Everything you need to know about Arogya Sanjeevani Policy

May 17, 2021 (0) comment , , , , ,

It is a difficult period for all of humanity collectively when a disease has gripped us hard. Our country’s health sector seems explicitly helpless and overwhelmed with an acute shortage of oxygen and hospital beds. Amidst the critical scenario, people who are still safe from falling prey into the deadly grip of COVID are anxious about how they can protect their family or themselves at times of need.  While everything cannot be in our hands, securing ourselves financially and covering medical emergencies should be at the top of everyone’s priority list right now.

In the year 2020, IRDA realized that customers seek an excellent health insurance plan that benefits them and help them in covering medical emergency when in need. The association also learned that people require more simplified policies when choosing them and knowing about them thoroughly. Hence, understanding the COVID situation and a person’s uncertain health response led to introducing policies covering general health emergencies and COVID health emergencies. The policy was termed as Arogya Sanjeevani Policy.

The dire need for the best health insurance makes it even more important to narrow down to a few good insurers who provide you with maximum benefits. However, the claim settlement ratio should not be a point of problem for the customers. IRDA announced and made it compulsory for the several insurance brands in the market to keep the policy conditions and benefits similar and standard. Therefore, it becomes even more difficult for the consumers to make their appropriate choice.

Hence, Secure Cover further in this article would discuss the specifications of the Arogya Sanjeevani Policy and information on the various benefits of taking the policy in the COVID-stricken era all your families are living in.


What is Arogya Sanjeevani Policy?

Arogya Sanjeevani Policy is regular or similar to any standard health insurance plan introduced by IRDA in 2020. The insurance policy, as IRDA authority, stated they this policy specifically aimed at simplifying and standardizing the benefits for the consumers irrespective of the company/brand they plan to choose. Therefore, the only difference to be found while a customer selects the health insurance policy from a specific brand is their premium rate for a fixed amount of Sum Insured.

It is one of the best standard policies introduced by IRDA to be adopted universally by all Indian Insurance Companies. Suppose a person is looking for a low rate of Sum insured with maximum benefits. In that case, Arogya Sanjeevani Policy could be the ultimate fit for them. The policy can help individuals and their families in times of medical crisis when the one thing anybody does not want is to feel the financial burden. The health policy covers pre & post-hospitalization expenses that include room bed & nursing charges, ICU, doctor’s consultation expenses, medication expenses prescribed under the treatment, etc.

The Arogya Sanjeevani Health Insurance Policy is a must-needed policy for every family, knowing the painful conditions outside and all over the world.


What are the Types & Eligibility Criteria for Availing the Policy and its Benefits?

The Arogya Sanjeevani Health Insurance Policy provides two kinds of policy. Depending on these two categories, the premium rate is selected based on the age criteria and any pre-existing health condition in a person.

Individual Health Plan, wherein a single person who has opted for the health policy, is the only policy and benefit holder in any medical emergency. The eligibility criteria for the health plan require the proposer to be between the age group of 18 years to 65 years to enter the insurance plan.

Family Health Plan involves a proposer/policyholder adding his/her family members under the health plan, who collectively can benefit from the insurance. For example, a person can add his/her spouse, dependent children, parents, in-laws, and other members in the family under the family floater Arogya plan. Thus, there would be multiple benefactors under a single policy who could take advantage of it when the medical need arises. It is beneficial to take this type of plan due to the fixed premium rate and same Sum insured amount for all individuals.

In this type of Arogya health plan, the dependent child under the proposer of the policy could be of the minimum age of 3 months and a maximum of 25 years. However, suppose the child above 18 years is financially independent. In that case, a proposer cannot add that individual to the family floater plan.

Some companies took the initiative to introduce a 5% or equivalent discount in the amount of premium paid in this plan. For example, suppose there are more than one policy beneficiaries with their individual Sum insured amount. In that case, they could benefit from this reduction in the overall premium rate.


