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AYUSH Benefit

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Modern Treatments

Cataract and Dental Treatment

Arogya Sanjeevani Health Insurance is a scheme introduced by the Insurance Regulatory and Development Authority of India (IRDAI) that offers standard health insurance coverage for both individuals and families.

At, our Arogya Policy stands out from other products by focusing on offering basic coverage for essential healthcare needs at affordable rates. Here is everything you need to know about our Arogya Sanjeevani Policy.

What is the Arogya Sanjeevani Policy?

Arogya Sanjeevani Health Policy is a basic health insurance policy that offers coverage at low costs. It was introduced by the IRDAI to provide a simple health policy with standard features available across health insurance companies in India.

It covers healthcare expenses for inpatient hospitalisation, pre-and post-hospitalisation, AYUSH treatment and cataract treatment.

It also provides broad coverage for medical procedures, like Deep Brain Stimulation, Bronchial Thermoplasty, Stem Cell Therapy and Oral Chemotherapy among others.

The Reliance Sanjeevani Policy can be purchased for individuals or families for one year and can be easily renewed annually.

Importance of Arogya Policy

Rising Medical Costs

With the rising inflation rate and the demand for quality healthcare services, we see an increase in the cost of medical treatments.

Growing Prevalence of Illnesses

Due to increasing stress levels and irregular lifestyle habits, illnesses are becoming more prevalent among younger individuals.

Comprehensive Coverage

The best Arogya Sanjeevani policies offer comprehensive coverage for a wide array of medical treatments.

Tax Benefit and Savings

Save on taxes and unexpected medical expenses with your Arogya Insurance Policy under Section 80D of the Income Tax Act, 1961.

Peace of Mind

When you know you are covered for unexpected medical expenses for you and your family, you can enjoy peace of mind.

Reliance Arogya Sanjeevani Policy Benefits and Features

Benefits and Features of the Arogya Sanjeevani Scheme	Details
Plan Options	Individual and Family Floater Plans
Online Purchase	Available
Sum Insured	₹50,000 to ₹10 lakhs
Policy Term	1 year
Renewability	Lifelong
Entry Age	Between 18 and 65
Cashless Hospitalisation	Available
Network of Hospitals	10,000+
Waiting Period	Initial Waiting Period - 30 days Pre-Existing Diseases Waiting Period - 36 Months Specific Waiting Period - 24/36 months based on the disease
Healthcare Expenses Covered	Hospitalisation, Pre-and Post-Hospitalisation, Day Care Procedures, AYUSH Benefit, Dental Treatment, Cataract Treatment, Modern Treatments, etc.
Cumulative Bonus	Sum insured increases by 5% for each claim-free year up to a maximum of 50% of the sum insured. In the event of a claim, the cumulative bonus is reduced by the same 5%.
Co-Payment	5% of the claim amount for all claims
Customer Support	24/7 Customer Support

Reliance Arogya Sanjeevani Health Insurance: Inclusions and Exclusions

What is Covered Under Arogya Sanjeevani Health Insurance Policy?

Arogya Sanjeevani Policy Cover - Inclusions	Details
Hospitalisation and Related Medical Expenses	Room Rent, Boarding and Nursing Expenses up to 2% of the sum insured subject to a maximum of ₹5000 per day. Intensive Care Unit (ICU)/Intensive Cardiac Care Unit (ICCU) expenses up to 5% of the sum insured, subject to a maximum of ₹10,000 per day. Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, costs towards diagnostics, diagnostic imaging modalities and similar other expenses.
Pre-Hospitalisation	Covers medical expenses incurred 30 days prior to the date of hospitalisation.
Post-Hospitalisation	Covers medical expenses incurred up to 60 days from the date of discharge.
Dental Treatment	Medical expenses for treatment required due to disease or injury
Cataract Treatment^	Cataract treatment is covered up to 25% of the sum insured or ₹40,000, whichever is lower, per eye, under one policy year.
AYUSH Treatment	Medical expenses under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy medical systems (inpatient care)
Plastic Surgery	Medical expenses for treatment required due to disease or injury
Day Care Treatment	Medical expenses incurred for day care procedures that require less than 24 hours of hospitalisation
Road Ambulance	Expenses of up to ₹2,000 per hospitalisation
Modern Treatments Under Arogya Sanjeevani Policy + Other Specific Treatments (up to 50% of the sum insured)	Modern Treatments: Balloon Sinuplasty Deep Brain stimulation Oral chemotherapy Robotic surgeries Stereotactic radio surgeries IONM - (Intra Operative Neuro Monitoring) Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.
	Other Specific Treatments: Uterine Artery Embolization and HIFU (High intensity focused ultrasound) Immunotherapy- Monoclonal Antibody to be given as an injection Intravitreal injections Bronchial Thermoplasty Vaporisation of the prostate (Green laser treatment or holmium laser treatment)

^24 Months waiting period is applicable for Cataract Treatment

Please Note: Medical expenses covered under Arogya Sanjeevani Health Insurance policy can vary depending on individual circumstances. Therefore, it is important to read through the policy wording for more detailed information.

