Arogya Sanjeevani was first introduced by IRDAI (Insurance Regulatory and Development Authority of India) in the year 2020 to provide a standard and affordable healthcare plan to the citizens of India.
Care Arogya Sanjeevani Policy is an affordable healthcare plan providing you and your families with the right healthcare needs. Under this policy, you are covered for expenses incurred for AYUSH treatment, pre and post-hospitalization expenses, ambulance cover, modern treatments, and lifelong renewability as subject to the policy schedule. A sum insured of INR 5 lakh is promised to all policyholders availing of this health plan. In case of a planned or unplanned hospitalization, 22,900+ care network hospitals across India are available for effective medical care for you and your family members. If you are thinking about Care Arogya Sanjeevani being the right health plan for you and your family, worry not as we can help you in making that decision.
Care Arogya Sanjeevani Plan Eligibility
Understand the minimum and maximum entry ages for the Care Arogya Sanjeevani Plan to identify if you and your family members are eligible to purchase this particular health plan.
Child Entry Age
Minimum: 5 Years Children: 3 Months to 25 Years
Adult Entry Age
Maximum: 65 Years
Plan Type
Individual/ Family Floater
Policy Term
1 Year
Sum Insured
1 L | 2 L | 3 L | 4 L | 5 L | 6 L | 7 L | 8 L | 9 L | 10 L
Initial Waiting Period*
30 Days
*The initial waiting period is the period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan*
Care Arogya Sanjeevani Health Plan Benefits
On investing in the Care Arogya Sanjeevani Health Policy, you and your family members are entitled to the following perks and benefits
Regular Increase In Sum Insured Value On filing zero claims throughout the policy year, you are entitled to a 5% increase in your sum insured subject to a maximum of 50% per policy year. This allows you to enjoy an enhanced sum insured amount which will be added to your base sum insured and can be utilized later.
Avail Advanced Treatments Secure yourself and your family members with the promise of advanced and modern treatments for listed ailments as per the policy schedule.
Tax Benefits You are eligible to avail yourself of tax benefits under Section 80D of the Income Tax Act of 1961 when investing in the Care Arogya Sanjeevani Health Plan along with the numerous medical care benefits mentioned in the policy schedule.
Covers Cataract Treatment A common ailment in senior citizens, the Care Arogya Sanjeevani Policy offers cataract treatment subject to sub-limits mentioned in the policy schedule. It is beneficial for those who require medical care coverage for their parents.
Diagnostics and Tests Covered Care Arogya Sanjeevani health policy covers you and your family members against all expenses related to diagnostics and tests prescribed by the doctor.
Choose Your Care Arogya Sanjeevani Health Plan
As per the policy schedule, you can opt for the following sum insured along with the following coverage benefits
In-patient & Out-patient coverage
Room Rent
Covered up to 2% of SI
ICU Charges
Covered up to 5% of SI
Pre-Hospitalization
Covered up to 30 days
Post-Hospitalization
Covered for up to 60 days
Domiciliary Hospitalization
Not Covered
Daycare Treatment
Covered
OPD Charges
Not Covered
Coverage Terms
COVID-19 Treatment
Covered
Cataract
Covered
No Claim Bonus
Applicable, max up to 50% of SI
Automatic Restoration
Not Covered
Daily Hospital Cash
Not Applicable
Organ Donor
Not Covered
Maternity Cover
Not Covered
New Born Baby Cover
Not Covered
Alternative Treatments
AYUSH Treatment
Covered up to SI
IVF Treatment
Not Covered
Modern Treatment
Covered up to 50% of SI
Emergency Coverage
Ambulance
Covered
Air Ambulance
Not Covered
Compassionate Travel
Not Covered
Global Coverage
Not Covered
Wellness Programmes
E-Consultation
Not Covered
Health Check-Up
Not Covered
Second Medical Opinion
Not Covered
Vaccination
Not Covered
Limitations
Co-payment
5% co-pay applicable on all claims
Sub-limits
Applicable
What is Room Rent?
The room rent limit is the maximum amount of bed charge that you can claim if you are hospitalized.
Common room categories covered under room rent are:
Private Single AC Room
Twin Sharing
General Ward
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, the room rent is covered up to 2% of SI per day.
What are ICU Charges?
The Intensive Care Unit (ICU) is a hospital special department where patients with severe medical conditions are treated.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, ICU charges are covered up to 5% of SI per day.
What is Pre Hospitalization?
Medical expenses incurred before the hospitalization of the policyholder.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, pre-hospitalization is covered for up to 30 days.
What is Post Hospitalization?
Medical expenses incurred after the discharge of the policyholder from the hospital.
