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Arogya Sanjeevani Policy by ACKO

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Arogya Sanjeevani Health Insurance

Arogya Sanjeevani, ACKO

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What is Arogya Sanjeevani Policy?

A standard and simple health insurance plan to secure you and your family from unforeseen medical expenses.

Medical costs may make your financial plan go for a toss! Hence, it is important to buy a health insurance policy that can protect you against unforeseen medical expenses. However, there are a plethora of health policies available, and finding the one that fits both your pocket and health insurance requirements can be a bit tricky.

IRDAI has been trying to make insurance more straightforward for customers by standardising the policy benefits. Arogya Sanjeevani, a health insurance policy with standardised benefits approved by IRDAI, is a step towards that goal. The policy offers financial support to you and your family during unforeseen medical emergencies at an affordable premium.

Since the benefits and coverage are standard across all the insurance companies, this policy is simple to comprehend. While the benefits are standard, the premium may vary from insurer to insurer based on the services, ease of buying and claim process, and the number of network hospitals.

Why should you choose Arogya Sanjeevani Policy by ACKO?

With ACKO’s Arogya Sanjeevani Policy, you don’t just unlock a cost-effective policy, but also a hassle-free claims experience.

6,500+ network hospitals

Cashless claims facility at any of our 6,500+ network hospitals.

Support 24*7

Our 24*7 customer support team will always remain beside you.

Go paperless

Say bye to tedious documentation while you buy, renew and raise claims online.

What’s covered in Arogya Sanjeevani Policy by ACKO?

All-in-one health plan that suits both your pocket and health insurance needs.

Covers COVID-19 treatment

Hospitalisation costs for Covid-19 will be covered post 30 days after the policy’s start date.

Broad coverage

Hospitalisation expenses due to accidents and illnesses are covered as per the terms and conditions of the policy.

Just 5% co-pay

ACKO will pay 95% of the admissible claim amount, and you only need to pay 5% out of your pocket for any claim.

ICU/ICCU coverage

Covered up to 5% of sum insured, subject to a maximum of Rs. 10,000 per day.

Room Rent Charges

Covered up to 2% of sum insured, subject to a maximum of Rs. 5,000 per day

Pre-existing illnesses

Pre-existing conditions will be covered after a waiting period of 48 months and continuous renewal for four years.

Pre and post hospitalisation

Medical expenses 30 days before and 60 days after any 24 hours or longer hospitalisation event are covered.

Day care treatments

Some surgeries and treatments that require less than 24 hrs of hospitalisation are also covered as per the policy terms.

New-age treatments

Some new age treatments (Oral Chemotherapy, Robotic surgeries, etc.) are also covered.

Ambulance charges

You can claim up to Rs. 2,000 against ambulance charges for each hospitalisation.

Cataract surgery

Cataract treatment cost for each eye is covered after two years from the policy start date. The coverage is up to 25% of the sum insured, subject to a maximum of Rs. 40,000.

AYUSH treatment (Ayurvedic)

Hospitalisation expenses under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment are covered in this policy as per the terms and conditions.

Dental & plastic surgery

Dental treatments or plastic surgeries due to accidents or diseases are also covered.

Key features of ACKO’s Arogya Sanjeevani Policy

Here are some of the features of Arogya Sanjeevani policy by ACKO.

Features Description
Sum insured Maximum of Rs. 10 lakh, in multiples of Rs. 50,000.
Premium Starting from Rs. 3,099 per year. This price is for a 19-year-old purchasing policy with the sum insured of Rs. 5 lakh for self. GST included.
Freelook period Free cancellation of the policy within 15 days of buying it.
Tax exemption Premiums paid up to Rs. 25,000 are exempt from tax under Section 80D.
Medical check-ups No medical check-up is required for people up to 55 years with no medical history.
Plan options Choose between a family floater or an individual plan for you and your family.
No Claim Bonus (NCB) 5% increase on the sum assured for each claim-free year, subject to a maximum of 50% of sum insured.
Lifetime renewability Enjoy lifelong renewability, as long as you renew the policy on time.
Network hospitals More than 6,500 across the country. See ACKO’s network hospitals list.