*Age based on completed years, No maximum cover ceasing age

What is Not Covered Under Arogya Sanjeevani Mediclaim Policy*?

Claims arising from the following treatments or expenses will not be paid for by us unless stated otherwise on your Arogya Sanjeevani Policy.

Domiciliary Hospitalisation
Investigation & Evaluation
Rest Cure, rehabilitation and respite care
Obesity/Weight Control
Change-of-Gender treatments
Cosmetic or Plastic surgery (unless medically necessary or due to accidental injury)
Hazardous or Adventure sports
Breach of law
Excluded providers

Alternate Therapy and Rejuvenation
Dietary Supplements & Substances
Refractive Error
Unproven Treatments
Sterility and Infertility
Maternity
Non-medical expenses
Outpatient treatment (OPD)
Overseas treatment
War or similar situations
Nuclear, chemical or Biological attack
Addictions, Drug / Substance Abuse

*T&C apply. For more details on risk factors, terms conditions, brochure, and exclusions, please read the policy wording and CIS carefully before concluding a sale. The details mentioned above are for Arogya Sanjeevani Policy,. UIN- RELHLIP21001V012021

You can Click here to read the policy wordings and learn more about the exclusions of the Arogya Sanjeevani Health Insurance Policy

Who Needs Sanjeevani Health Insurance?

Individuals Seeking Affordable Health Insurance Plans

If you need a budget-friendly health insurance policy with essential features, the Sanjeevani Health Insurance Scheme is certainly the best option.

Individuals With Lower Health Risks

If you are healthy and have a low probability of getting affected due to an illness or disease, you can buy the Arogya Sanjeevani Policy for standard coverage.

Individuals Seeking Standard Coverage for their Families

Individuals seeking comprehensive coverage that meets the basic medical needs of all family members will find the Arogya Policy an ideal choice.

Young Individuals

Young and healthy individuals who need basic health coverage and want to prioritise their health and well-being without straining their finances can buy an Arogya Sanjeevani policy.

Arogya Sanjeevani Policy Eligibility Criteria

Eligibility Criteria	Details
Age	Adult: 18 years to 65 years Dependent children: 91 days to 25 years*
Coverage	For self and the following family members: Spouse Parents and Parents-in-law Dependent children

Eligibility Criteria

Details

Age

Adult: 18 years to 65 years
Dependent children: 91 days to 25 years*

Coverage

For self and the following family members:

Spouse
Parents and Parents-in-law
Dependent children

How to Buy the Arogya Sanjeevani Policy Online?

Step 1: Visit our official
Step 2: Under the ‘Explore Products’ tab, choose ‘Aarogya Sanjeevani Policy’.
Step 3: Click on the ‘Get Your Quote’ option. Enter the required information and complete the KYC verification process.
Step 4: Determine the health insurance coverage features and pay the applicable premium to buy the Arogya Sanjeevani Policy online.
Step 5: We will send your Arogya Sanjeevani Health Insurance Policy almost instantly.

How to Renew the Arogya Insurance Policy?

Step 1: Visit our official website.
Step 2: Under the Renewal tab, choose the ‘Renew Health Insurance’ option to proceed with the Arogya Sanjeevani Plan renewal.
Step 3: Provide your registered mobile number or policy number to proceed.
Step 4: Review your existing health insurance coverage, modify your requirements if necessary and complete the process.
Step 5: Pay the applicable premium, and we will renew your Arogya Sanjeevani Scheme immediately.