Coverage status under Care Arogya Sanjeevani Plan?
Care Arogya Sanjeevani Plan covers medical expenses incurred during post-hospitalization for 60 Days.
What is Domiciliary Hospitalization?
Home hospitalization arrangement for the insured person due to unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get financial coverage.
Coverage status under Care Arogya Sanjeevani Plan?
Care Arogya Sanjeevani Plan does not cover domiciliary hospitalizations.
What is Daycare Treatment?
Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.
Coverage status under Care Arogya Sanjeevani Plan?
Care Arogya Sanjeevani Plan covers the expenses of all daycare procedures up to 50% of SI.
What are OPD charges?
Covers the cost of doctor consultation and prescribed medical tests that may not require hospitalization.
Coverage status under Care Arogya Sanjeevani Plan?
OPD charges are not covered under the Care Arogya Sanjeevani Plan.
What is COVID-19 Treatment?
COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. an approved center.
Coverage status under Care Arogya Sanjeevani Plan?
Covid-19 Covered.
What is Cataract Treatment?
A common eye condition in which your vision gets blurred.
Coverage status under Care Arogya Sanjeevani Plan?
Care Arogya Sanjeevani Plan covers Cataract Treatment subject to a limit of 25% of SI or INR 40,000 whichever is lower, per eye in one policy year.
What is a No-Claim Bonus?
For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as a no-claim bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain percentage that varies from plan to plan.
Coverage status under Care Arogya Sanjeevani Plan?
Care Arogya Sanjeevani Plan offers a 5% no-claim bonus on a claim-free policy year for each policy year, subject to a maximum of 50% of SI.
What is Automatic Restoration?
Automatic restoration is a benefit in which an insurance company restores the sum insured amount completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from plan to plan.
Coverage status under Care Arogya Sanjeevani Plan?
Care Arogya Sanjeevani Plan does not offer automatic restoration benefits.
What is Daily Hospital Cash?
It is a cash amount that you receive each day during the time of hospitalization.
Coverage status under Care Arogya Sanjeevani Plan?
Daily hospital cash is not available under the Care Arogya Sanjeevani Plan.
What is an Organ Donor Cover?
It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, organ donor expenses are not covered.
What is a Maternity Cover?
It refers to the cover that includes expenses for normal and c-section procedures deliveries.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, Maternity Cover is not available.
What is a New Born Baby Cover?
It takes care of the medical expenses that arise due to the hospitalization of the newborn baby in case of unforeseen circumstances. Some of the common treatments that are covered under the newborn cover are listed below and these common treatments can vary from plan to plan:
Congenital anomaly (conditions since birth)
Acute condition
Chronic condition
Premature delivery
Birth asphyxia
Day care treatment
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, a newborn baby cover is not available.
What is AYUSH Treatment?
Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, AYUSH treatments are covered up to SI.
What is IVF Treatment?
In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:
Full infertility
No fertility
Infertility diagnosis
Infertility diagnosis and limited fertility treatment
Medication (which may or may not include fertility drug prescriptions)
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, IVF is not available.
What is a Modern Treatment?
Medical treatments that demand modern technology such as robotic surgeries, stem cell therapy, etc.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, modern treatments are covered up to 50% of SI.
What is an Ambulance Cover?
An ambulance is used to move the patient from home to hospital, transfer to another hospital, and take them for different tests outside the hospitals.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, ambulance cover is covered up to INR 2000 per hospitalization
What is an Air Ambulance?
Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, the air ambulance is not covered.
What is Compassionate Travel?
Refers to the traveling expenses of a family member of the insured person in case the policyholders get admitted to a hospital outside his/her residential city.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, compassionate travel is not covered.
What is Global Coverage?
Any kind of medical/health emergency when you are outside of India.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, global coverage is not covered.
What is E-Consultation?
If a policy offers E-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, E-consultation is not covered.
What is a Health Checkup?
A facility where the policyholder can avail free health check-ups after fulfilling the company's policies.
Coverage status under Care Arogya Sanjeevani Plan?
Under the Care Arogya Sanjeevani Plan, a health check-up is not covered.
What is a Second Medical Opinion?
If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company’s network of medical practitioners.
Coverage status under Care Arogya Sanjeevani Plan?
Care Arogya Sanjeevani Plan does not cover the expenses for a second medical opinion.
What is Vaccination cover?
Coverage against the expenses incurred on vaccinations is provided by the insurance companies.
Coverage status under Care Arogya Sanjeevani Plan?
Care Arogya Sanjeevani Plan does not cover vaccination expenses.
What is Co-payment?
In the co-payment clause, policyholders have to pay a portion of the hospitalization expense on their own and the insurer will pay the rest of the amount.
