Care Health Arogya Sanjeevani Policy

Having a reliable insurance plan becomes indispensable when healthcare expenses are on the rise. A notable solution that has captured attention is the Care Arogya Sanjeevani Policy, previously recognized as the Religare Arogya Sanjeevani Policy. This policy introduces a standardized framework with the primary goal of delivering crucial hospitalization coverage to individuals. It is a comprehensive and accessible option in the face of escalating healthcare costs, providing a safety net for individuals seeking essential medical coverage.

Since its inception, the Arogya Sanjeevani policy has become a go-to option for those seeking comprehensive coverage without straining their financial resources. Available through various insurers, including the Care Arogya Sanjeevani Policy provider, this policy caters to the needs of individuals across different income brackets.

With coverage ranging from Rs 1 lakh to Rs 5 lakh, the Care Health Arogya Sanjeevani Policy fills a crucial gap in the healthcare insurance landscape. Its affordability, coupled with basic yet vital coverage, makes it an attractive choice for many. If you want to buy a basic health insurance plan, understanding the offerings of the Care Arogya Sanjeevani Policy can help you take the next step.

Let’s learn more about the specifics of the Care Health Arogya Sanjeevani Policy and how it could potentially benefit you and your loved ones.

Features of Care Health Arogya Sanjeevani Policy

• Eligibility Criteria: Individuals above 65 years can purchase the policy for family members, excluding themselves.
• Age requirement: Between 18 and 65 years.
• Coverage Amount: The policy provides coverage ranging from Rs 1 lakh to Rs 5 lakh.
• Coverage Options: Arogya Sanjeevani plan offers coverage on both an individual and family floater basis.
• Children between 3 months and 25 years are eligible for coverage under the family plan.
• Renewal Process: The policy comes with an annual renewal requirement.
• Grace Period: Care Health provides a grace period of 30 days for policy renewal.
• Co-payment Clause: A co-payment of 5% applies to all claims.
• Add-Ons: Arogya Sanjeevani Policy does not offer add-on or optional covers.
• Special Coverage: Despite the absence of add-ons, Care Health Arogya Sanjeevani plan extends a unique cover for dental expenses and plastic surgery arising from illness or injury.

Recommended Read: Government Health Insurance Schemes: About, Types, Benefits, & More

Inclusions of Care Health Arogya Sanjeevani Policy

• Coverage for in-patient hospitalization, encompassing Ayush treatment, up to the sum insured limit
• Pre-hospitalization expense cover for 30 days and post-hospitalization expense cover for 60 days
• Coverage for expenses related to cataract treatment, subject to the specified limit
• Ambulance expense cover, with a limit set at Rs 2000.
• All day-care treatments cover
• Cumulative bonus offering a 5% increase for every claim-free year

Exclusions of Care Health Arogya Sanjeevani Policy

The policy does not cover certain medical expenses, including:

• Until the completion of the waiting period, pre-existing diseases are not covered under the policy.
• Diseases or illnesses contracted within the first 30 days from the policy purchase date are not covered except for accidental cases.
• Treatment related to HIV/AIDS is not considered within the coverage of Care Health Arogya Sanjeevani policy.
• Expenses incurred due to the overdose of alcohol and drugs, including associated treatment and illnesses, are not covered.
• Self-inflicted injuries, suicidal attempts, symptoms of depression, and mental disorders are not eligible for insurance claims.

Understanding the inclusions and exclusions of the Care Health Arogya Sanjeevani Policy is crucial for individuals seeking a comprehensive health insurance solution. 

Also Read: A Complete Guide to Finding Cheap Health Insurance Plans

Care Health Arogya Sanjeevani Policy: Eligibility Criteria

• Minimum entry age: 5 years (for the floater option, the primary member must be at least 18 years and 3 months, and children included in the plan can be up to 24 years old)
• Maximum Entry Age: 65 years for adults and 24 years for children
• Policy Term: 1 year
• Coverage Options: Individual or family floater coverage
• Renewability: Lifelong 
• No Claim Bonus: Ranging from 5% to 50%

Understanding these eligibility criteria can help individuals assess whether the policy aligns with their specific requirements and family structure.

Care Health Arogya Sanjeevani Policy Renewal

Ensuring uninterrupted and comprehensive health insurance coverage for yourself and your family requires timely renewal of the Arogya Sanjeevani policy. Here’s a concise guide on the online renewal process:

• Access the Care Health website and locate the ‘Renew’ option.
• Input your policy number and date of birth to initiate the renewal process. 
• Choose from the convenient online payment options, including net banking, credit card, or debit card, to settle the renewal premium.

