The COVID-19 outbreak has definitely made it clear that a health crisis comes uninvited and a good insurance plan will help protect your family members and yourself from unnecessary financial constraints caused by large medical bills, especially at a private hospital.
Starting 1 April 2020, all insurance companies in India have been offering the "Arogya Sanjeevani" plan among the health insurance policies offered by them as per IRDAI's (Insurance Regulatory and Development Authority of India) mandate.
So what is this "standard" health insurance product cover and is it the best fit for you?
What is Arogya Sanjeevani plan?
Insurance regulator IRDAI introduced a standard health insurance policy, calling it "Arogya Sanjeevani" to not overwhelm a first time health plan buyer with insurance jargons.
The policy is the same whether bought from a private or public sector insurer. It will include the name "Arogya Sanjeevani" followed by the name of the insurer.
The idea behind the introduction of the policy was to provide a simple, entry level health insurance product to consumers with a cover of up to Rs 5 lakh for when hospitalised for injuries or illnesses.
It was introduced to encourage more people in India to opt for health insurance products to cover basic hospitalisation charges without being confused by the endless number of health policies offered by insurance companies.
IRDAI has banned insurers to impose deductibles or offer riders and variants with this policy.
- It covers basic hospitalisation expenses like day-care treatment, pre and post-hospitalisation expenses.
- The policy terms under Aarogya Sanjeevani are the same irrespective of the insurance company you buy from.
- Available for both individual lives and on family floater basis.
- Minimum sum insured is Rs 1 lakh and the maximum is Rs 5 lakh.
- Minimum entry age: 18 years, maximum entry age: 65 years. For children under 'Family Floater' policies, the entry age: 3 months, exit: 25 years.
- It is annually renewable with a grace period of 30 days, with a lifelong renewability option.
- A co-payment of 5 percent.
- No add-ons and optional covers available.
- As a special benefit, plastic surgery and dental cover in case of injury or illness are provided.
- Cumulative bonus facility is available, that is, an additional increase in sum insured (up to a maximum of 5 percent) without any increase in existing premium payment.
How to decide which insurance company to choose?
Under the Arogya Sanjeevani health insurance policy, coverage, exclusions and aspects of the policy such as co-payment (cost-sharing arrangement that is, a certain percentage of claim amount that the customer has to compulsorily pay from his/her pocket) and sub-limits (cap on coverage for a particular treatment), are the same across insurers.
However, premium and process of on-boarding a customer will vary between the insurance companies. Therefore, the decision of which insurer should one choose will rest on the credentials of their insurer, the cost of premium offered, their network of hospitals for the cashless facility (or reimbursement of incurred expenses) and their customer service.
You could also look at the convenience of their online facility to purchase insurance as well as pay the premium, if that is important to you.
The Arogya Sanjeevani policy eliminates the need to compare a long list of complex features across different products offered by a different insurer. Further, due to the standardisation, a customer can seamlessly port between insurers if he/she is not happy with their existing insurer's service.
Is it suitable for you?
As mentioned before, the Arogya Sanjeevani policy is a simple health plan with a cover of up to Rs 5 lakh. It will probably suit those who do not have a good health insurance cover from their employer, are young and new to the health insurance buying terms. It could be used as a starter pack to protect yourself against unexpected health emergencies.
However, if you have dependents (parents or children), Rs 1 to 5 lakh cover may not be sufficient considering the high costs of hospitalisation in private hospitals based in metro cities. You could look at other sophisticated health insurance plans to suit your family's needs.