• Eligibility
   

Arogya Sanjeevani Health Insurance Policy can be purchased by individuals between 18 and 65 years of age. The Arogya Sanjeevani family floater plan allows the insurer to cover up to two adults and three dependent children between 3 months and 25 years and parents and parents in law.

• Sum insured
   

The plan provides sum insured options ranging from a minimum of Rs. 50,000 to a maximum of Rs. 10 lakhs under the individual and floater basis.

• Policy term
   

Available for 1 year.

• Co-payment
   

The policy has a co-payment of 5% on admissible claim, which means that the Policy holder (insured) to pay 5% and 95% would be paid by the insurance company (insurer) of the eligible claim amount. This means that every time a claim is filed with the company, the insured will be required to pay a fixed 5% of the claim, and then Star Health Insurance will process the rest of the claim.

• Cumulative bonus
   

Arogya Sanjeevani Policy offers its policy holders a 5% of the sum insured as bonus for every claim-free year subject to a maximum of 50% of the sum insured.

• Waiting period
   

1. Any illness contracted within 30 days of the policy inception date is not covered. The exception is in case of an accident.
2. Coverage for specified illnesses/ surgeries becomes effective after 24/48 months.
3. Pre-existing diseases are covered after a waiting period of 48 months from the policy inception date.

• Portability
   

This policy can be ported. Such option should be exercised at least 45 days before, but not earlier than 60 days from the policy renewal date.

• Pre-medical screening
   

Persons above 50 years of age will have to undergo pre-acceptance health screening at the company's nominated centers.

• Lifelong renewability
   

While the eligibility for the purchase of this policy is limited to those between the ages of 18 to 65 years, this policy provides lifelong renewability as long as it is renewed on time. By doing so, the insured can enjoy continuous benefits like on coverage of PED’, cumulative bonus, etc.

Here are various expenses that are covered under the Arogya Sanjeevani Policy.

• Hospitalisation expenses
   

1. Room rent, boarding, and nursing expenses are covered up to 2% of the sum insured subject to a maximum of Rs.5000 per day.
2. Intensive Care Unit (ICU) and Intensive Cardiac Care Unit (ICCU) expenses are covered up to 5% of the sum insured subject to a maximum of Rs.10000 per day.
3. Surgeons, anesthetists, medical practitioners, consultants, and specialist fees are covered.
4. Costs incurred on anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, costs towards diagnostics, diagnostic imaging modalities.

• AYUSH treatment
   

Inpatient care treatment taken in AYUSH Hospital under Ayurveda,Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured. Also mention it in the table itself.

• Ambulance expenses
   

The policy covers road ambulance expenses charges up to a limit of Rs. 2000 per hospitalisation.

• Accident cover
   

All in-patient hospitalisation expenses related to accidental injury are covered under the Arogya Sanjeevani Insurance Policy.

• Modern treatments
   

Twelve modern treatments are covered up to 50% of the sum Insured.

1. Uterine artery embolization and HIFU (High intensity focused ultrasound)
2. Balloon sinuplasty
3. Deep brain stimulation
4. Oral chemotherapy
5. Immunotherapies - monoclonal antibody to be given as an injection
6. Intra vitreal injections
7. Robotic surgeries
8. Stereotactic radio surgeries
9. Bronchial Thermoplasty
10. Vaporisation of the prostrate
11. ION M Intra Operative Neuro Monitoring
12. Stem cell therapy
13. ICU/ICCU expenses

The policy covers expenses incurred due to admission to the ICU / ICCU up to the policy’s sub-limits. This covers the reimbursement / payment of all other hospital expenses, excluding medicine costs, in accordance with the permissible rate per day to the actual rate per day of ICU/ICCU charges.

      14. COVID-19 treatment cover

Arogya Sanjeevani Mediclaim Policy covers treatment for Covid-19 along with other illnesses. However, an initial waiting period of 30 days is applicable for COVID-19 related expenses under this policy.

Lower premiums

Keeping in mind the rising medical costs in India, the Arogya Sanjeevani policy’s premiums are comparatively lower than other health insurance policies in the market.

Low co-payment

There is a minimum co-payment of 5% required to be paid by the insured during an admissible claim in this policy.

Instalment premium options

The insured person can choose to pay their premiums in instalments, such as half-yearly or quarterly.

Tax benefits

As per Section 80D of the Income Tax Act of 1961, an income tax assessee, either individual or family members under the age of 60 can get Rs. 25,000 rebate on health insurance premium payment, and the amount can reach up to Rs. 50,000 for senior citizens above 60 years. The deductible amount would increase to Rs 1 lakh if two family members over 60 were insured under one policy. Conversely, if one family member is under 60 years of age and his parents are enrolled under the same policy, they can get a deduction of Rs 75,000.

The following list of policy exclusions is partial and not a complete list. Make sure you read through all the exclusions in the policy clauses.

• Expenses related to the treatment of pre-existing diseases (PED) and their direct complications before the expiry of the waiting period as intended in the policy clauses.
• Treatments, surgeries, and diseases prescribed under the insurance policy clauses will not be covered before the waiting period of either 24 months or 36 months, as applicable.
• The policy will not cover medical bills arising due to illness within the first 30 days of policy inception under the Arogya Sanjeevani Policy except for Accidental medical expenses, which will be covered from the day of purchase of the policy.
• Any treatments related to gender change
• Home treatments and OPD treatments

Arogya Sanjeevani is a common product designed by the insurance regulator. But few insurers are offering optional cover of Critical illness by demanding additional Premium. But Star health offers all features designed by the regulator, but the policy holders can avail good cashless facility across india.

Arogya Sanjeevani has a policy term of one year. The Premiums can be paid quarterly, half-yearly & annually.

5% copay to all admissible claims.

The sum insured options provided under this policy ranges from ₹50000 to ₹10,00,000 in multiples of fifty thousand.