Arogya Sanjeevani Policy, Star Health and Allied Insurance Co Ltd.

• 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 policyholder (insured) has 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 policyholders a 5% of the sum insured as a 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 24/36 months.
3. Pre-existing diseases are covered after a waiting period of 36 months from the policy inception date.

• Portability
   

This policy can be ported. Such an option should be exercised at least 30 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 centres.

• Lifelong renewability
   

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

• 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, anaesthetists, medical practitioners, consultants, and specialists' fees are covered.
4. Costs incurred on anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, costs towards diagnostics, and 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.

• Ambulance expenses
   

The policy covers road ambulance expenses 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 embolisation and HIFU (High intensity focused ultrasound)
2. Balloon sinuplasty
3. Deep brain stimulation
4. Oral chemotherapy
5. Immunotherapies - a 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 prostate
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.

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, 1961, an individual can claim a deduction of up to ₹25,000 for health insurance premiums paid for self, spouse, and dependent children (below 60 years). This limit increases to ₹50,000 if the insured is a senior citizen. An additional deduction of up to ₹25,000 (₹50,000 for senior citizen parents) is available for premiums paid for parents. The maximum deduction can go up to ₹1,00,000 if both the individual and their parents are senior citizens.

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 expiryof 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 Arogya Sanjeevani Policy will not cover medical bills arising from illness within the first 30 days of policy inception, except for accidental medical expenses, which will be covered from the day of policy purchase.
• Any treatments related to gender change
• Home treatments and OPD treatments

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.

The Arogya Sanjeevani premium chart shows the premium applicable to different age groups, sum insured options and family configurations, helping customers understand the cost of the policy. An Arogya Sanjeevani Policy premium offers transparency in costs, supporting health insurance policyholders in making informed decisions about their health coverage.

You need an Arogya Sanjeevani health insurance policy to obtain financial security against increasing healthcare costs, particularly during unexpected medical emergencies.

The major advantage of the Arogya Sanjeevani policy is its affordable, standardised, and comprehensive coverage for various medical expenses, like hospitalisation, pre- and post-hospitalisation costs, daycare procedures, and even modern treatments, all within a single Standardize  Health Insurance product offered by different Insurer.