between 03 Months to 18 Months |
| Minimum Sum Insured | Rs. 01 Lakh |
| Maximum Sum Insured | Rs. 05 Lakh |
| Waiting Period | 30 Days |
| Room Rent Limit | 2% of SI (Sum Insured) up to Rs. 5,000 Per Day |
| ICU Limit | 5% of SI (Sum Insured) up to Rs. 10,000 Per Day |
| Hospitalization Expenses | Covered |
| Day Care Treatments | Covered |
| Pre – Hospitalisation Expenses | 30 Days |
| Post – Hospitalisation Expenses | 60 Days |
| Road Ambulance Cover | Rs. 2000 per hospitalisation |
| AYUSH Benefit | Available |
| Other Features | |
| Maternity Benefit | Not Available |
| Critical Illness Benefit | Not Available |
| Free Health Checkups | Not Available |
| Co-Payments | Yes, 5% on all claims |
| Cumulative Bonus | 5% per claim free year, Maximum 50% of Sum Insured |
| Modes of Payment | Monthly, Quarterly, Half – Yearly & Yearly |
| Sub – Limits | |
| Standard Waiting Period | 24 Months |
| Pre – Existing Disease | Covered after 48 months |
| Cataract | Rs. 40,000 or 25% of Sum Insured per eye whichever is lower |
| Joint Replacement | A waiting period of 48 months |
Exclusions under Arogya Sanjeevani Policy
A person looking for a basic health insurance policy need not compare the entire available plan in the market. He just needs to opt for an Arogya Sanjeevani policy from any health insurance company.
This plan is also a cashless plan like other health insurance policies & TPA facility is also available in this plan.
As mentioned earlier, it’s a basic plan so it has some impediments also. Co-payment of 5% & absence of maternity benefit are a few of those.
A married couple & who are planning to have a baby soon needs to check it carefully before opting for it.
Also, exclusions like treatments related to weight loss, change of gender, plastic surgery, hazardous adventure sports, and breach of law or due to war are here.
There are sub-limits for treatments like cataracts, oral chemotherapy, bronchial thermoplasty, and several other treatments. One needs to be aware of this also.
The policy has a 48-month waiting period for pre-existing diseases, which is 12 months longer than offered by many insurers.
Should you buy Arogya Sanjeevani Policy?
Hence, in our view, it’s a good health insurance product covering all the major standard benefits. But its acceptance by the people will depend upon the amount of premium charged by the issuing insurance company as there is no set guideline issued by the regulator. So, the premium amount will be an important factor while opting for this policy.
Take care of exclusions. You may need a comprehensive policy to cover certain enhanced health problems.
If it is your first Mediclaim or Health Insurance it can work fine for you. Later on, in life, you may need full cover or specific illness-related policies such as cancer or diabetes. Also, a cover of 5 lakh will seem less in the coming years for a grown-up family.
So if you are looking for a no-frill policy with low cost – Arogya Sanjeevani is the one for you. The policy is available online as well as offline on all major insurance company websites & insurance web aggregators.
Do let us know your doubts on this.
(All graphics sourced from ET Wealth Edition of 18 May 2020)