Note: Tax savings and exemptions are as per section 80D of the Income Tax Act are subject to changes in the tax laws.

FAQs about ACKO's Arogya Sanjeevani Policy

Here are the commonly asked questions about Arogya Sanjeevani Policy by ACKO.

Buying related FAQs

What is Arogya Sanjeevani? Is it a government-sponsored insurance policy?

The Insurance Regulatory and Development Authority of India (IRDAI) regulates the insurance industry in India. ‘Arogya Sanjeevani’ is an affordable and simple health insurance policy approved by IRDAI. All general insurance companies, including ACKO, have been authorised to provide this policy to their customers. Even though it is approved by IRDAI, it is not ‘sponsored’ by the government. People who want Arogya Sanjeevani health insurance policy, need to purchase it on their own.

What is the policy tenure of Arogya Sanjeevani policy by ACKO?

The tenure for this policy is 1 year. 

Can I increase my coverage?

No, you can select the sum insured only up to a maximum of Rs. 10 lakh, and in multiples of Rs. 50,000. You cannot increase coverage beyond Rs. 10 lakh.

Do I need a medical test to buy this policy?

In most cases, where you don’t have any existing medical conditions and your lifestyle habits are healthy, you don’t have to go for a medical test to buy the policy. If medical tests are required, we’ll inform you about it before you make any payments to us. Note: It’s very important to be truthful while answering the questions about your health while making a purchase and not shy away from medical tests. Incorrect information to medical questions can lead to rejections of claims.

Is there any age limit to buy this policy?

Yes. Under this policy, the entry age limit for adults is 18 years to 65 years. While for children when you buy a family floater plan, it is 3 months to 25 years.

Can I buy this policy only for my children?

No. Only children cannot be covered in this policy, although you can cover your children along with yourself and your spouse.

Can I claim tax benefits with Arogya Sanjeevani health policy by ACKO?

Yes, you can claim tax benefits under Section 80D of the Income Tax Act, 1961. An individual can claim a deduction on the premium paid for the insurance of self, spouse, and dependent children up to Rs. 25,000.

What is the meaning of the waiting period?

The waiting period is the time you need to wait before you can avail of a specific benefit from the date your policy or coverage starts. For example, If you bought a policy on 1st August 2020, you’ll only be able to claim for hospitalisation costs against Coronavirus after 31st August 2020. You can check the waiting period in the policy schedule here.

What is the difference between the Family Floater plan and the Individual policy?

When you purchase a family floater plan, you can cover your entire family (spouse, children, parents) under one plan with the sum insured of a maximum of Rs. 10 lakh. On the other hand, if you buy an individual poly, you need to purchase a policy separately for each family member.

Coverage and claims related FAQs

Is coronavirus covered under this policy?

Yes, Covid-19 is covered under the hospitalisation benefit. 

Can I make cashless claims with this policy?

Yes, you can make cashless claims if you get hospitalised in any of the hospitals in our network. 

If you get hospitalised at any of the network hospitals, ACKO will settle the bill directly with the hospital. You just have to pay the co-pay amount and any other amount applicable as per the policy terms and conditions. 

Is co-pay compulsory?

Yes, 5% co-pay is mandatory under this policy. Meaning, you need to pay 5% of the total admissible expenses, while ACKO will handle the rest 95%. The amount you need to pay is subject to standard terms and conditions mentioned in your policy document and will be communicated to you along with billing details.

Why should you buy Arogya Sanjeevani Health Insurance Policy, ACKO?

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Rising medical costs

With a fast-paced and hectic lifestyle, healthcare issues and costs are soaring. A health insurance plan like the Arogya Sanjeevani policy by ACKO safeguards you from such unforeseen medical expenses.