What are some of the features/benefits of the Arogya Sanjeevani Health Policy?

A policy that has been simplified and standardized by IRDA for the comfort and benefit of consumers, Arogya health policy offers a good amount of advantages to the policyholder, which is universally similar and covers maximum benefits. Moreover, Arogya Sanjeevani Health insurance has optimized the services provided to customers separately by distinct insurance brands by standardizing all of them.

Here are a few features or benefits of the insurance policy that majorly remains similar irrespective of the insurance brand.

  1. The Sum Insured option in the Arogya Sanjeevani health plan ranges from 1 Lakh to 5 Lakhs. This amount has been sanctioned by IRDA and opted for by the various insurance companies in the market. However, some insurance companies have upped their Sum insured rate to provide the customers with the advantage of a more significant amount.
  2. Arogya Sanjeevani Policy has proven to be the most economical health plan currently, following the country’s medical crisis and health situation.
  3. Due to the COVID situation, no insurance company is currently asking for a health check-up for people up to the age limit of 65. Instead, the companies prefer tele underwriting (a telephonic recorded interview) to get all the necessary information from the customer. An additional amount of premium is added in case of any pre-existing disease.
  4. Arogya Health Plan also provides a No Claim Bonus offer to its customer if they have not claimed their Sum insured in a year. The company can reward by increasing the Sum insured amount by 5% on the same premium rate. Thus, it could also gradually increase to 50%.
  5. Arogya Health Plan comes with the feature of lifetime renewability that has no restriction concerning age, and the policy tends to be for one year.
  6. Arogya Sanjeevani Policy has eliminated all kinds of doubts or confusion associated with choosing the most appropriate insurance brand. Moreover, since IRDA declared it as a standardized policy covering the same benefits universally in every insurance brand, it is now more accessible for everyone to go for any company to opt for this particular health policy.
  7. Most companies offer a co-payment option as low as up to 5% in this health insurance. It means that the customer will only have to pay 5% of the claim amount. After that, the insurance company would pay up the rest.
  8. The most crucial advantage of this health plan comes up for those who are first-time buyers. A customer could utilize the policy when in a medical emergency with maximum coverage of benefits. The person would also have the advantage of paying a lower premium rate for a fixed sum insured.


What does the Policy Cover & What Not?

A specific checklist adds and discards medical treatments, including emergencies under the Arogya Sanjeevani Health Insurance.

Coverage included:

  1. Arogya Health Plan covers the post and pre-hospitalization expenses due to any illness, especially COVID-19, a significant cause of concern in the country at present. All the medical costs are borne by the company, except for accidental injury, for which different companies have different guidelines. The expenses include doctor’s fees, nurse charges, etc.
  2. Arogya Policy helps bear expenses related to regular medical treatment and other alternative treatments too, such as ayurvedic, homeopathic, which should, of course, be done in an approved hospital.
  3. Under this policy, the insurance companies are responsible for paying the ICU or ICCU charges of a policyholder by up to 5% of the total Sum insured amount per day.
  4. The policy would include road ambulance charges of up to Rs. 2000 as a maximum cap per hospitalization basis, and Rs. 5000 per day for room rent. The amount/ratio could also vary on the company’s policy guidelines and the Sum insured amount.
  5. Daycare Treatments (Any surgical treatment or procedure undertaken in a hospital where the patient remains for less than 24 hours) are also covered in the Arogya Sanjeevani Health plan by up to 50% or whatever ratio is decided in the company’s guidelines.
  6. Plastic Surgeries and or dental care treatment is covered only in the scenario where it is initiated due to a disease.
  7. Cataract Surgery expenses are also covered under the Arogya Sanjeevani Plan, where the costs per eye are subject to a limit of 25% of the Sum insured amount or Rs. 40,000, whichever is less.
  8. Some of the New Age treatments or surgeries have also been added to this standardized health policy. The list of these new-age treatments will be mentioned further in the article.