Arogya Sanjeevani Policy Waiting Period-

Type of Waiting Period	Duration and Specifics
Initial Waiting Period	30 days from the first policy start date for any illness, except for claims arising out of accidents
Pre-Existing Diseases Waiting Period	36 months of continuous coverage after the start date of the first policy with us
Specific Waiting Periods	24 Months: Benign ENTdisorders Tonsillectomy Adenoidectomy Mastoidectomy Tympanoplasty Hysterectomy All internal and external benign tumours, cysts, polyps of any kind, including benign breast lumps Benign prostate hypertrophy Cataract and age-related eye ailments Gastric/ Duodenal Ulcer Gout and Rheumatism Hernia of all types Hydrocele Non-Infective Arthritis Piles, Fissures and Fistula in anus Pilonidal sinus, Sinusitis and related disorders Prolapsed intervertebral Disc and Spinal Diseases, unless arising from an accident Calculi in the urinary system, Gallbladder and Bile duct, excluding malignancy. Varicose Veins and Varicose Ulcers Internal Congenital Anomalies
Specific Waiting Periods	36 Months: Treatment for joint replacement, unless arising from an accident Age-related Osteoarthritis & Osteoporosis

Arogya Sanjeevani Health Insurance Claims Process

Cashless Claims

Step 1: Inform us about the claim within 24 hours of emergency hospitalisation and 48 hours prior to planned hospitalisation.
- Call us on our paid helpline number - +91 22 48903009
- Writing to us- rcarehealth@relianceada.com
- Login on to our Reliance Self-i App.
Step 2: Visit anynetwork or non-network hospital for the treatment.
Step 2: Fill out the cashless request form (available at the hospital TPA) and provide the necessary medical information to claim Arogya Sanjeevani Policy.
Step 3: We will verify the details and issue the pre-authorisation letter.
Step 4: At the time of discharge, verify and sign all the medical bills. We will settle the claim amount directly with the hospital.

Reimbursement Claims

Step 1: Inform us about the claim within 24 hours of emergency hospitalisation and 48 hours prior to planned hospitalisation.
- Call us on our paid helpline number - +91 22 48903009
- Writing to us- rcarehealth@relianceada.com
- Login on to our Reliance Self-i App.
Step 2: Visit any authorised hospital and receive the necessary treatment.
Step 3: Pay the applicable bills and keep the receipts safe.
Step 4: Scan and submit the required documents, including the medical bills and the payment receipts, to us within 7 days.
Step 5: We will review your claim and reimburse the applicable expenses for the Arogya Sanjeevani Scheme.

Documents to Claim Arogya Sanjeevani Policy

Types of Documents to Claim Arogya Sanjeevani Policy	Details
Standard documents	Duly Completed claim form for Arogya Sanjeevani Policy Photo Identity proof of the patient
Medical Documents	Medical practitioner's prescription advising admission Discharge summary including complete medical history of the patient along with other details Investigation/ Diagnostic test reports, etc., supported by the prescription from the attending medical practitioner OT notes or Surgeon's certificate giving details of the operation performed (for surgical cases) Sticker/Invoice of the Implants, wherever applicable MLR(Medico-Legal Report copy, if applicable
Payment Documents	Original bills Payment receipts
Otder Documents	FIR (First information report) if registered NEFT Details and cancelled cheque KYC (Identity proof with Address) of the proposer, if applicable Legal heir/succession certificate

Arogya Sanjeevani Cancellation and Refund Policy

Cancelling your Arogya Sanjeevani Policy is not advisable, as it may lead to unexpected financial strain during a medical emergency.

However, if you choose to cancel, the Arogya Sanjeevani Refund Policy is detailed below.

Free-Look Period

You have a 30-day free-look period to return your policy with proportionate deductions for covered risks and medical examination costs if no claims have been raised.

In Case of No Claim After the Free-Look Period

If you have cancelled the policy and raised no claims during the policy year, the refund amount will be on a pro-rata basis.

It is calculated as follows:

Return of Premium = Total policy premium paid * [1-(Number of Policy Days Expired/Total Policy Days)]

In Case of a Claim After the Free-Look Period

If you have raised a claim under the Arogya Sanjeevani Health Insurance policy and later decided to cancel, there shall be no refund of the premium.

We may also cancel the policy with 7 days’ written notice. In such scenarios, the premium refund will be based on the short-term rates for the unexpired policy period.

We may also cancel the policy on grounds of any fraudulent incidents, such as misrepresentation or non-disclosure of required information. It will be on 15-day written notice, and no refund shall be applicable.

Difference Between Arogya Sanjeevani and Health Insurance (Other Regular Plans)

Differentiating Factors	Arogya Sanjeevani Health Insurance Policy	Regular Health Insurance
Coverage	Basic and standardised health insurance coverage for essential medical needs. The Arogya Sanjeevani Health Policy is similar across the different health insurance providers.	Basic and extensive coverage for a wide range of healthcare requirements. Varies with individual health insurance providers and within their policy options.
Premium	Sanjeevani health insurance is more affordable and has lower premium rates.	It can be lower or higher and is based on the extent of coverage offered.
Sum Insured	₹50,000 to ₹10,00,000	Specific to the health insurance policy it can be beyond ₹10,00,000.
Eligibility Criteria	Individuals aged 18-65 (Children can be included under a family floater policy)	Broader age limits, including newborn babies
Customisation	Limited scope for Sanjeevani Insurance	Extensive options with a wide array of add-ons or optional covers
Co-payment	5%	Can differ across health insurance policies and may be optional.

