Know All About Arogya Sanjeevani Health Insurance Policy
18 February, 2021
0 Shares
490 Reads
Share
As of April 2020, the Insurance Regulatory and Development Authority of India has directed all health and general insurance firms to provide the Aarogya Sanjeevani Policy, which is a regular health insurance policy for individuals and families that covers basic hospitalization-related costs up to Rs 5 lakh, along with hospitalization costs for COVID-19 patients. The regulator has forbidden insurers from implementing deductibles or providing riders and variants with the policy to make it easier to understand for someone who is looking to buy the policy.
This blog will discuss the plans, policy premiums, and benefits of the Arogya Sanjeevani scheme.
Plans and Policy Available Under Arogya Sanjeevani Scheme
Under the Arogya Sanjeevani Policy, there are two types of Plans Available:
- An individual plan where the Sum Insured will be separate for each member.
- A family floater plan where Sum Insured will be shared among all members.
Arogya Sanjeevani Policy Premium
This policy is a regular health insurance plan available in India from a number of insurers. The benefits and product features will be same across however the premium will vary for each insurer.
The individual plan start at around Rs. 3000, while Family Floaters two member plan start at around Rs. 4,500. The actual premium will depend on age, Sum Insured chosen and family members covered under the policy. Your chosen insurer's website will have the exact insurance premium chart and prices, as well as other information about your Arogya Sanjeevani Policy.
Arogya Sanjeevani Health Policy Eligibility
The Arogya Sanjeevani Health insurance policy is applicable to everyone between the ages of 18 and 65. You can also include dependent children aged 3 months to 25 years in the policy.
The family members allowed under this policy are self, spouse, children, parents, and parents-in-law. This health insurance policy can be renewed lifelong subject to payment of due renewal premium.
Benefits of Arogya Sanjeevani Policy
The policy covers pre- and post-hospitalisation, hospitalisation, doctors' and nurses' fees, and intensive care expenses, among other things and medical conditions. A complete list of coverage should be obtained from your insurance provider.
1. Hospitalization cover
- Inpatient care at a hospital, including room rent and ICU charges.
- Room rent limits:
a. Room rent: up to 2% of sum insured subject to a maximum of Rs.5,000 per day.
b. ICU/ICCU: up to 5% of sum insured subject to a maximum of Rs.10,000 per day.
2. Pre & Post hospitalization
Expenses for Pre hospitalization up to 30 days prior to hospitalization and Post hospitalization up to 60 days post discharge from a hospital will be covered
3. Tax Benefit
If you purchase this health insurance policy, you may claim a tax advantage under section 80D of the Income Tax Act of 1961.
4. Cumulative bonus
Cumulative bonus of 5% in respect of each claim free policy year, maximum up to 50% of sum insured. In case of a claim, the accrued cumulative bonus will be reduced at the same rate.
5. Free Look Period
On Arogya Sanjeevani Policy, you will have a free look-up period. This is the window of opportunity for you to thoroughly review the terms and conditions of your health insurance policy and determine whether or not to retain it. If you want to cancel the contract, you can obtain a refund according to the term and conditions of the policy.
6. Ambulance Costs
Under the Arogya Sanjeevani Policy Road Ambulance charges up to Rs.2,000 per hospitalization is also covered on.
Inclusions Under Arogya Sanjeevani Scheme
The following are the limitations of the National Arogya Sanjeevani health plan:
Any costs associated with medical evaluation and investigation.
Hospitalisation costs for respite care, rest cure, and rehabilitation.
Any costs associated with cosmetic and plastic surgery.
Sterility/Infertility/Maternity expenses are also ineligible for reimbursement.
Expenses for hospitalisation incurred as a result of participation in adventure/risky sports activities.
Gender treatments are also prohibited.
Expenses for surgical treatment of obesity that do not meet certain criteria.
Claim Settlement Process
The claim settlement process under this policy is categorised under two types: Payment claims and Cashless claims. Policyholders can use the claim procedure and steps outlined below:
Arogya Sanjeevani Payment Claims
For emergency hospitalisations, you must notify the insurer within the time frame specified below:
Within 72 hours of hospitalisation, you must share a written notification/fax/call the TPA (both emergency and planned).
Post-treatment expenses for pre- and post-hospitalization are reimbursed separately.
Sign the Investigation report, discharge summary, and other relevant documents before leaving the hospital.
Submit all required documents to the TPA in original within 15 days of hospital discharge.
Cashless Claims Made by Arogya Sanjeevani
To make a cashless claim under your National Arogya Sanjeevani policy, fill out the claim form.
Submit it to the TPA, and after verification, you will be granted authorisation to begin treatment.
At the time of discharge, sign and verify your papers.
If the insurer does not approve the cashless claim for any reason, you can get your expenses reimbursed.
Conclusion:
Arogya Sanjeevani Policy is offered by all health and general insurance firms in India, and they offer a range of advantages. It includes hospitalization cover, pre- and post-hospitalization costs, ambulance charges among other items. Arogya Sanjeevani Policy shields you and your loved ones from financial catastrophe in the event of a medical emergency.