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Covers COVID-19 treatment

The pandemic has profoundly affected our day-to-day lives. ACKO’s Arogya Sanjeevani policy not just covers medical and hospitalisation costs but COVID-19 treatment costs as well.

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Affordable pricing

This policy offers adequate coverage at an affordable premium. This doesn’t just enable you to get access to a health insurance plan but optimise savings as well.

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Great for first-time buyers

If you are buying a health insurance policy for the first time or are young, the Arogya Sanjeevani policy by ACKO is perfect to start with. It’s easy to understand and offers essential coverage at an affordable premium.

Exclusions: What’s not covered in ACKO’s Arogya Sanjeevani Policy?

Arogya Sanjeevani policy by ACKO offers adequate coverage against various medical costs. However, there are a few exclusions that you need to know. For a detailed list, refer to the policy document.

1. Excludes any kind of hospitalisation costs not covered in your policy document.

2. Obesity or weight control treatment that is not a result of comorbidities is excluded.

3. It excludes claims resulting from wars and participation in defense.

4. The policy does not cover domiciliary care costs.

5. Medical costs due to adventure sports are excluded.

6. Fertility treatments are not covered.

7. Self-inflicted injuries are excluded from this policy.

8. Plastic/cosmetic surgeries are excluded from this policy.

9. Treatments due to substance abuse are not covered.

Eligibility for Arogya Sanjeevani Plan by ACKO

A person aged between 18 to 65 years is eligible to purchase the policy.

Children aged between 3 months to 25 years can be covered under a family floater plan.

Note: ACKO’s Arogya Sanjeevani policy comes with lifelong renewability. Meaning, you can renew the policy even if you cross 65 years of age.

How to raise a claim and the documents required?

Similar to other health insurance plans, you can raise claims either through a cashless process or either reimbursement process.

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Cashless claims process

The cashless claims process works when you get hospitalised in one of the ACKO’s network hospitals. In case of emergency hospitalisation, you need to inform ACKO 24 hours in advance. And in case of planned hospitalisation, 48 hours in advance. Here, ACKO will settle the bill directly with the network hospital. All you have to do is fill the pre-authorisation form available at the hospital’s TPA desk and share it with us. After that, we will take care of the bills, and you only have to pay the amount as per the terms of the policy.

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Reimbursement claims process

Under this process, you get hospitalised at any hospital of your choice, pay the expenses, and then claim a refund from us. To claim reimbursement, you need to submit a few documents such as original medical bills, payment receipts, practitioner’s prescription, discharge summary, or any other document required by the team. Hence, the reimbursement process can be more time-consuming as compared to the cashless claims process.

How to buy/renew ACKO's Arogya Sanjeevani Health Insurance Policy online?

Step 1

Visit ACKO’s website or mobile app to purchase the policy online. Note that to purchase this policy on ACKO, you don’t need to fill any form or submit any documents.

Step 2

Answer a few questions such as whom you want to include in the policy, birth date, location, and preferred sum insured amount.

Step 3

Once you enter the details, you get a quote. Make a payment and get a policy within a few minutes in your inbox.

Note: The policy to renew your policy is very simple. All you have to do is log in to your account through the website or mobile app, confirm the details, and make the payment.

Benefits of buying/renewing ACKO’s Arogya Sanjeevani Policy online

Save time

When you buy online on ACKO, you can purchase or renew the policy entirely at your convenience from anywhere in the world. Moreover, since the process is online, you save both time and effort while buying the policy.

Optimise savings

Since the entire process is online, which reduces the operational costs for us, ACKO can offer cost-effective policies to their customers. This means you do not just secure your health but save money as well.

Skip the paperwork

Filling long forms or couriering documents can be a challenging task, and we get it! Hence, when you buy on ACKO, you don’t need to go through this painstaking process. Instead, answer a few questions online, and you can buy/renew the policy.

How to choose the best Arogya Sanjeevani Plan?

Even though most of the benefits are standardised across all the insurance companies, there are a few factors that you can consider while buying this policy.