  1. Tests done to diagnose or investigate a disease would not be covered under the plan.
  2. The insurance company would not bear expenses related to obesity or weight management under the Arogya Health Plan.
  3. No expenses related to gender change treatment would not be borne.
  4. Expenses for any cosmetic or plastic surgery, the need for which has not been arisen due to physical burn, cancer, or any other severe injury, would not be covered under this policy.
  5. Expenses related to enforced bed rest where there is no medical treatment scenario and rehabilitation needs would not be covered in the policy.
  6. Any dietary supplements bought without the doctor’s recommendation are not included in reimbursement or claim settlement.
  7. No covering of treatments related to infertility or sterility.
  8. Any accident or injury due to participation in adventurous or hazardous sports would not be covered.
  9. Expenses of treatment related to alcohol or drug addiction.
  10. The policy does not cover any maternity expenses related to childbirth or pregnancy.
  11. No out-patient treatment or OPD expenses are covered under Arogya Sanjeevani Plan.
  12. There is no covering of COVID home quarantine treatment expenses where there is no medical practitioner or nurse involvement.


List of New Age Treatments covered under Arogya Sanjeevani Health Policy:

  1. Balloon Sinuplasty
  2. ItraoperativeNeuromonitoring (IONM)
  3. Uterine Artery Embolization and HIFU (High-Intensity Focused Ultrasound)
  4. Intra Vitreal Injection
  5. Robotic Surgeries
  6. Thermoplasty
  7. Stem Cell Therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions
  8. Oral Chemotherapy
  9. Stereotactic Radio Surgeries
  10. The Vaporization of the Prostate (green laser treatment or holmium laser treatment)

More new-age treatments vary from one insurance to other.

List of Insurance Companies providing Arogya Health Plan

Secure Cover has some of the excellent insurance companies providing Arogya Health Insurance with the most affordable premium rates. In addition, a good number of qualified staff assists in claim settlement during a time of medical emergency.

Here is the list of insurance brands we deal with their maximum sum insured amounts.

Name of Insurance Brand

Minimum to Maximum Sum Insured

ICICI Lombard

1-5 Lakhs

Bajaj Allianz

1-25 Lakhs

HDFC Ergo Health

1-10 Lakhs

Max Bupa

1-5 Lakhs

Star Health

1-10 Lakhs

Future Generali

1-5 Lakhs

Reliance General

1-5 Lakhs

15 day free-look period:

All the companies in the market offer a 15 day free-look period where a policyholder would be able to cancel his policy within these 15 days without having to pay any cancellation charges along with it. The premium will be refunded to the policyholder within the time frame as decided according to the company policy, reducing any expenses incurred by the company.

This 15 day free-look period is not applicable during the time of renewal of the policy. Although, after the 15 day free-look period is over, the customer can still cancel the policy by giving 15 days written notice to the insurance provider to cancel the policy.


Let’s Wrap Up

Arogya Sanjeevani Health Insurance is the new economic health pan that has been able to help many people, especially during these times of the COVID crisis. Various insurance brands in the market are trying to offer a reasonable premium rate at a good sum insured amount that could assist the customers during medical emergencies.

Secure Cover can assist you with some of the best insurance brands in the markets with a team of skilled insurance advisors and a competent crew behind claim settlement assistance.

Note: The initial standard waiting period for all claims except for accidental claims is 30 days from the date of policy issued. For pre-existing health conditions, it is four years, and for any specific or unique treatment, it is 2/4 years.

{To know more about Arogya Sanjeevani Policy or get a quote about the best available premium rates for these insurance brands, email us at: info@securecover.in, or contact us at +91 9650836644.}

Disclaimer: The content of this blog is based on the personal research of the writer. Reader’s discretion is advised. Neither Secure Cover nor the writer will be held responsible for any wrongful interpretation of the content of this blog.

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