Status under Care Arogya Sanjeevani Plan?
A mandatory 5% co-pay is applicable under the Care Arogya Sanjeevani Plan for all claims
What is the Sub limit?
Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder.
Status under Care Arogya Sanjeevani Plan?
Sub-limits applicable under Care Arogya Sanjeevani Plan
Room Rent - Up to 2% of SI subject to a maximum of INR 5,000 per day
ICU Charges - Up to 5% of SI subject to a maximum of INR 10,000 per day
Listed modern treatments - Up to 50% of SI
Care Health Insurance Network Hospital List
Care Health Insurance promises a wide Network of cashless Hospitals across India. A well connected network of over 22900+ cashless hospitals, Care Health Insurance ensures that you are medically secured, irrespective of the city you reside in
Premiums calculated for Arogya Sanjeevani Health Plan are on an individual and family floater basis for a sum insured amount of INR 5 lakhs including GST for your reference. For further premium details contact our team of experts at PolicyX
1 Adult
Sum Insured (In Rs.)
5 L
Premium (In Rs.)
6,013
1 + 1 Adult
Sum Insured (In Rs.)
5 L
Premium (In Rs.)
9,932
2 Adults + 1 Child
Sum Insured (In Rs.)
5 L
Premium (In Rs.)
12,350
Care Arogya Sanjeevani Health Plan Exclusions
Permanent Exclusions
Permanent diseases or health conditions that are not included under the Care Arogya Sanjeevani health plan are mentioned below
Injury or diseases caused due to involvement in illegal activities
Hospitalization caused due to adventure sports
Change of gender treatments
Plastic surgeries or cosmetic treatments
Treatment for obesity
Coverage after Waiting Period
Certain diseases and treatments are covered under this plan after a specific period which is mentioned below
Pre-existing diseases 48 Months
Specific Ailments 24/48 Months
Conclusion
Care Arogya Sanjeevani is an ideal health insurance plan for you and your family if you are on the lookout for basic health care coverage at affordable premium rates. The policy was designed by IRDAI and is sold by all insurance providers in India. Provided on an individual and family floater basis, the Care Arogya Sanjeevani policy has something for everyone in your family.
This plan is exclusively designed to provide 32 defined critical illness treatment cover to the policyholders and also offers psychiatric counselling.
Unique Benefits
32 critical illness cover
Global healthcare
Quick recovery counselling
Care Critical Mediclaim(Pros)
In-patient hospitalisation
Daycare treatment
Dialysis cover
Psychiatric counselling
Organ donor expense coverage
Care Critical Mediclaim(Cons)
Adventure sport injuries not covered
No cover for cosmetic treatment
Sub-limits not applicable
SI restoration unavailable
Maternity & newborn cover NA
Care Critical Mediclaim(Other Benefits)
Individual plan (max 6 persons)
Annual health check-ups
International 2nd medical opinion
Cashless claim settlement
AYUSH treatment cover
Care Critical Mediclaim(Eligibility Criteria)
Child Entry age -5 years
Adult Entry Age- 18 Years- No Limit
SI - INR 10 Lakhs - 2 Crore
Waiting Period - 90 days
Care Arogya Sanjeevani Policy: FAQ's
1. What is Care Arogya Sanjeevani Policy?
It is a standard and affordable health insurance plan launched by IRDAI for individuals and families. Care Arogya Sanjeevani provides medical cover to individuals between the age groups of 5 to 65 years and dependent children between the age groups of 3 months to 25 years.
2. What is covered under the Care Arogya Sanjeevani Plan?
You and your family can avail of these features when purchasing the Care Arogya Sanjeevani health plan
Ambulance Cover
Pre and Post Hospitalization
Cataract Treatment
AYUSH Treatment
In-Patient Hospitalization
Cumulative Bonus, and more
3. What is the entry age for the Care Arogya Sanjeevani Health Plan?
The minimum entry age for the plan is 5 to 65 years. While dependent children can be covered from 3 months of age up to 25 years.
4. What is the cumulative bonus available under Care Arogya Sanjeevani Plan?
The cumulative bonus available under the Care Arogya Sanjeevani Plan for you and your family is 5% of SI up to a maximum of 50% of SI for every claim-free year.
5. Does Care Arogya Sanjeevani health plan offer cashless hospitalization?
Yes, Care Arogya Sanjeevani health plan offers cashless hospitalization for planned and unplanned treatments across 22,900+ hospitals nationwide.
Simran is an insurance expert with more than 4 years of experience in the industry. An expert with previous experience in BFSI, Ed-tech, and insurance, she proactively helps her readers stay on par with all the latest Insurance industry developments.
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