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What Are The Exclusions Of Arogya Sanjeevani Insurance Policy?

The rise in medical technology has also risen the cost of treatment. This has put a serious dent in the savings of a common man. This is the reason why buying health insurance is one of the best things that one can do to protect their hard-earned savings. This is why IRDAI or Insurance Regulatory and Development Authority of India in April 2020, launched, an Arogya Sanjeevani Policy that provides a basic health cover that will protect you and your family financially in case of medical urgency. Under this plan, you will get a sum insured for Rs 5 Lakhs and various other benefits. You can buy this plan online from the comfort of your home. However, there are some exclusions that you should be aware of before purchasing this plan. 

Exclusions are the medical treatments, procedures, diseases, and medical conditions that are not covered under a particular health plan. This means if you are making any claim under the Arogya Sanjeevani Health insurance coverage, and if it comes in the exclusion, then your claim can get rejected. Exclusions are necessary as several customers use ways to claim falsely. Given below are some of the exclusions of the Arogya Sanjeevani Policy: 

Investigation And Evaluation

  • Expenses related to diagnostic and evaluation purposes.
  • Any diagnostic expenses which are not related to the current treatment and diagnosis 
  • Rehabilitation, Rest cure, and Respite care
  • Expenses related to enforced bed rest and not for treatment.

    • Obesity/ Weight Control

    Several people take the help of surgery to lose their weight. However, one will only get coverage, if the following conditions are fulfilled: 

  • If surgery is advised by the Doctor
  • The procedure is supported by clinical protocols
  • The insured or the person having the surgery should be 18 years of age
  • Body Mass Index or BMI should be greater than or equal to 40. In case, if the person is suffering from cardiomyopathy, coronary heart disease, sleep apnea, and uncontrolled type2 diabetes, then it should be greater than or equal to 35.

    • Change of Gender Treatments

    This insurance does not cover expenses related to any gender change treatments such as surgical management, or changes in body characteristics.

    Cosmetic or Plastic Surgery

    Any expenses related to plastic or cosmetic surgery or any other treatments that are used to change appearance is excluded under this plan. However, if reconstruction is required in case of an accident, cancer, burns, or any medically necessary treatment, then it is covered under this plan. 

    Hazardous or Adventure Sports

    Any expenses related to treatment that is required due to the participation in adventurous or hazardous sports such as rock climbing, para-jumping, motor racing, mountaineering, etc.

    Other Expenses

    Other expenses related to domiciliary hospitalization, nuclear, OPD treatment, chemical, war, biological attack, maternity expenses for complicated deliveries and c section, and infertility and sterility treatments excluded from the coverage.

    In A Nutshell!

    You must go through all the exclusions mentioned above before you purchase the Arogya Sanjeevani Policy. Knowing about exclusions will help you in the future as it ensures hassle-free claims. You can buy this plan online from the comfort of your home.