A Guide to Arogya Sanjeevani Health Insurance

Arogya Sanjeevani is a comprehensive health insurance policy that has been established by the IRDAI (Insurance Regulatory and Development Authority of India) that must be issued by all health insurance providers. This was launched on April 1, 2020 to help simplify the health insurance search for most consumers. This plan offers basic comprehensive insurance with sum insured coverage from Rs. 100,000 to Rs. 500,000.

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What Is the Arogya Sanjeevani Policy?

Arogya Sanjeevani is a basic health insurance policy that was launched by the IRDAI to try and simplify the process of researching and selecting comprehensive health insurance. This policy allows individuals and families to opt for lower sum insured amounts for less coverage and lower premiums. and receive basic coverage.

This policy is also offered by every health insurance provider. Since people do not have to switch health providers to obtain an Arogya Sanjeevani policy, it will simplify the process of applying for the policy even more. This will be a great option for those who are looking to purchase a policy and are not frequent hospital visitors. With this being said, there are many other health insurance policies available, some of which may work better for you depending on your conditions and health issues. We recommend that you consult with a doctor and do your own due diligence before selecting a policy.

What Are the Benefits of Arogya Sanjeevani?

Health insurance policies have their own strengths and weaknesses that set them apart. A key measurement to determine this are the benefits that they offer. Similarly, Arogya Sanjeevani also has benefits that can be utilized by policyholders. Health insurance benefits help justify the premiums. The benefits here are no different. Arogya Sanjeevani offers a comprehensive policy that charges a lower premium and a range of benefits, which include:

BenefitBenefit Details
Pre-HospitalizationThe insurance provider will cover the treatment that is required as a preparation for your specific health concern.
  • Hospitalisation includes nursing expenses, bed charges, hospital stay, and other related expenses.
  • Your insurer may put a 2% sum insured limit— up to Rs.5,000 per day on hospitalization.
  • There are many procedures that would require patients to remain under hospital care or to continue treatment after the procedure is complete, the insurer will cover these expenses with this benefit.
  • Post-hospitalisation costs are covered for 60 days after the procedure.
ICU and ICCU ExpensesThe room rent for ICU and ICCU treatments will be covered up to 5% of the sum insured amount up to Rs. 10,000 per day.
Ambulance ChargesThe insurance company will cover the expense of ambulance transportation up to Rs. 2,000 per hospitalisation during the given policy period.
Daycare TreatmentFor out-patient treatments and day care expenses, patients can claim up to 50% of the sum insured amount.
AYUSH CareAll expenses alternative medication related to AYUSH will be covered up to the sum insured amount.
Dental Treatment and Plastic SurgeryThe cost of dental and plastic surgery can be claimed up to the full limit of the selected sum insured.
Cataract TreatmentThe cost of cataract treatment will be insured up to Rs. 40,000 or 25% of the sum insured, whichever one is lower—for each eye.
Stem Cell TherapyStem Cell Therapy is categorized as out-patient treatment and due to this it will be covered up to 50% of the selected sum insured amount.
No Claim BonusArogya Sanjeevani offers a no claim bonus, which gives policy holders that make no claims during a policy period a cumulative bonus of 5% of the sum insured. This discount is capped at 50%.

Arogya Sanjeevani Insurance Policy Exclusions

There are exclusions that apply to patients under the Arogya Sanjeevani policy. Exclusions that apply include are the following:

  • Treatment required due to illegal actions
  • Cosmetic and plastic surgery procedures
  • Gender change procedures
  • Injuries that are a result of hazardous or adventurous sports as a professional sport
  • Injuries related to war or related during a war-like situation
  • Eyesight correction
  • Infertility or sterility
  • Rehabilitation center and spa treatment expenses
  • Dietary supplements
  • Maternity expenses
  • Substance abuse
  • International treatment

What Are the Drawbacks of Arogya Sanjeevani?

Arogya Sanjeevani is a policy that offers a simple, comprehensive health insurance policy. However, it does have its drawbacks. For instance, Arogya Sanjeevani does not offer a wide range and high amount of sum insured. Consumers are asked to pick between Rs. 100,000 - Rs. 500,000. In comparison, other health care plans offer more sum insured variety, but higher premiums. Therefore, people that need more coverage may be more inclined to look for a different health insurance plan.

Additionally, the Arogya Seevanji policy does not cover all comprehensive insurance benefits. For example, a common benefit that is not included is maternity coverage. Not having maternity coverage means that individuals and families looking to have a baby might be better off with another type of health insurance.

Who is Eligible for the Arogya Sanjeevani Policy?

The Arogya Sanjeevani policy is offered as both an individual and a family floater policy, giving everyone access to it. The policy's family floater option also covers parents and parents-in-law. This policy offers lifelong renewal, but only if the policy was first purchased before the primary policy holder was below 65 years old.

Arogya Sanjeevani Waiting Period

The waiting period is the amount of time the insurance holder must wait before making a claim on an injury or illness. The following table lists out the waiting periods required by the Arogya Sanjeevani policy:

CoverageWaiting Period
Pre-Existing Diseases48 months
Joint Replacement Treatments48 months
Age-Related Osteoarthritis & Osteoporosis48 months
Certain Specific Diseases24 months
After Purchasing the Policy30 days

Arogya Sanjeevani Grace Period

The grace period is the buffer time you get after your existing health insurance policy expires to renew the plan. As a result, the longer the grace period, the longer you can take to make your annual payments. The grace period for Arogya Sanjeevani is 30 days. It is important to note that you cannot make any claims against the insurance policy during the grace period, which is why it would be better to make your payments immediately if you know you will be returning to the same policy. Furthermore, the policy period for this plan is 1 year. The grace period will be put into place after the policy period expires.

Plan NameEligibility Requirements
Arogya Sanjeevani
  • Minimum age of entry: 3 months
  • Maximum age of entry: 65 years

How Sign-Up for Arogya Sanjeevani

Arogya Sanjeevani can be found under the health insurance products page or health insurance section on all health insurer provider websites. The method of applying differs based on provider; however, it is the same as applying for any regular health insurance policy. For instance, some insurance providers will apply from a products page, whereas others will have an apply button on the home page. For further information, contact the insurer of your choice.

Check out our reviews for health insurance companies in India:

Health Insurance Providers in ValueChampion’s Study
Aditya BirlaBajaj AllianzCare (Formerly Religare)Future GeneraliHDFC Ergo
ICICI LombardIFFCO TokioKotakLibertyMagma HDI
ManipalCignaNew IndiaRoyal SundaramSBI GeneralStar Health
Tata AIGUniversal Sompo

Sahmi Chowdhury

Sahmi is a finance graduate from Northeastern University. He has had experience in the financial services sector working at Brown Brothers Harriman in trade settlement and True Capital Management as an investment analyst prior to joining ValueChampion.