Arogya Sanjeevani Policy Premium Chart and Calculator

The premium for the Arogya Sanjeevani Policy is based on various factors, such as your age, pre-existing diseases and the health insurance coverage amount (sum insured).

You can use the Arogya Sanjeevani Policy premium calculator available at the top of this page to calculate the premium specific to your individual circumstances.

Here is a premium chart to illustrate the applicable cost for an adult (individual policy) with no pre-existing diseases.

Age	Sum Insured (₹)	Premium (₹)
25	3 lakhs	2680 + GST
35	5 lakhs	5590 + GST
45	7 lakhs	8976 + GST
55	9 lakhs	14,140 + GST
65	10 lakhs	27,116 + GST

Please Note: The above table is just an illustration and the premium is indicative. Use the calculator at the top of this page to determine the premium accurate to your specific individual circumstances.

Arogya Sanjeevani Tax Benefits

By purchasing the Arogya Sanjeevani Insurance for yourself and your family, you can claim a tax deduction under Section 80D on the premium paid. In addition, you can claim a separate tax deduction for the premium paid on your parents’ Arogya Policy, making both deductions applicable.

The maximum limit based on the age is as follows:

Individuals Covered	Section 80D Tax Deduction Limit (₹)		Total Tax Deduction Applicable Under Section 80 (₹)
Individuals Covered	Self, Spouse and Dependent Children	Parents	Total Tax Deduction Applicable Under Section 80 (₹)
Self, family and parents less tdan 60 years of age	25,000	25,000	50,000
Self and family less than 60 years and parents greater than 60 years of age	25,000	50,000	75,000
Self, family and parents greater than 60 years of age	50,000	50,000	1,00,000

Arogya Sanjeevani Policy - Cashless Hospitalisation

By buying the Arogya Sanjeevani Policy, you can get cashless hospitalisation benefits at network and non-network hospitals. This means you can receive the treatment for your planned or emergency healthcare needs at any hospital in India, and we will settle the bills directly with the hospital on your behalf.

We also have a wide network of over 10,000 hospitals that offer streamlined cashless services. Here is how you can locate our network of hospitals.

Frequently Asked Questions About Arogya Sanjeevani Insurance

Is Arogya Sanjeevani a government-sponsored scheme?

Arogya Sanjeevani Health Insurance is a health insurance policy introduced and approved by the Insurance Regulatory and Development Authority of India (IRDAI). All general insurance companies are authorised to offer it to their customers.
What is co-payment in the Arogya Sanjeevani Insurance Policy?

Co-payment refers to the percentage of the claim amount that you have to pay out of your pocket. The Co-Payment applicable to Arogya Sanjeevani Policy is 5% of your claim amount.
What is the waiting period for the Arogya Sanjeevani Scheme?

The waiting period refers to the duration you need to wait before you apply for a claim under the Arogya Policy. It has an initial waiting period of 30 days, pre-existing diseases waiting period of 36 months and a specific waiting period of 24 or 36 months for certain specified illnesses.
Are there any tax benefits with Arogya Sanjeevani Insurance?

Yes, you can claim a tax deduction benefit under Section 80D of the Income Tax Act, 1961, of the premiums paid for Arogya Policy. It is applicable separately for yourself, or including your family (spouse and dependent children) and your parents.
Are there any policy options under the Arogya Sanjeevani Health Insurance policy?

No, there are no policy options available under the Arogya Insurance Policy. However, you can choose the health insurance coverage amount based on your requirements.
Can NRIs buy the Arogya Sanjeevani Policy?

Yes, NRIs are eligible to buy the Arogya Sanjeevani Policy.
Is a medical examination mandatory for Arogya Sanjeevani Health Insurance Policy?

Generally, medical examination is not necessary to buy the Arogya Sanjeevani Health Insurance Policy. However, in certain cases, it might be required considering the specific health conditions or age.
What factors affect the Arogya Sanjeevani Health Insurance premium?

The key factors that affect your Arogya Policy premium are your age, type of policy (whether individual or family) and the sum insured.
How long does the Arogya Sanjeevani policy cover my medical expenses?

The policy will cover you for a period of one year after which you can opt to renew it for a further 12 months.
Can I renew my Arogya Sanjeevani Insurance policy online?

