Is Arogya Sanjeevani Suitable Health Insurance Plan for India
Health Insurance companies in India under the guidelines of IRDAI, the insurance regulator in India, have recently started offering (w.e.f. April 1, 2020) an affordable plan known as Aarogya Sanjeevani. The benefits under this plan are standard across insurers but the premium amount varies. Let us look at this plan in detail to understand if it is beneficial for the common man.
What is Aarogya Sanjeevani?
Aarogya Sanjeevani (AS) offers basic, standard health care coverage at an affordable price point. Insurance experts estimate that the premium for AS is around 20-50% less than comparable base plans currently in the market.
Read here: Arogya Sanjeevani Policy
Features of Aarogya Sanjeevani
|
Sum Insured |
Rs. 3 lakhs – Rs. 5 lakhs |
|
Eligibility |
18 to 65 years of age (Lifelong renewability) |
|
Coverage type |
Individual or Family floater |
|
Dependent Coverage |
Self, spouse, dependent children aged 3 months to 18 years, parents and in-laws |
|
Co-payment |
5% of claim amount per claim |
|
Bonus |
5% of sum insured subject to a maximum of 50% of sum insured. |
|
Hospitalization expenses |
Minimum 24 hours |
|
Pre/Post-Hospitalization |
30/ 60 days |
|
Modern Treatments |
Covered subject to max. 50% of SI |
|
AYUSH |
In patient treatment covered |
|
Pre-existing diseases |
Wait period of 48 months |
Read more: SBI Arogya Sanjeevani Policy Health Insurance
How does Aarogya Sanjeevani compare against other existing plans?
Let us look at how Arogya Sanjeevani compares against other basic plans.
- SI Capped: While most basic plans which offer similar coverage but when it comes to Sum Insured (SI), there are provisions for choosing higher SI as well. In case of AS, the SI is capped at Rs. 5 lakhs. In rural and semi-urban areas, this would be adequate, however, in tier 1 and 2 cities this amount may fall short for families.
- No Add-ons: Some basic plans, currently in the market, provide options for add-ons or riders that provide some valuable benefits which are not allowed in AS.
- Co-pay: Many basic plans do not come with a co-pay clause whereas it is mandatory 5% of claim amount in case of AS. This could be a sizable amount for single-large-amount claims.
- Bonus: The bonus in case of AS is capped at a maximum of 50% of SI which is limiting in some way when compared to other existing base plans. Some of the existing plans provide 100% SI as cumulative bonus.
- Maternity Cover Exclusion: Another exclusion that may be missed by many families is Maternity cover.
Who Should Buy Arogya Sanjeevani Plan?
Although it might appear that the Aarogya Sanjeevani has certain limitations, it is important to note that it is a pretty good plan for young individuals, even in metro cities, and many families all over India who are not residing in top tier cities. This is because the coverage is adequate for this segment; the policy is simple for first timers and people relatively new to health care; and its standard offering makes it easy for future portability or migration to other plans offering greater benefits. The most important thing to note is that people who had no exposure to insurance earlier, who ended up paying 100% of their health care completely out-of-pocket can now expect to pay much less (just the 5% co-pay).
Know more: Arogya Sanjeevani Policy of ManipalCigna Health Insurance Company
Conclusion
All things considered, Arogya Sanjeevani looks promising as a base plan that can introduce a large segment of the Indian population to standard healthcare coverage. Once people start to avail the benefits, it is more likely to gain wider acceptance, not just for protection against the current pandemic, but a safe cover in general.
Disclaimer: This article is issued in general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.
