Care Health Arogya Sanjeevani Policy Overview

In India, an increasing number of families are realizing the critical need for health insurance, especially with growing medical costs and uncertainties in public health. Here, the Care Health Arogya Sanjeevani Policy stands out as a reliable and affordable health insurance option in 2025.

This standard health plan, recommended by the IRDAI, covers essential hospitalization expenses and aims to provide financial protection to individuals and families of all income groups.

Designed as a simple, easy to understand medical cover, Arogya Sanjeevani removes complex jargon and offers pan India coverage. This makes healthcare more accessible for millions looking for trusted and effective health insurance plans with standardized benefits.

What are the Key Features of Care Health Arogya Sanjeevani Policy?

Care Health Arogya Sanjeevani Policy offers several highlights that make it suitable for most people searching for basic health protection.

• Sum insured options: Choose from 1 lakh to 5 lakh rupees (in multiples of One Lakh)
• Policy tenure: Renewable every year without age restriction
• All age groups: Entry age starts from 18 years for adults, up to 65 years. Dependent children can be covered from 3 months to 25 years.
• Family floater: Cover self, spouse, up to 3 children and 2 parents under one premium
• Cashless hospital network: 7000 plus network hospitals across India
• Wide coverage: Hospitalisation, room rent, ICU, AYUSH treatments and pre post hospitalisation expenses
• No claim bonus: 5 percent increase in sum insured for each claim free year up to max 50 percent
• Lifelong renewability

Did you know?
The Arogya Sanjeevani Policy is mandated by the IRDAI for all insurance companies, ensuring uniformity and standardized benefits for policyholders.

How Much Does the Plan for Hospitalization Expenses?

A major concern during medical emergencies is the high cost of treatment and stay. This policy covers actual medical expenses incurred during hospitalisation, subject to the sum insured and sub limits specified under the policy.

In-patient hospitalization including room rent, nursing, boarding, ICU and medical practitioner’s fees are all covered up to the sum insured. There are some limits, such as room rent capping at 2 percent of the sum insured up to a maximum of 5000 rupees per day. ICU charges are capped at 5 percent of the sum insured or 10000 rupees per day, whichever is less.

Pre hospitalisation expenses are covered up to 30 days before admission and post hospitalisation up to 60 days after discharge, provided they are linked to the treatment.

What are the Important Inclusions Under this Policy?

• Medical expenses for road ambulance up to 2000 rupees per hospitalisation
• AYUSH hospitalisation for Ayurveda, Yoga Naturopathy, Unani, Siddha, and Homeopathy treatments
• Day care treatments that do not require 24 hour hospitalisation
• Cataract treatment coverage up to 25 percent of sum insured or maximum 40000 rupees per eye
• Coverage for modern treatment methods like Robotic surgery, Organ donor expenses and Stem cell therapy within sum insured

Expert insight:
Health insurance experts recommend including parents and dependent children in a family floater plan to maximise coverage at affordable premiums.

What are the Pros and Cons of Care Health Arogya Sanjeevani Policy?

Evaluating both advantages and limitations helps you decide if this plan meets your needs.

Pros

• Simple and easy to understand
• Uniform benefits across all insurers as per IRDAI guidelines
• Broad hospital coverage and cashless facility
• Affordable annual premium, suitable for individuals and families
• Includes AYUSH and modern treatments
• Lifelong renewable
• Tax benefit under Section 80D of Income Tax Act

Cons

• Low sum insured may not cover major illnesses or surgeries
• Room rent and ICU room capping can lead to out-of-pocket expense if you choose a higher category room
• Specific waiting period for pre-existing diseases and certain treatments like cataract, hernia, etc
• No maternity or infertility treatment coverage
• Outpatient and dental treatments not included

People also ask:
What is not covered in Arogya Sanjeevani Policy?
The policy does not cover OPD, cosmetic treatments, dental care, hearing aids, and pre-existing diseases within the first forty eight months.

Comparison of Arogya Sanjeevani Policy to other Regular Health Insurance Plans?

Let us compare Arogya Sanjeevani and a regular comprehensive health insurance to understand the differences better for 2025.

Did you know?
Many urban families in 2025 prefer holding the Arogya Sanjeevani as a base policy and purchase a top up plan for added protection.

Can You Customize Your Coverage in This Policy?

Unlike many regular plans, the Care Health Arogya Sanjeevani Policy offers only set benefits and fixed sum insured options. There is no option to add riders such as maternity, personal accident or critical illness cover. The intent is to keep the plan simple, affordable and accessible for all, especially first-time health insurance buyers.

However, you can choose individual or family floater based on your need. Additionally, increasing your sum insured within the given slab and opting for voluntary co payment may help manage premium costs.

People also ask:
Is Care Health Arogya Sanjeevani worth buying in 2025?
Yes, it is a good entry level health insurance cover, especially for budget buyers, small families and those who do not have any insurance coverage currently.

Whom Should Buy Care Health Arogya Sanjeevani Policy?

