IRDAI had mandated all standalone health insurance companies and general insurance companies to offer a standard health product to the policyholders from April 1, 2020.
Buying a health insurance plan has become much simpler than before. As a buyer now one need not have to compare policies across insurers in terms of their features. IRDAI had mandated all standalone health insurance companies and general insurance companies to offer a standard health product to the policyholders from April 1, 2020. Such standard health insurance is called Arogya Sanjeevani Health Insurance Policy and will carry almost similar features across insurers.
Several insurers including Digit Insurance, a new age general insurance company has launched Arogya Sanjeevani Health Insurance Policy, let us see what it has to offer.
For someone who is 30 years of age, for the Rs 5 lakh cover, the annual premium comes to about Rs 2914 plus GST. In comparison, the regular health insurance policy of Digit Insurance for the same individual and for the same insured will cost Rs 3900 plus GST. The latter will, however, cover Critical Illness in addition to hospitalisation. Further, it will not have any co-payment clause.
The policy provides Cashless facility that can only be availed at the Network hospitals (5900 as on Feb 11, 2020) else one has to apply for reimbursement of the claim for which the payment is supposed to be received within 30 days from the receipt of the last necessary claim document.
The room rent is 2 per cent of Sum insured up to a maximum of Rs 5,000 per day. The ICU/ICCU room rent charges will be 5 per cent of Sum Insured, up to a maximum of Rs. 10,000 per day. The plan covers Day care procedures. Daycare procedures refer to medical treatments undertaken in a hospital, requiring less than 24 hours due to technological advancement.
Owing to the success of technology in medicine, there many modern treatments like Balloon Sinuplasty, Immunotherapy, Stem Cell Therapy, Robotic surgeries amongst many other treatments which are covered as a part of this policy. Plastic Surgery and Dental treatment necessitated owing to an injury or a disease are also covered. Cataract surgery for both eyes up to 25 per cent of Sum Insured Rs. 40,000 whichever is lower, per eye is covered. If you wish to get hospitalized under an alternative therapy such as Ayurveda, Unani, Siddha, Yoga and/or Homeopathy, it is also covered. The Pre-hospitalization and Post-Hospitalization expenses are covered for 30 and 60 days respectively.
There will be a waiting period depending on the nature of ailments in addition to the waiting period for pre-existing ailments. One needs to carefully read the inclusions and exclusions before buying any policy.
If there is a claim in a year, there is an increase in the base Sum Insured, without any increase in your annual health insurance premium. This increase in Sum Insured is called as the Cumulative Bonus and is 5 per cent for each claim-free year up to maximum up to 50 per cent.
Further, there will be a Co-payment clause in such a policy that refers to the amount of money you need to pay from your pocket, during a health insurance claim. In this policy, it is 5 per cent Co-payment on each claim.
The Arogya Sanjeevani Health Insurance Policy has a maximum sum insured of Rs 5 lakh and as medical inflation is rising fast, you may have to buy additional coverage through a regular health insurance policy. If you still do not have a health insurance policy for self and family members, its time you get one. Before buying you may compare the premium across a few insurers.