Proactive renewal ensures continuous protection and allows you to reassess your healthcare requirements and potentially explore enhanced coverage. Before renewing, it is advisable to compare different plans and use health insurance premium calculators. Explore online reviews of Care Health Insurance to make an informed decision aligned with your evolving healthcare needs.

Policy Terms for Care Health Arogya Sanjeevani Policy

• Pre-existing Diseases

Coverage for pre-existing diseases becomes effective after a waiting period of 48 months. Policyholders must be aware of and plan for this waiting period.

• Initial Waiting Period

A 30-day waiting period is applicable for all illnesses, except for injuries. During this period, coverage for illnesses will not be extended.

• Specific Diseases Waiting Period

For certain diseases, coverage is subject to a waiting period of 24 months. Policyholders need to be mindful of this timeline for comprehensive understanding.

• Co-payment Clause

A 5% co-payment clause is applicable to all claims. 

Being acquainted with these policy terms ensures that policyholders are well-informed about the waiting periods and co-payment obligations. 

Care Health Arogya Sanjeevani Health Insurance Claim Process

Here is a concise guide on the Care Health Arogya Sanjeevani Mediclaim policy claim procedure:

1. Immediately intimate your insurer by submitting a claim request. In cases of emergency hospitalization, notify the insurer within 24 hours. For planned hospitalization, inform the insurer within 48 hours.

2. For cashless treatment pre-authorization, follow these steps:

• Email or fax the pre-authorization form, available at the TPA or hospital insurance desk or downloadable from the insurer’s website.
• The claim management team will issue a letter of approval if the claim request is accepted.
• In case of any queries, the insurance company will directly contact the hospital for clarification.
• If the cashless request is not approved, you will need to proceed with a reimbursement claim.

3. For reimbursement claims in non-network hospitals, follow these steps:

• Submit the claim form along with required documents specified during policy purchase.
• Address any queries raised by the claim management team of the insurance company.
• Receive either a letter of approval or rejection after the completion of the claim submission process.

Documents Required for Care Health Arogya Sanjeevani Policy Claim

When opting for claim reimbursement under the Care Health Arogya Sanjeevani Policy, ensure that the following documents are carefully submitted:

• Duly Filled and Signed Claim Form
• Patient’s Photo ID Proof
• Doctor’s Prescription Advising Hospitalization
• Bills/Receipts/Discharge Summary
• Diagnostic Reports
• OT Reports
• Medico-Legal Report (MLR) or First Information Report (FIR) as per the nature of the case
• KYC for Claims Above Rs 1 Lakh:
• Any Other Document as Required after Case Assessment

FAQs

Who should consider purchasing the Care Health Arogya Sanjeevani Policy?

The Care Health Arogya Sanjeevani Policy is an appropriate choice for individuals seeking comprehensive health coverage without the burden of a higher premium. Specifically, this policy is designed for those who find affordability a crucial factor in their insurance decision-making process. If you are looking for a nominal sum insured, ranging up to Rs 5,00,000, this policy caters to your financial considerations.

What are the age limits for coverage under the Care Health Arogya Sanjeevani plan?

The Care Health Arogya Sanjeevani plan extends coverage to individuals within the age range of 18 to 65 years. This policy is specifically tailored to cater to the healthcare needs of individuals within this demographic.

Is there a co-payment requirement under the Care Health Arogya Sanjeevani plan?

Yes, there is a co-payment provision associated with the Care Health Arogya Sanjeevani plan. A co-payment of 5% is applicable to all claims made under this policy. This implies that the policyholder is required to contribute 5% of the incurred medical expenses, while the insurance company covers the remaining 95%.

What is meant by the waiting period in the Care Health Arogya Sanjeevani plan?

The waiting period in the Care Health Arogya Sanjeevani plan refers to the immediate duration following the policy purchase date. During this specified timeframe, policyholders are unable to file claims for medical expenses incurred on certain predetermined diseases that might have existed before the initiation of the policy.

How many network hospitals are associated with Care Health Insurance?

Care Health Insurance boasts a substantial network of healthcare providers, with more than 7400 hospitals in collaboration. These network hospitals offer the insured individuals the convenience of availing cashless treatment facilities.

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