Aditya Birla Health Insurance Co. Ltd. offers the Arogya Sanjeevani health plan as per the regulations that the Insurance Regulatory and Development Authority of India (IRDAI) set forth. This standardized medical insurance product is designed to facilitate access to quality healthcare services for individuals who do not possess insurance coverage, all at a reasonable premium.
Aditya Birla Arogya Sanjeevani policy provides a range of sum insured options (from Rs 1 lakh to Rs 5 lakh), thereby catering to diverse healthcare needs. Here, we will cover a comprehensive examination of the policy’s features, inclusions, and exclusions. With this information, you can make informed decisions regarding your health insurance requirements.
Key Features of Aditya Birla Arogya Sanjeevani Policy
- Cashless Treatment
Upon admission to a network hospital, you get the privilege of availing cashless treatment, eliminating the need for upfront payments for covered medical services.
- Incremental Sum Insured
Aditya Birla Arogya Sanjeevani policy rewards policyholders with a 5% increase in the base sum insured for each claim-free year, providing added financial protection against escalating healthcare costs.
- Flexible Policy Tenure
With a policy tenure option of one year, available on both individual and family floater bases, individuals can tailor their coverage period to suit their specific healthcare needs and preferences.
- Waiting Period
Following a waiting period of 30 days from policy inception, you become eligible to avail of coverage for any necessary medical treatments, ensuring timely access to healthcare services.
- Coverage for Pre-existing Conditions
Pre-existing diseases are covered under the policy after a waiting period of 48 months, enabling individuals with existing health conditions to receive comprehensive medical coverage over time.
- Compulsory Co-payment
The policy entails a compulsory co-payment of 5%, ensuring a shared financial responsibility between the insured individual and the insurer for covered medical expenses.
- Coverage for Specific Illnesses
Certain specific illnesses, such as hernia and others, are claimable under the policy after a waiting period of 24 months, offering comprehensive coverage for a diverse range of healthcare needs.
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Inclusions of Aditya Birla Arogya Sanjeevani Policy
- Expenses related to ICU/ICCU treatment, with a daily limit of up to Rs 10,000 or 5% of the sum insured
- Coverage for cataract treatment up to 25% of the sum insured or a maximum of Rs 40,000
- Expenses incurred for in-patient Ayush treatment, including Homeopathy, Ayurveda, Unani, Naturopathy, Yoga, and Siddha (under reimbursement claim)
- Room rent and nursing charges, extending coverage up to Rs 5,000 or a maximum of 2% of the sum insured
- Claims for 30 days of pre-hospitalization expenses and 60 days of post-hospitalization expenses
- All daycare procedures for medical treatments that do not require overnight hospitalization
Exclusions of Aditya Birla Arogya Sanjeevani Policy
- Any health emergencies arising from war, acts of a foreign enemy, revolution, and similar circumstances
- Outpatient Department (OPD) charges and domiciliary treatment
- Costs associated with treatment for drugs, alcoholism, and substance abuse
- Treatments received in spas, nature cure clinics, or similar establishments T
- Treatment outside India
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Eligibility Criteria of Aditya Birla Arogya Sanjeevani Policy
- Applicants must fall within the age bracket of 18 to 65 years to be eligible for enrollment in the Aditya Birla Arogya Sanjeevani policy.
- Dependent children between 3 months and 25 years are eligible for inclusion under the policy, providing coverage for minors and young adults within the designated age limit.
- Policyholders can choose a sum insured ranging from Rs 1 lakh to Rs 5 lakh.
- The policy entails a mandatory co-payment of 5%, requiring policyholders to bear a portion of the medical expenses incurred.
- Applicants can select either an individual or family floater coverage type, allowing for the inclusion of family members under a single policy for comprehensive healthcare protection.
FAQs
Is the Aditya Birla Arogya Sanjeevani Policy suitable for senior citizens?
Yes, the policy is suitable for individuals aged 18 to 65 years. Senior citizens within this age bracket can avail of comprehensive healthcare coverage under this policy.
Can I include my dependent children in the policy?
Yes, dependent children aged between 3 months and 25 years can be included in the policy, ensuring coverage for minors and young adults within the specified age range.
What is the co-payment requirement under the Aditya Birla Arogya Sanjeevani policy?
The policy entails a compulsory co-payment of 5%. This means policyholders need to bear 5% of the medical expenses incurred, and the insurer covers the remaining expenses.
How does the cumulative bonus work?
The policy offers a cumulative bonus of 5% for every claim-free year, providing policyholders with increased coverage benefits over time as a reward for maintaining a healthy lifestyle and minimizing healthcare utilization.
Are there any restrictions on treatment locations?
Yes, medical treatments received outside the geographical limits of India are not eligible for claims under the Arogya Sanjeevani medical insurance policy.
Disclaimer:
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