All About Arogya Sanjeevani Health Insurance Policy & Who Should Buy It



IRDAI had mandated all insurance companies to offer Aarogya Sanjeevani Policy from April 2020. It is a standard health insurance policy that provides coverage of up to Rs 5 lakh for individuals and families. The cover can be used for basic hospitalisation-related expenses. Again, to make the product simpler, IRDAI has barred insurers from imposing any deductibles, riders or variants of the policy.

Arogya Sanjeevani health insurance policy

The Arogya Sanjeevani policy covers you against healthcare expenses from Rs 3 lakhs to Rs 5 lakhs. The coverage includes hospital room rent, ICU services, pre and post hospitalisation expenses, and also new age treatments.

Given that COVID-19 cases are on the rise in India, the Arogya Sanjeevani Policy could be a cost-effective way to cover you from COVID-19 in the short-term and other illnesses in the long-term.

Is buying Arogya Sanjeevani policy worth it

Experts believe that Arogya Sanjeevani Policy is an excellent entry-level product. Whereas, some other experts find the coverage of Rs 5 lakh to be not sufficient for a family of four.

Arogya Sanjeevani is a basic health insurance policy. It is relatively affordable and offers the option to get a sum insured of up to Rs 5 lakh. It does not have features of a comprehensive health policy. It has a co-payment of 5 per cent, which might not be there in a fully-fledged policy. Although, IRDAI has mandated a 5 per cent increase in sum insured for every claim-free year. The limit to increase in sum insured is 50 per cent and the policy must be renewed without a break.

Who should buy it

Arogya Sanjeevani policy is suitable for first-time health insurance buyers. The policy not only offers a wide coverage at a low premium but the cover and terms & conditions of the policy are also standard across insurance companies. The common policy wordings make it easier for you to understand it.

The awareness of the need for health insurance has only increased over the past few years, more so because of COVID-19. Even though, its penetration is still appalingly low in India. The main reason for low health insurance penetration in India is the complexity in health insurance policies and unaffordability of premiums. These factors have long deterred an average individual from buying health insurance plans in India. Arogya Sanjeevani Policy addresses exactly these problem areas.

Arogya Sanjeevani policy is simple and standard in its construct and has a moderate premium structure best for first-time policy buyers with limited budget. The policy is beneficial for younger people looking for a comprehensive cover for themselves. Along with low premium as compared to other policies, the policy has a wide coverage that also include day procedures. Thus, if you are unmarried and working with no dependents consider buying this policy.

Who should not buy it

The sum insured under the Arogya Sanjeevani policy is limited to Rs 5 lakh. So, as explained above, it is suitable for young, first-time insurance buyers. However, for someone living in metro cities, a cover of Rs 5 lakh may not be adequate to fulfill the high cost of healthcare. Thus, someone living in a big city and having the capacity to pay higher premiums should go for a cover bigger than the Arogya Sanjeevani Policy to get adequate health cover. But before you buy a policy, make sure you consult a financial advisor to asses your exact insurance needs.

If you have dependents, it is better you buy a family floater health insurance plan. Again, if your dependents include parents along with children, that warrants a higher cover. Hence, choose policies on the basis of coverage and inclusions. Arogya Sanjeevani policy has a sum insured limit of Rs 5 lakh that does not suffice for families.

Thus, if you are in need of a health insurance policy with higher sum insured or already have a sufficient basic health insurance, Arogya Sanjeevani policy might not be suitable for you. In such a case, you should consider buying a super top-up health policy.

Arogya Sanjeevani policy vs super top-up health policy

Insurance experts believe that super top-up health insurance plans are formulated to enhance the health insurance coverage of existing health care plans. Super top-up health plan can be bought as an add-on to increase the total sum assured of your base plan. It acts as a supplementary plan to your basic health plan and pays for multiple bill claims. On the other hand, buying another comprehensive health insurance policy with a higher sum assured is expensive.

A super top-up health insurance plan in India pays for all the expenses surpassing base cover for one-time hospitalisation. It is a regular indemnity based plan that can be renewed annually. Nevertheless, know that the super top-up health insurance plan comes into action only once the deductible limit is crossed.

How Arogya Sanjeevani policy could be a better option for COVID-19

Since the COVID-19 outbreak, the awareness regarding health insurance policies is increasing among Indian populace. People are looking for a policy that could cover the cost of Coronavirus treatment if they’re infected with the virus. If you also are looking for such a policy, Arogya Sanjeevani Policy can be a better option than coronavirus specific plans as the costs for both the policies are almost the same and Arogya Sanjeevani policy covers many other diseases and illnesses apart from COVID-19.

Bottom note

The coverage for the Arogya Sanjeevani health policy is standard across all insurers. Only the customer service and premium rates can vary from one insurer to another. The premium rates are decided by insurance companies based on the factors like their expectations of claim ratios that is based on assumptions. The actuarial team of one insurance company may make different assumptions, and fix the premium rate different from another insurance company. Again, the quality of services and customer care of different insurers are different. This two reason mark the difference in pricing of premium amounts for different insurers.

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