All You Need to Know About Arogya Sanjeevani Health Insurance Policy

All You Need to Know About Arogya Sanjeevani Health Insurance Policy

Arogya Sanjeevani Health Insurance Policy is basically a standard health insurance policy for individuals as well as families. This health cover provides with the coverage of up to Rs 5 lakh for the expenses related to basic hospitalization. Along with that, possibly to make the product easier and simple to understand, the Insurance Regulatory and Development Authority of India (IRDAI) has banned insurers from imposing any deductible or offering any rider and variants along with the policy. In addition, IRDAI has mandated all insurance companies in India to provide the Arogya Sanjeevani Policy from April 2020.
Should You Consider Buying the Arogya Sanjeevani Policy?
According to a number of reputed financial planning experts, such a health insurance policy is a good entry-level product. While on the other hand, a number of financial experts consider this coverage of Rs 5 lakh to be low since it will not be enough for covering a family of four (two adults & two children).
Arogya Sanjeevani policy is a simple and basic health insurance policy which is available at a relatively cheaper price. The policy provides with the option of getting a Sum Insured up to only Rs 5 lakh.  In addition, it has some features that a fully-loaded comprehensive health policy doesn't offer. For example, it has a co-payment of 5% which might not be there in a fully-loaded health cover.
The regulator has also mandated a 5% increase in the Sum Insured for each claim-free year subject to a maximum of 50% of the Sum Insured, given that the policy is renewed without a break.
Who Should Buy Arogya Sanjeevani Health Insurance?
  • The Arogya Sanjeevani Health Insurance Policy can be appropriate for first-time health insurance buyers since the product not only provides with wide-ranging coverage at an affordable premium but also the cover, terms & conditions of the policy are standard (common policy wordings) across all insurance companies. This part of the policy it quite easier for everyone to understand it.
  • The policy can be beneficial for younger people on the lookout for a comprehensive health cover for themselves.
  • If you are working but do not have any dependents and are unmarried, you can consider buying Arogya Sanjeevani Health Insurance Policy.
The Policy May Not Be Suitable for...
As mentioned above, the Sum Insured under the Arogya Sanjeevani policy is restricted to Rs 5 lakh. Taking the high costs of healthcare into consideration, a cover of Rs 5 lakh may not be sufficient, specifically for people living in bigger cities. 
Therefore, it is advisable to someone living in a metro or a big city, with the capacity to pay higher premiums to go for a health cover beyond the Arogya Sanjeevani Policy to ensure the sufficiency of policy.
In such a scenario, you can go for other health insurance policies with a higher Sum Insured. Further, you can consider buying a family floater health insurance policy if you have dependents. 
In short, if you are on the lookout for a health cover with a higher Sum Insured or if you already have an adequate health cover, Arogya Sanjeevani policy may not be the best suit for you. In actual fact, you should consider a super top-up health policy.
Coverage & Benefits of Arogya Sanjeevani
  • Given that the Arogya Sanjeevani Health Insurance Policy is a basic, standard policy set by the IRDAI, the premium for the same is relatively lower than other health covers available in the market.
  • The expenses of AYUSH treatments will be covered provided that the policyholder chooses to go for alternative treatment in place of the normal allopathic one.
  • Arogya Sanjeevani offers either Rs. 40,000 or 25% of the Sum Insured for Cataract Treatment.
  • Offers coverage for Uterine Artery Embolization and HIFU
  • The policy covers the treatment and hospitalization costs for COVID-19 too.
  • The coverage includes Covers Balloon Sinuplasty in extreme cases of rhinosinusitis or sinus inflammation, and blockages in the nasal cavity of a patient.
  • Covers Deep Brain Stimulation for the treatment of Parkinson’s Disease and Tourette syndrome.
  • Comes with Oral Chemotherapy expenses coverage.
  • Covers Immunotherapy
  • IONM – (Intra Operative Neuro Monitoring)
  • Covers ICU and ICCU Expenses
  • Covers Pre & Post hospitalization expenses
  • Covers Ambulances charges up to Rs. 2000/- per hospitalization during the policy period.
  • The Arogya Sanjeevani Policy will pay 2% of the Sum Insured up to Rs. 5000/- per day for Room Rent/Doctor’s Fee and Nursing Expenses.
  • For out-patient treatments or also known as Day Care Treatments, 50% of the Sum Insured can be claimed under the policy.
  • Covers Stereotactic Radio Surgeries, Bronchial Thermoplasty and Robotic Surgeries


Point to Note

Although the coverage of the Arogya Sanjeevani health insurance policy is universal for all insurance companies in India, the premium rates and customer service may vary from one insurer to another.
Lake a look at the below table of premium for Arogya Sanjevani (30 Years Age), Sum Insured - 5 Lakh (Including GST)

Insurance Company

  Annual Premium for 1 Adult  

  Annual premium for 2 Adults + 1 Child  

Raheja QBE

Rs 3190/-

Rs 5880/-

Universal Sompo

Rs 4164/-

Rs 7388/-

Star Health Insurance

Rs 4170/-

Rs 8255/-

SBI General Health

Rs 4501/-

Rs 9535/-

Religare Health Insurance

Rs 5094/-

Rs 10, 466/-

From the above write-up, it should be clear to you whether going for Arogya Sanjevani Scheme is a good decision or not, depending on your financial boundaries and existing health covers. Nevertheless, it is undoubtedly a groundbreaking health cover for the first-time health insurance policy buyers and people belonging to a lower income group.

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