Health insurance is a policy which pays for medical treatments and hospitalisation. It is a very useful product for those looking to insure themselves against unforeseen health risks. But health insurance can also be a complicated purchase, due to the exhaustive conditions, different features and varying premium costs. 

 

To reduce this confusion, the insurance regulator, Insurance Regulatory and Development Authority of India (IRDAI), mandated insurers to launch a standardised health insurance product. This product would be called Arogya Sanjeevani and its features and coverage will be the same, regardless of which insurer you purchase it from. So what are the features of this standard health insurance product? Also, we will mention the features that are found in a regular health policy, for better comparison.

 

 

As you can see, most of the features are the same in Arogya Sanjeevani policy and a regular health insurance policy. The key differences lie in the room rent costs, co-payment clause and, to some extent, the capped sum insured (SI) for modern treatments. 

 

The room rent limit is not an issue, in most cases, except in times of shortage of beds in hospitals where the costs can rise rapidly. Or in case you have to be admitted at a high-end hospital for some special treatment. Ideally, there should not be any limit.

 

The co-payment clause of 5% is the worrying part. If we assume that a hospitalised person makes a claim of Rs5 lakh, then 5% of such claim is Rs25,000, which has to be paid by the policyholder. The same goes with the limited SI for modern treatments. Such treatments can cost lakhs of rupees and that means you still have to pay a huge sum from your own pocket even after having insurance.

 

In essence, Arogya Sanjeevani attempts to offer the best of health insurance but with certain conditions. Is it good to have these conditions? Only if you compare it with someone who does not have health insurance. But, otherwise, these conditions are a heavy burden on the policyholder.

 

A buyer might go for the standard Arogya Sanjeevani seeing the low premium costs, which is true, as this policy may cost half as much as a normal health insurance policy. However, even if you do save Rs5,000 to Rs10,000 a year in premiums, such savings would be lost at the time of claims.

 

 

But, again, this policy is essentially targeted for those who cannot afford regular health insurance. This policy is a MUST for them because now they can afford a cover of Rs5 lakh for their entire family (assuming two adults and two children) for as low as Rs1,000 per month. This also means you can gift such a policy to your maids and servants at an affordable cost.

 

For the rest who can afford spend a little more, skip this policy and buy yourself regular health insurance.