Yes, you can renew your Arogya Sanjeevani Health Insurance policy online.
What is the difference between Individual and Family Floater Health Insurance plans available under Arogya Sanjeevani Policy?

Individual plans cover the medical expenses of a single individual. On the other hand, a family floater health insurance plan covers the medical expenses of the individual members of a family. It can be used to cover your spouse, dependent children and parents.
Who can buy an Arogya Sanjeevani health insurance policy?

Any individual between the age of 18 to 65 years can purchase an Arogya Sanjeevani policy. If opting for a family plan, children from 3 months to up to 25 years can be added.
What are the eligibility criteria for dependent children?

Natural or legally adopted children between the ages of 3 months and 25 years can be included in the Arogya Sanjeevani Policy. However, if the children are above 18 years of age and financially independent, they become ineligible for the coverage.
Is it possible to port my existing policy to an Arogya Sanjeevani health policy?

Yes, it is possible to port your policy as per the rules stipulated by the IRDAI. Porting is possible during the time of policy renewal.
Can I port Arogya Sanjeevani Policy?

Yes, you can port the Arogya Sanjeevani Policy from your existing insurance provider to us if you are not satisfied with any aspect.
What is the room rent policy in Arogya Sanjeevani?

Room rent coverage up to 2% of sum insured subject to a maximum of ₹5,000 per day is offered under the Arogya Policy. For ICU and CCU, the coverage offered is 5% of sum insured subject to a maximum of ₹10,000 per day.
Does the Arogya Sanjeevani Health Insurance plan cover maternity benefits?

No, the Arogya Sanjeevani Policy does not cover medical expenses related to maternity, including pregnancy and childbirth.
Are pre-existing diseases covered under the Arogya Sanjeevani Health Insurance Policy?

Yes, pre-existing diseases are covered under the Arogya Sanjeevani Health Policy. However, it is applicable after the completion of the waiting period of 36 months.
Does the Arogya Sanjeevani Health Insurance policy cover overseas medical treatment?

No, Arogya Sanjeevani Insurance Policy does not cover medical expenses incurred outside India. You can refer to our Reliance Health Global for overseas health insurance coverage.
What is the maximum sum insured limit for the Arogya Sanjeevani Health Insurance Plan?

You can choose a sum insured up to ₹10 lakhs under Arogya Sanjeevani Health Insurance Policy.
Can I buy the Arogya Policy exclusively for my children?

No, the Arogya Sanjeevani Policy cannot be purchased exclusively for your children. It can be purchased as a family floater plan that includes both you and your children.
Can I increase the health insurance coverage under the Arogya Sanjeevani Policy?

Yes, you can increase the health coverage in multiples of ₹50,000 and up to ₹10,00,000.
Is cashless hospitalisation applicable under the Arogya Sanjeevani Insurance Policy?

Yes, you can benefit from cashless hospitalisation in our network of over 10,000 hospitals across India. With the recent GIC announcement, you can avail of cashless hospitalisation benefits even in non-network hospitals.
Who should I contact for a claim under the Arogya Sanjeevani Policy?

You can contact us in any of the following ways to inform us about your claim.
1. Call us on our paid helpline number - +91 22 48903009
2. Writing to us - rcarehealth@relianceada.com
3. Login on to our Reliance Self-i App.

Here’s what our customers say about us!

"Good health insurance policy"

A decent policy by which covers hopitalization and helped me recover expenses.

Mohan A 12 December 2019, Kerala

"Health insurance with cashless benefit"

It is a good health insurance policy which cover hospitalization and helped me avail cashless hospitalization

Dino S 13 February 2020, Hyderabad

"Customizable health insurance policy"

I could select and customize the health insurance plan as per my needs. It was good to purchase the health insurance plan as needed.

Chetan O 5 February 2020, Vijayawada

"Don't miss health insurance"

I paid my own bills last year when I was admitted to the hospital and it was painful as I didn't had a health insurance policy

Himani S 14 January 2019, Bengaluru

Disclaimers:

*T&C apply For more details on risk factors, terms conditions, brochure, and exclusions, please read the policy wording and CIS carefully before concluding a sale.

Premium: The premium mentioned is excluding taxes for single person aged between 5 years to 20 years with individual health policy for Sum Insured of ₹3 lakhs considering no adverse health conditions/pre-existing disease/medical conditions with waiting period of 3 years. For more details, please refer to the policy wordings. Premium used is 2,919/year converted into a month which gives us Rs.243/month (2,919/12).

Tax benefits: Tax benefits are subject to conditions under Section 80D of the Act and amendments thereof. The tax laws are subject to amendments/changes from time to time. Please consult your tax advisor for details.

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