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How Arogya Sanjeevani Policy avails the best AYUSH treatments

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Imagine you are suffering from an ailment, and despite getting hospitalised and seeing different doctors, your condition didn’t improve much. Then, one day, someone suggested you should try a certain homoeopathy treatment, and it proved to be beneficial. While your health got better, there was a rude shock that awaited you. When you raised a claim for that, your insurance provider rejected it stating that AYUSH treatments are not covered as part of your healthcare policy. Well, you are not alone. There are many who aren’t aware of the coverage regarding AYUSH. However, there is a simpler solution for that — Arogya Sanjeevani Policy. Let’s learn more about it.

What is the Arogya Sanjeevani Policy?

Arogya Sanjeevani Policy was launched by the Insurance Regulatory and Development Authority of India (IRDAI) in 2020. It is a basic health insurance policy offered by all insurance providers with uniform coverage. This means, all insurers are mandated to offer this policy with the same benefits and features with slight variations like premium amount. The policy is affordable and covers hospitalisation, pre- and post-hospitalisation, daycare procedures, AYUSH treatments, and more. One of the most significant benefits of this policy is that it covers AYUSH treatments (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) up to the sum insured. There are two types of Arogya Sanjeevani policies – individual health insurance and family floater.

Benefits of Arogya Sanjeevani Policy

Some key benefits of the Arogya Sanjeevani Policy are –

• Comprehensive coverage

The policy offers comprehensive coverage, which includes hospitalisation, pre- and post-hospitalisation, AYUSH treatments, daycare treatments, ambulance charges, cataract surgeries, dental treatments, etc.

• Affordable premium

The premiums are affordable, making healthcare accessible to everyone.

• No Claim Bonus

You are eligible for a no-claim bonus (NCB) if you do not make any claims during the policy term. The NCB is offered as a discount on your policy premium or an increase in the sum insured without any extra cost. The NCB can start from 5% and if the bonus gets accumulated over multiple policy years, you may be entitled to a discount of up to 50%.

• Tax Benefits

You can claim a tax benefit of up to Rs 25,000 on the premiums paid towards the Arogya Sanjeevani Policy. For senior citizens, the tax deduction is up to Rs 50,000.

• No medical test

Individuals below 45 years and with no medical history do not have to undergo any medical test while buying the policy.

Demerits/Limitations of Arogya Sanjeevani Policy

Arogya Sanjeevani has a few limitations, such as –

• Limited coverage

For some treatments like cataract surgeries or modern treatments (like stem cell therapy, robotic surgeries, and immunotherapy), the insurer does not compensate up to the sum insured. For instance, for cataract surgery of one eye, the insurer will pay INR 40,000 or 25% of the sum insured (whichever is lower) and for modern treatments, it will cover 50% of the sum insured in one policy year.

• Low sum insured

The sum insured is limited to Rs 5 lakhs, which may not be sufficient if you consider the increasing cost of healthcare.

• No riders

You cannot opt for any riders or add-on covers to further enhance the coverage.

What is Covered in Arogya Sanjeevani Policy?

• Hospitalisation costs

This includes in-patient hospitalisation, pre- and post-hospitalisation, emergency ambulance, daycare procedures, cataract surgeries, dental treatments, etc.

• AYUSH treatments

The policy covers alternative treatments like Ayurveda, Unani, Siddha and Homeopathy (AYUSH) done in a government hospital or any institute recognised by the government and/or accredited by the Quality Council of India/National Accreditation Board.

• Modern treatments

Modern procedures, such as robotic surgeries, Uterine Artery Embolisation, HIFU (High-Intensity Focused Ultrasound), oral chemotherapy, Bronchial Thermoplasty, Intra Vitreal injections, and stem cell therapy are covered.

Waiting Period

• Pre-existing diseases are covered after a waiting period of 3 years.

• Specific procedures like hernia and knee replacement surgery are covered after a 2-year waiting period.

Exclusions

• Cosmetic surgeries, obesity treatments

• Self-inflicted injuries

• Injuries due to participation in adventure sports

• War-related injuries or injuries sustained while participating in defence operations

Who is eligible for the Arogya Sanjeevani Policy?

The eligibility criteria for availing of Arogya Sanjeevani include –

1. Individuals between the ages of 18 years and 65 years

2. Dependent children between 3 months and 25 years can be covered in the family floater

3. The policyholder’s legally wedded spouse, parents, and in-laws can be included in the plan.

Conclusion

Many people shy away from buying health insurance because of the high premiums and end up denting their savings on medical bills. The Arogya Sanjeevani Policy is a great relief for those who cannot afford the high premiums. Although the policy offers basic coverage, it provides policyholders financial security against a wide range of medical services. If you are a firm believer in alternative medicines, this is the ideal policy for you as it covers AYUSH treatments up to the sum insured. However, if you are at risk of contracting a critical illness like cancer, kidney failure, or stroke, it is advisable to buy critical health insurance for comprehensive protection against the high treatment costs of such ailments.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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