Secure your Health with comprehensive insurance plans from Niva Bupa
Popular Searches - Health Insurance | Medical Insurance | Best Health Insurance Plans | Health Insurance Plans | Health Insurance Policy | Best Health Insurance Plans | Best Family Health Insurance | Best Mediclaim Policy | Best Health Insurance In India | Best Medical Insurance In India | Best Health Insurance Plans In India | Best Health Insurance Policy In India | Mediclaim | Best Health Insurance For Senior Citizens In India | Best Health Insurance | Health Insurance With Opd Cover | Mediclaim Insurance | Medical Insurance Plans | Best Health Insurance Company in India | Critical Illness Insurance | Personal Accident Insurance | Mediclaim Policy | Individual Health Insurance | Pregnancy Insurance | Maternity Insurance | | Best Family Health Insurance plans in India | Best Health Insurance company | Family Health Insurance | Best Health Insurance plans for Senior Citizens | Mediclaim Policy for Family
Health Insurance Schemes - Chief Ministers Comprehensive Health Insurance Scheme | Employee State Insurance Scheme | Swasthya Sathi Scheme | Pradhan Mantri Matru Vandana Yojna | Government Health Insurance Scheme | Dr. YSR Aarogyasri Scheme | Pradhan Mantri Suraksha Bima Yojna | Health Insurance Deductible | West Bengal Health Scheme | Third Party Administrator | Rashtriya Swasthya Bima Yojana | In Patient Vs Out Patient Hospitalization | Mukhyamantri Chiranjeevi Yojna | Arogya Sanjeevani Health Insurance | Copay Health Insurance | Cashless Health Insurance Scheme | Mukhyamantri Amrutum Yojna
Travel Insurance Plans - Travel Insurance | International Travel Insurance | Student Travel Insurance | Travel Insurance USA | Travel Insurance Canada | Travel Insurance Thailand | Travel Insurance UK | Travel Insurance Germany | Travel Insurance Bali | Travel Insurance Vietnam | Travel Insurance Dubai | Travel Insurance Singapore | Schengen Travel Insurance
Top Hospitals - Best Hospitals in Chennai | Top Hospitals in Delhi | Best Hospitals in Gurgaon | Best Hospitals in India | Top 10 Hospitals in India | Best Hospitals in Hyderabad | Best Hospitals in Kolkata | Best cancer hospitals in Bangalore | Best cancer hospitals in Hyderabad | Best cancer hospitals in Mumbai | Best cancer hospitals in India | Top 10 cancer hospitals in India | Top 10 cancer hospital in Delhi | Multi Speciality Hospitals in Mumbai | Multi Speciality Hospitals in Chennai | Multi Speciality Hospitals in Hyderabad | Super Speciality Hospitals in Delhi | Best Liver Hospitals in Delhi | Best Liver Hospitals in India | Best Kidney Hospitals in India | Best Heart hospitals in Bangalore | Best Heart hospitals in India | Best Heart hospitals in Kolkata | Best Heart hospitals in Delhi
Others - Top Up Health Insurance Policy | Corporate Health Insurance | Health Card | Section 80d of Income Tax Act | Ayushman Bharat | Health Insurance Portability | GoActive Family Floater Plan | Health Companion Family Floater Plan | Health Premia Family Floater Plan | Health Pulse Family Floater Plan | Health Recharge Family Floater Plan | Heartbeat Family Floater Plan | Money Saver Family Floater Plan | Saral Suraksha Bima Family Floater Plan | Senior Citizen Family Floater Plan | Super Saver Family Floater Plan | Corona Kavach Family Floater Plan | Hospital Cash Insurance | Cashless Health Insurance | Health Companion Price revision | Heartbeat Price revision | ReAssure Price revision
COVID - Omicron | Coronavirus Health Insurance | Covid XE Variant | Norovirus
www.nivabupa.com
+91 11 41743397
1860-500-8888
14th Floor, Capital Cyberscape, Sector 59, Gurgaon
- Insurance is a subject matter of solicitation. Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company Limited) (IRDAI Registration Number 145, Category:Health), 'Bupa' and 'HEARTBEAT' logo are registered trademarks of their respective owners and are being used by Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company Limited) under license. CIN: U66000DL2008PLC182918
- 1 Niva Bupa processes pre-authorisation requests within 30 minutes for all active policies, subject to receiving all documents and information(s) up to Niva Bupa’s satisfaction. The above commitment does not include pre-authorisation settlement at the time of discharge or system outage.
- 2 Since Inception refers to claim data from 2010 till December 2023.
- 3 ReAssure 2.0 Premium: The premium is including taxes and for Bronze Variant, for a 25-year-old individual living in Delhi.
- 4 Aspire Premium: The premium is including taxes and for Gold+ Variant, for a 25-year-old individual living in Delhi.
- 5 Senior First Premium: The premium is including taxes and for Gold Variant, for a 65-year-old individual living in Delhi.
- 6 Health Premia Premium: The premium is including taxes and for Silver Variant, for a 25-year-old individual living in Delhi.
- 7 SmartHealth + Disease Management Premium: The premium is including taxes and for Disease Management Gold Variant rider when bought with ReAssure 2.0 Bronze variant with Base Sum Insured of 5 lacs, for a 25-year-old individual living in Delhi.
- Beware of spurious / fraud phone calls! Do not share your confidential information like Debit / credit card number, Internet Banking User ID/Password, Pin, CVV, OTP, etc. with anyone. Avoid clicking on attachments / payment link received in mails / message from unknown sources. IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment or premium. Public receiving such phone calls are requested to lodge a police complaint. Do not respond to unsolicited and attractive offers received through unidentified calls, emails, SMSs, and other social media platforms. Beware of misleading telephone calls from people posing as Niva Bupa officials, agents, IRDAI Officials, Officials from ECI (Office of the Executive Council of Insurers) etc. and offering alluring benefits or sharing false information on your policy or on Niva Bupa. Niva Bupa shall not be responsible for any loss or damages whatsoever for any acts or omissions arising out of such spurious calls, and all customers are advised to contact our customer care at 1860-500-8888 and verify any representations or promises made by any such spurious callers before acting upon the same.