This standard plan serves as a good choice for:

• First time health insurance buyers seeking a simple policy
• Young professionals, small families or senior citizens with limited health cover
• Those with employer group insurance but looking for extra personal cover
• Individuals who have not been covered before and want to avoid large premiums
• People aiming for tax saving and health protection together

This policy is not recommended as the only cover for those with a high health risk, lifestyle diseases or senior citizens above 60, as coverage may fall short for bigger medical expenses.

Expert insight:
Healthcare planners in 2025 suggest holding a standard plan like this, and increasing health portfolio over time as financial protection requirements grow.

How to Buy this Plan and What Is the Claiming Process?

Purchasing Care Health Arogya Sanjeevani Policy is hassle-free. The process can be done online on the official Care Health Insurance website, insurance aggregator portals or through company agents.

Steps for Buying:

• Compare plans online for the best premium and hospital network
• Fill proposal form, select sum insured and family details
• Complete KYC and medical declaration
• Make premium payment and receive policy document in email

Claim Process:

• Get admitted in a cashless network hospital or choose any hospital for reimbursement
• Show e-health card and policy details
• Fill cashless form or reimbursement claim form
• Submit bills, discharge summary and other supporting docs
• Track claim status via customer portal or app

Most cashless approvals are given within three hours in big hospitals as per current Care Health records for 2025.

People also ask:
What documents are required for claim?
You generally require hospital bills, medical reports, doctor’s prescription, valid ID, and policy document for processing claims.

What are the Some Common Exclusions and Waiting Periods?

Every insurance comes with certain exclusions. Under this policy, exclusions include:

• Pre-existing diseases for first four years
• Any cosmetic, aesthetic or weight related treatments
• Hospitalisation for investigations and diagnosis without active treatment
• Injuries due to self harm, war or nuclear risks
• Drug or alcohol addiction
• Treatment outside India

Waiting Periods:

• 30 days initial waiting except accident
• Two years waiting for specific conditions like hernia, osteoporosis, joint replacement
• 48 months or four years for any pre-existing illnesses

Customers are advised to read the policy wordings in detail to avoid surprises at the time of claim.

Did you know?
In 2025, more Indians are seeking transparent and paperless claims. Care Health app allows uploading scanned copies of claim documents instantly.

What are the Premium Rates and Payment Options Available?

The policy premium is determined by factors such as:

• Age of insured
• Sum insured opted
• Individual or family floater
• Number of insured members

On average, annual premium for a young healthy adult for 5 lakh sum insured starts at approximately INR 3200 to 4000. For a four member family floater, approximate annual premium is INR 9500 to 12000 for sum insured of 5 lakh in 2025.

Payment is accepted via online modes, UPI, bank cards and net banking, making renewal simple. There is also an option for auto debit with most banks.

People also ask:
Will my premium increase on renewal?
Premiums will generally remain similar unless there is a revision by IRDAI or age band crossing; medical inflation can also have an effect.

What Should You Remember Before Choosing this Policy?

• Always disclose pre-existing medical history truthfully
• Review list of cashless network hospitals in your location
• Take note of sub limits, exclusions and waiting periods
• Consider buying a top up plan for higher coverage needs
• Read customer reviews and insurer’s service record to avoid claim hassles

Why is the Policy Relevant in 2025?

With increasing incidents of medical emergencies, lifestyle diseases, and viral infections, the demand for basic and affordable health insurance has never been higher. Hospital costs continue to rise, especially in urban India. Care Health Arogya Sanjeevani Policy bridges this gap for millions of Indians by:

• Offering a standardized, transparent, and accessible insurance product
• Encouraging health security for lower and middle income families
• Promoting digital claims and hasslefree renewal for customer convenience
• Supporting government’s vision of ‘Health for All’

Quick Recap TLDR:

The Care Health Arogya Sanjeevani Policy is a standard IRDAI mandated health insurance plan covering hospitalisation, modern and AYUSH treatments for individuals and families, with sum insured options from 1 to 5 lakh rupees. It is affordable, suits first time buyers, comes with simple features, and cashless claims at 7000 plus network hospitals. Sum insured limits may be low for higher health risks, but it serves as a strong foundation for anyone starting their health insurance journey in India in 2025.

People Also Ask: FAQs

Q1. Is Care Health Arogya Sanjeevani policy cashless?
Yes, you can avail cashless hospitalisation at over 7000 network hospitals across India.

Q2. Can senior citizens buy this policy in 2025?
Yes, adults up to 65 years can purchase, and the plan is renewable for life for existing customers.

Q3. What diseases are covered under Arogya Sanjeevani?
It covers hospitalisation, all diseases including COVID 19, cardiac, cancer and AYUSH treatments as per the policy wording, after stipulated waiting period.

Q4. Is there any bonus for claim free years?
Yes, 5 percent increase in sum insured for each claim free year up to a max of 50 percent.

Q5. Does the policy cover pre-existing diseases?
After forty-eight months waiting period and continuous renewal, declared pre-existing diseases are covered.

Sources:

Care Health Insurance Official Website
Economic Times: Health Insurance Trends 2025