The Insurance Regulatory and Development Authority of India (IRDAI) has mandated a new, standard health insurance policy that requires 29 health and general insurers to provide health insurance coverage to meet policyholders’ essential needs. With a cover between Rs. 1 lakh and Rs. 5 lakh, the standard plan is available from all general and health insurance providers in India. The recently introduced standard health insurance, known as the Arogya Sanjeevani Policy, is available to individuals as well in an effort to provide standardised health insurance coverage for families. #
Details of the standard health insurance policy
The Standard Health Insurance Policy provides basic hospitalisation coverage with a sum assured range of Rs. 1 lakh to Rs. 5 lakh. The policy is available starting on 1 April 2020 and can be purchased from any health and general insurance provider. This policy aims to provide more affordable coverage. *
Arogya Sanjeevani’s Standard Health insurance policy’s features and benefits
The following are the attributes and advantages of the fundamental health insurance plan:
- Regularity of premium payments: The annual premium for a typical health insurance coverage may be paid in full or divided into monthly, biannually, or quarterly payments.
- Sum assured: The regular health insurance policy has a minimum and maximum sum insured of Rs. 1 lakh and Rs. 5 lakh, respectively. This amount will be divided into multiples of 50,000 for the insured sum. The sum covered will apply to each individual family member in the event of the individual standard health plan and the complete family in the case of health insurance plans for family. *
- Policy duration – The usual health insurance plan’s term, which can be extended or renewed annually, is one year.
- Low copayment option – You may choose to pay a lesser co-payment of 5% of the claim amount with this coverage. This means that when paying the final hospital bill, you will only be required to pay up to 5% of the claim amount. *
- Free look period – Before the coverage can be terminated, a 15-day review window starting on the day the Standard Health Insurance Policy is received is provided. *
- Cumulative bonus – The Standard Health Insurance Policy offers a cumulative bonus of 5% on the sum covered for each year without a claim. *
- Renewability – The purpose of the policy is to provide policyholders with lifelong renewability.
- Family and individual floater availability – Individual and family floater policies are among the two different forms of health insurance coverage included in the policy.
- Sub-limits – The amount that can be spent on room rent and medical expenses is subject to a sub-limit or limitation under this health insurance policy. The cap for room rent, boarding, and nursing costs is 2% or a maximum of Rs. 5,000 per day. ICU and ICCU fees are limited to 5% of the insured amount, up to a daily maximum of Rs. 10,000. The sub-limit for cataract surgery is up to 25% of the insured amount or Rs. 40,000, whichever is less. *
- AYUSH treatment – This policy also includes health insurance coverage in India for therapies using alternative medicine, such as AYUSH, which includes Ayurveda, Homeopathy, Unani, and Siddha.
- Waiting period –
- 24 months: Conditions like sinusitis, ENT disorders, cataracts, non-infective rheumatoid arthritis, stomach ulcers, rheumatoid arthritis, age-related eye conditions, tympanoplasty, gout, mastoidectomy, tonsillectomy, and cysts.
- 48 months: Treatment for joint replacements other than those caused by accidents, age-related osteoarthritis, and osteoporosis.
- Pre and post-hospitalisation – Treatment fees incurred 30 days before the date of admission and 60 days after the date of discharge from the hospital are covered under the Arogya Sanjeevani standard health insurance policy.
* Standard T&C Apply
# Visit the official website of IRDAI for further details.
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