Arogya Sanjeevani Insurance Policy

Section 1: Basic Benefits of Arogya Sanjeevani Policy

Inpatient Care: Covers medical expenses like room rent, ICU charges, medical practitioners fee, OT charges, nursing charges etc. incurred during hospitalisation due to an illness or accident for a period of more than 24 hrs.

• Room Rent, Boarding, Nursing Expenses as provided by the Hospital /Nursing Home, up to 2% of the sum insured subject to maximum of ₹5000/- per day.
• Intensive Care Unit (ICU)- /Intensive Cardiac Care Unit (ICCU) expenses up to 5% of sum insured subject to maximum of ₹10,000/- per day.
• Cost is included up to sum-insured for Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, diagnostics, diagnostic imaging modalities and such similar other expenses.
• Doctor/Surgeons fees is covered

Special Treatments: Special treatments as listed below are covered with up to 50% of the sum-insured under Arogya Sanjeevani health insurance:

• Uterine Artery Embolization and HIFU (High intensity focused ultrasound)
• Balloon Sinuplasty
• Deep Brain stimulation
• Oral chemotherapy
• Immunotherapy- Monoclonal Antibody to be given as injection
• Intra vitreal injections
• Robotic surgeries
• Stereotactic radio surgeries
• Bronchical Thermoplasty
• Vaporisation of the prostrate (Green laser treatment or holmium laser treatment)
• IONM - (Intra Operative Neuro Monitoring)
• Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered

Day Care Procedures: Medical expenses incurred for day care procedures taken at a hospital or day care centre. 24 hours mandatory hospitalisation is not necessary in the day care procedure.

Cataract Treatment^: Cataract treatment is covered up to 25% of Sum insured or ₹40,000/-, whichever is lower, per eye, under one policy year.

AYUSH Benefit: The medical expenses for in-patient treatment taken under Ayurveda, Unani, siddha and homeopathy are covered without sublimits.

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.

Emergency Road Ambulance: Actual expenses incurred for utilizing road ambulance service for transporting the insured to the nearest hospital with adequate emergency facilities is covered upto ₹2000 per hospitalisation.

Dental Treatment and Plastic Surgery: Dental treatment & Plastic surgery necessitated due to any disease or accidental injury is covered

Section 2: Co-payment and Cumulative Bonus

Cumulative Bonus: Increase in the sum insured by 5% in respect of each claim free year subject to a maximum of 50% of SI. In the event of claim the cumulative bonus shall be reduced at the same rate.

Co-payment: 5% for all claims