JEEVAN AROGYA

What is Jeevan Arogya ?  

• It is LIC’s family Medical Insurance Plan. 

Whom All I can cover under Jeevan Arogya ?

• Yourself (Known as Principal Insured), Your Spouse, all your family members including dependent parents and parents-in-law in the age group 0-75.

Is there any Maturity or Death Benefit under Jeevan Arogya ?

• No

What is the Mandatory requirement for claiming Medical Benefits under Jeevan Arogya ?

• Hospitalization in India due to either accident or sickness for atleast 24 hours, every block of 4 hours deemed as 1 day.

What is the basis of calculating Medical Benefits Under Jeevan Arogya ?

• Hospital Cash Benefit (HCB) you opt for at the time of entering the plan. It can be anything between Rs 1, 000/- to Rs 4, 000/- per day (in multiples of Rs 1,000).

What are the eventualities covered under Jeevan Arogya ?

Hospitalization as above. No surgery : 

• Cash reimbursement equal to Applicable Daily Benefit (ADB) x No of day's hospitalization.

ICU admission : 

• Cash reimbursement equal to Double the ADB.

Listed Surgical Procedures : 

• Cash reimbursement equal to 2 times the ADB subject to a maximum of 45 days in a year or 360 days during the entire policy term (15 days - First Year).

Listed Day Care Procedures  : 

• 5 times the ADB applicable regardless of the actual costs incurred not exceeding 3 times in a year and 24 times in the entire policy term.

What is `Applicable Daily Benefit' (ADB)' referred to under Jeevan Arogya ?

• It is the sum total of HCB you have opted for at the commencement of the plan + 5% of the HCB you earn every year subsequent to first year reaching a maximum of additional 50% of the initial HCB + 5% of the HCB you earn at the end of every 3 years in case you have not claimed any amount under the plan for previous 3 years, without any limit.

How long I need to pay premium  under Jeevan Arogya ?

• Upto age 80, if the age at entry is 18-75 years,
• Upto age 25, if the age at entry is 0-17.

Does  premium under Jeevan Arogya remains same throughout the premium payment term or will it keep varying ?

• It keeps varying once in 3 years.

Is there any Income-Tax Benefit  on Jeevan Arogya Premium ?

• Yes, Premium paid every year enjoys I.T exemption under section 80 D within the statutory limit for medical insurance premium upto Rs 15,000/- per annum in case of individuals and Rs 30,000/- for the family members.

Does Jeevan Arogya offer any Cash-less facility ?

• No.

What is so special about Jeevan Arogya ?
This is one plan where,

• You get medical coverage upto age 80 without any interruption, provided, policy is kept in force by premium payment in time.

• You can cover all your family members including your parents and parents- in law in the age group 0-75.

• Medical reimbursement available under the plan is independent of the actual medical expenses incurred. Mere hospitalization followed by discharge certificate is enough to claim medical reimbursement unlike Mediclaim plans where medical reimbursement is directly related to the actual expenses claimed by your hospital. As a result, unlike Mediclaim Plans, Jeevan Arogya takes care of your post treatment expenses and possible drop in your income especially during prolonged illness.

• You can draw upto 50% of the claim amount in advance for meeting surgical procedures instead of waiting for the claim settlement.

• ADB keeps increasing every year by 5%, reaching a maximum of 150%. As a result, other benefits like HCB and MSB sum also stand increased.

• You can claim HCB every year upto 30 days at a stretch that includes 15 days in ICU or as a lifetime benefit upto 720 days that includes 360 days in ICU.

• It provides you premium waiver for next 1 year in case of your undergoing major surgical procedures.

• Last but not least, you can go for Jeevan Arogya investment as an additional benefit, even if you have invested in General Insurance Companies' Mediclaim plans. Infact, a combination of Jeevan Arogya + Mediclaim could be the best way of providing for medical exigencies. While Mediclaim provides for Medical Expenses during treatment, Jeevan Arogya takes care of your monetary requirement after treatment.

K.Nagesh