This new standard health insurance policy available with every general and standalone health insurer takes care of basic health needs, and is a must for first-time buyers, especially in smaller towns
All general and standalone health insurance companies in India are launching a standard health insurance policy known as Arogya Sanjeevani after the insurance regulator gave its clearance.
Arogya Sanjeevani will cover the hospitalisation treatment costs of Covid–19 and will ensure quality healthcare remains accessible and affordable, especially at a time when the number of people infected with coronavirus is rising rapidly across the country.
In January this year, Insurance Regulatory and Development Authority of India (Irdai) issued guidelines on standard health insurance policy to take care of basic health needs of insuring public and have a standard product with common policy wordings across the industry. The policy will provide a basic health cover of Rs 1 lakh-Rs 5 lakh and there will be no deductibles. However, it will have co-pay of 5% applicable across all the ages. The minimum entry age is 18 years and the maximum is 65 years and the policy can be renewed for life.
Tapan Singhel, MD & CEO, Bajaj Allianz General Insurance, says a good health insurance policy can increase life expectancy of individuals. “The launch of this standard health insurance product will play a crucial role in encouraging people to opt for health insurance. Since the policy wordings are same across all insurers, the main differentiator will be the service you provide to the customer. The product coverage is easy to understand and will be same across all insurers, making it even easier for customers to opt for,” he says.
Coverage under Arogya Sanjeevani
The policy will cover hospitalisation expenses such as room, boarding and nursing at 2% of the sum insured, maximum up to Rs 5,000 each day. It will also cover fees of doctors, surgeons, anaesthetists, etc. For intensive care unit, the expenses will be 5% of the sum insured up to Rs 10,000 a day. Even pre-hospitalisation medical expenses for 30 days prior to the date of hospitalisation will be admissible. Also, post-hospitalisation medical expenses incurred for period of 60 days from the date of discharge from the hospital will be admissible.
The policy will cover plastic surgery and dental treatment. It will also cover cataract surgery subject to a limit of 25% of the sum insured or Rs 40,000, whichever is lower. If the treatment or surgery is done in a day, the insurance company will cover the medical expenses seamlessly.
Expenses incurred on hospitalisation under Ayush systems of medicine will also be covered without any sub-limits in the policy. As it is an indemnity-based cover, one can also take a family floater policy. Insurers cannot combine with critical illness or benefit-based covers. An individual can take the policy for self, spouse, dependent children from three months to 25 years, parents and parents-in-law. However, the policy cannot include children who are above 18 and are financially independent.
The policy will have waiting period of 24 to 48 months for certain diseases. Like all other health insurance policies, Arogya Sanjeevani too will have the option to port to another insurance company. The premiums on the policy will be same for all companies and all regions across the country and can be paid every month, quarter, six months or year. The sum insured will be increased by 5% for each claim-free year, up to 50% of the sum insured, provided the policy is renewed without a break.
Prasun Sikdar, managing director and CEO, ManipalCigna Health Insurance Company, says that considering the growing medical inflation, and rise of infectious diseases such as coronavirus, having a health insurance cover is a necessity for every individual and family. “It’s important for us to be prepared in advance and a safety net of health insurance coverage for yourself and family gives protection against the medical expenses of the future,” he says. The company is providing a family discount of 15% for covering two and more family members under the single individual policy to make it more affordable for families.
Arogya Sanjeevani is a good choice for first-time health insurance buyers, and especially for those living in smaller towns. However, with rising healthcare expenses, it is always better to go for a health insurance policy with higher sum insured.