Services

Be it a health insurance policy or a vehicle insurance policy; you buy insurance so that you claim the expenses in a hassle-free way. Hence, we recommend going with an insurance company that settles your claims super-quick and hassle-free.

Premium

Even though the plan is approved by IRDAI, different health insurance companies may charge different premium rates for the same policy and sum insured amount. Therefore, all factors being the same, it is advised to opt for a plan that charges you lower for the policy.

Claim Settlement Ratio (CSR)

Don’t forget to check the claim settlement ratio before buying the policy. Claim Settlement Ratio (CSR) in layman’s terms, depicts the probability of your claim getting settled. Usually, the higher the number, the better the chances of claim settlement.

Network hospitals

When you want to opt for a cashless claims settlement process, you need to get admitted to the nearest network hospital. Hence, the insurer must have a wide network of hospitals across the country.

Arogya Sanjeevani Policy premium rates and calculator

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Get quote

You can check the quote based on your requirements by visiting www.acko.com or the mobile app.

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Modify sum insured amount

You can also play around with the sum insured to check the impact on the premium amount.

IRDAI Hikes Maximum Sum Insured Amount to Rs. 10 lakh

IRDAI decided to expand the sum insured amount to Rs. 10 lakh from Rs. 5 lakh to widen the plan's coverage. Furthermore, keeping in mind the ongoing pandemic, IRDAI mandated all health insurers to offer this policy between Rs. 50,000 to Rs. 10 lakh, in multiples of Rs. 50,000.

IRDAI Issues Guidelines Related to Arogya Sanjeevani Policy

– July 7, 2020

Today, the Insurance Regulatory and Development Authority of India (IRDAI) issued a circular regarding the Arogya Sanjeevani Policy. As per the circular, General Insurance Companies and Health Insurance Companies can offer the Arogya Sanjeevani Policy for a minimum Sum Insured of INR 50,000 and maximum Sum Insured of over INR 5,00,000 based on their underwriting policy. Currently, the policy’s minimum Sum Insured is INR 1,00,000 and maximum Sum Insured is INR 5,00,000.  Therefore, the modification means that insurers can offer a policy for Sum Insured as low as INR 50,000 instead of INR 1,00,000, and not restrict the higher limit to a Sum Insured of INR 5,00,000. This lends more flexibility to the potential policyholder as well as the insurance company. The Arogya Sanjeevani Policy is a standard health insurance product that covers basic requirements. The modified policy can be offered by the insurers after successful filing and receipt of UIN from IRDAI.

COVID-19: Pay Health Insurance Premium in Equated Monthly Installments (EMIs)

– May 21, 2020

The Insurance Regulatory and Development Authority (IRDAI) has announced that policyholders can pay their premium in Equated Monthly Installments (EMIs). It has directed all health insurance companies to offer the same to policyholders to ease the situation. In the wake of the lockdown to contain the spread of COVID-19 in the country, the IRDAI has extended this benefit to health insurance policyholders. They can pay the premium on a monthly, quarterly or half-yearly basis for those policies, which is due for renewal up to 31 March 2021. Insurance companies will notify the applicable conditions and policyholders will be asked for their consent before the EMI options will be provided. Last year, the IRDAI had already notified insurance companies to provide the EMI facility from 1 October 2020. But with the COVID-19 situation in the country, the option has been fast-tracked.

CIN: U66000KA2016PLC138288

IRDAI Registration No: 157

Category: Non-Life Insurance

The use of images and brands are only for the purpose of indication and illustration. ACKO claims no rights on the IP rights of any third parties. The ratings are derived from reviews and feedback received from Google and Facebook users on their respective platforms. | *Savings of upto Rs. 50,000 have been calculated on the IDV of Rs. 18,00,000 and 0% NCB. Amount saved is in comparison to tariff rates. Product name: Private Car Policy - Bundled | UIN: IRDAN157RP0014V01201819 |

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