What is Arogya Sanjeevani Scheme?

Due to increasing number of insurance companies and their online policies, people are often confused about the right and wrong policy and the best policy for themselves. Each of the schemes offered to the customers has its own distinct characteristics and that is why customers are dilemma about choosing the best plan for themselves. Therefore, the Insurance Regulatory and Development Authority of India (IRDA) has come up with a standard health insurance policy in January 2020 to address such a problem. The scheme is named Arogya Sanjeevani. This is the first scheme of its kind. Therefore, information related to this is being given through this article.

Arogya Sanjeevani Yojana

IRDA has announced that this standard scheme will be named Arogya Sanjeevani scheme for all companies. This will give better clarity to customers and they will be able to avoid confusion. No other name can be used for this scheme in any document. Each insurance company (standalone and general) will have to offer the Arogya Sanjeevani scheme. About 22 diseases will be covered under this scheme and the waiting period will vary depending on the treatment and diseases. It can range from 24 to 48 months. Depending on the coverage, the price of the policy will be determined by the insurance companies under the guidelines of IRDA. The scheme has been introduced with the objective of ensuring the availability of health insurance policies easily, hence it is expected to be affordable. The minimum age for availing the policy is 18 years and it can be renewed throughout life. The term of the policy is one year.

Cover provided in Arogya Sanjeevani Scheme

It is mandatory to provide the following cover under the Arogya Sanjeevani scheme –

  • Hospitalization expenses.
  • Essential dental and plastic surgery due to illnesses or injuries.
  • Treatment of cataract (up to a limit).
  • A maximum daycare cost of Rs 2,000 for ambulance and hospitalization.
  • Expenses incurred before hospitalization (30 days prior to hospitalization)
  • Post-hospitalization expenses (60 days after date of discharge)
  • Expenditure on Aayush treatment (for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy etc.)

The Arogya Sanjeevani Yojana aims to cover the basic health needs of customers of any age. Most of the health insurance policies offered in India have an age limit of 60 years. In some cases it can be up to 80 years old. At the same time there is no age limit in Arogya Sanjeevani Yojana and you can claim for benefits during your whole life. For this, you just have to renew it annually.

If you do not make any claim within a year, the company offers a 5% increase on the sum insured. This increase will be done every year. With this, if you do not get the benefit of your policy during a particular year, then a part of it is added in the next year. Cumulative bonuses are offered by most health insurance plans. But in this plan special bonus is being offered on the sum assured. However there are some conditions for this also. The Arogya Sanjeevani scheme will be implemented from April 1, 2020.

To understand how beneficial this scheme is, let’s have a look at the drawbacks of a general health insurance plan –

waiting period – The waiting period is the period after which the insured starts receiving the benefits of the health insurance scheme. There is a long waiting period for newborns, pre-existing diseases etc. We all take health insurance policies to reduce the burden of hospital charges and no one wants to have a new disease. We want to reduce the burden of expenses of already existing diseases. We cannot claim to cover pre-existing diseases immediately after taking the policy if the waiting period of general health insurance plans is longer.

Age Range – As we get older, we start to get sick and the frequency of hospital visits increases. Old age is the last lesson of life and at this age people are most in need of medical help. But most health insurance policies have a certain age limit. Most health insurance policies have a maximum age limit of 60 years.

  • Each health insurance plan is different. Cheap health insurance plans cover only a few diseases. In most cases basic needs are also not covered.
  • Health insurance policies are expensive. If you want to take advantage of a policy with good coverage, you will have to pay a higher premium. Even after this, if you get any disease that is not covered under the policy, then your claim will not be settled.

Arogya Sanjeevani Yojana is a well-drafted health insurance policy by IRDA, which is being introduced to provide a standard health insurance policy to every person. In this scheme, the solution of all the deficiencies mentioned above has been introduced.