Arogya Sanjeevani health insurance policy: Benefits, limitations to know before buying

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Updated: April 28, 2021 4:20 PM

The policy is most suitable for young first-time health insurance buyers or someone looking for an affordable health insurance policy that covers the basics.

Arogya Sanjeevani, policy, scheme, ACKO Insurance, standard health insurance policy, plan, deductible, co-payment, coverageArogya Sanjeevani provides coverage from a minimum of Rs. 50,000 to a maximum of Rs. 10 lakh.

Cost of hospitalization or medical inflation was always considered to be one step ahead of regular inflation in the economy. With coronavirus-led hospitalization, the importance of health insurance policy has gained currency to protect one’s savings. By paying a fraction of the coverage amount in a health insurance policy, one ensures that the hospital bill is reimbursed by the insurer.

But then, which could be the right health insurance policy to buy? There are several kinds of health insurance plans with varying features and even add-on features that could get confusing for the buyers.

In order to help buyers, the insurance regulator IRDAI had mandated insurers to launch a standard health insurance policy called Arogya Sanjeevani Policy which also covers the hospitalization expenses incurred due to Covid-19. Biresh Giri – EVP – Actuary, ACKO Insurance tells FE Online more about the plan, its benefits, limitations and the watchouts before buying it.

What is Arogya Sanjeevani Policy? Whom does it suit?

Arogya Sanjeevani is also called Standard Health Insurance. It is called so because it is a balanced policy with standardised features and benefits. The policy is most suitable for young first-time health insurance buyers or someone looking for an affordable health insurance policy that covers the basics. Considering the standardization of the terms and conditions across insurers, it is easy to comprehend the policy structure.

What are some important watchouts before buying Arogya Sanjeevani Policy?

You can buy an individual or even a family-floater alternative under this plan. However, for both, Arogya Sanjeevani provides coverage from a minimum of Rs. 50,000 to a maximum of Rs. 10 lakh. With the growing healthcare costs, Rs. 10 lakh sum insured split between spouse, children and parents might not be enough for a big family, especially if you are living in a city.

Hospitalization costs are surging and are unlikely to drop anytime soon. Considering you buy a personal health insurance policy that can last you a lifetime, Arogya Sanjeevani might not scale with your lifestyle. While Rs. 10 lakh cover seems enough now, the question you need to answer is will it suffice 10-20 years down the line for you? There is of course the option to buy a top-up or port your policy for a higher Sum Insured, but it is something to think about for the buyer.

Any limitations in Arogya Sanjeevani that a buyer needs to be aware of?

To keep Arogya Sanjeevani affordable for all, there are certain limitations on the benefits. The policy has a Room Rent Limit of 2% of the Sum Insured and a Co-Payment of 5% of Sum Insured. Health Insurance is meant to protect you from financial liabilities and also make good healthcare affordable to you.

Arogya Sanjeevani achieves that goal despite the limitations. But if you would prefer to pay the absolute minimum amount in case of hospitalization, then Arogya Sanjeevani may not be the right fit for you. There are other plans that don’t have any limit on Room Rent nor do they have a co-payment clause that will drastically reduce your out-of-pocket expenses at the time of hospitalization.

Also, if you are seeking specific benefits or exemptions for events or illnesses like maternity, critical illnesses, and diabetes then Arogya Sanjeevani might not be a good fit. To achieve simplicity, Arogya Sanjeevani comes with benefits that appeal to the masses. If you have a specific need then you can either include them with the help of add-ons, or go for a comprehensive policy that includes those benefits.

What if someone already has a corporate health insurance policy?

Many of us are covered under a corporate health insurance policy and don’t feel the need to buy a retail health insurance policy. But a corporate health insurance policy doesn’t protect you in the following cases where you arguably need it the most:

  • After you retire
  • If you lose your job or switch to a firm that doesn’t provide adequate health insurance

Arogya Sanjeevani is a great policy to buy alongside your corporate health insurance. In this case, the policy limitation becomes an asset. Owing to the limitation, the policy is affordable. Since Arogya Sanjeevani comes with lifetime renewability, you can keep renewing the policy to help you if and when you lose access to Corporate Health Insurance. It also serves to complement your corporate health insurance cover which may not be sufficient for your family.

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