HEALTH INSURANCE MADE SIMPLE & EASY
Arogya Sanjeevani Policy – HDFC ERGO
Health insurance is an essential safeguard for you and your family. The Arogya Sanjeevani Policy by HDFC ERGO is designed to provide a standard, comprehensive, and simple health coverage solution with lifetime renewals and flexible premium options.
🌟 Key Features
- 💰 Multiple Sum Insured Options: ₹50,000 to ₹10,00,000
- 🏥 Comprehensive Coverage: Hospitalisation, day-care procedures, pre & post-hospitalisation, AYUSH treatments
- 📅 Flexible Premium Payment: Monthly, Quarterly, Half-Yearly, or Annual
- 🌐 Network Coverage: 12,000+ cashless healthcare providers across India
- 🧬 Specialized Treatments: Stem cell therapy, robotic surgeries, immunotherapy, and other advanced procedures up to 50% of sum insured
🏥 Hospitalisation Coverage
The policy covers medical expenses incurred during hospitalisation, including:
- 🛏 Room Rent & Boarding: 2% of sum insured per day, max ₹5,000/day
- 🩺 ICU/ICCU Charges: 5% of sum insured per day, max ₹10,000/day
- ⏱ Pre-Hospitalisation: Medical expenses for 30 days prior to admission
- ⏱ Post-Hospitalisation: Medical expenses for 60 days after discharge
- 🚑 Road Ambulance: Expenses up to ₹2,000 per hospitalisation
- 👁 Cataract Treatment: 25% of sum insured or ₹40,000/eye per year
Day-Care Procedures & Specialized Treatments
This policy covers all day-care procedures and advanced treatments including:
- Uterine Artery Embolization & HIFU
- Balloon Sinuplasty
- Deep Brain Stimulation
- Oral Chemotherapy
- Immunotherapy (Monoclonal Antibodies)
- Intra Vitreal Injections
- Robotic Surgeries & Stereotactic Radiosurgeries
- Bronchial Thermoplasty
- Laser Prostate Treatments (Green/Holmium Laser)
- IONM (Intra Operative Neuro Monitoring)
- Stem Cell Therapy for bone marrow transplant
🧘 AYUSH Treatments
Expenses for inpatient care under Ayurveda, Yoga, Naturopathy, Unani, Siddha & Homeopathy hospitals are covered up to the sum insured per policy year.
⏱ Waiting Periods
- 🕒 First 30 Days: Illnesses within 30 days from policy start are excluded except accidents
- 📆 Specific Waiting Period (24 months): For conditions such as ENT disorders, hernia, cataract, benign tumors, and certain surgeries
- 🧾 Pre-Existing Diseases: Covered after 48 months of continuous coverage if declared at proposal
- ⚕️ 48 Months Waiting: For joint replacement, age-related osteoarthritis, and osteoporosis
🧪 Pre-Policy Checkups
Based on age and sum insured, medical tests may include:
- Medical Examination, CBC, Lipid Profile, ECG, FBS, Sr Creatinine
- 2D Echo, TMT, USG Abdomen & Pelvis, Chest X-Ray, CEA, HBsAg
Tests are conducted at HDFC ERGO network centers, with 50% reimbursement on acceptance of the proposal.
🚫 Major Exclusions
- Cosmetic/plastic surgery unless medically necessary
- Obesity/weight control treatments not meeting criteria
- Treatments for addiction, infertility, or maternity (except ectopic pregnancy)
- Adventure or hazardous sports injuries
- OPD treatment, domiciliary hospitalization, treatment outside India
📊 Table of Benefits
| Feature | Details |
|---|---|
| Product Name | Arogya Sanjeevani Policy, HDFC ERGO |
| Policy Type | Individual/Floater |
| Sum Insured | ₹50,000 – ₹10,00,000 |
| Eligibility | Proposer 18–65 yrs; spouse, children (3mo–25yrs), parents, in-laws |
| Co-Pay | 5% on all claims |
| Cumulative Bonus | 5% per claim-free year, max 50% |
💰 Discounts
- Family Discount: 10% for 2+ members
- Online Policy: 5% off
- Employee Discount: 10% for HDFC ERGO employees
- Loyalty Discount: ₹250 off
- Rural Discount: 15%
Total discounts capped at 20%
📄 Claim Process
Claims must include:
- Completed claim form and photo ID
- Doctor’s prescription & hospitalization documents
- Original bills with itemized break-up
- Discharge summary, investigation reports, OT notes
- Implant invoices, NEFT details, KYC if claim > ₹1 lakh
📞 How to Apply
🌐 Online: www.hdfcergo.com
📞 Phone: 022 6242 6242
Disclaimer: This post is for informational purposes only. Always read the official policy document for complete terms, conditions, and exclusions before purchase.
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