LIC Arogya Rakshak Health Insurance Plan
LIC Arogya Rakshak is a comprehensive health insurance product offered by the Life Insurance Corporation of India (LIC). Designed to meet the evolving medical needs of individuals and families, it provides a blend of hospitalisation cover, pre and posthospitalisation expenses, and a range of additional benefits at an affordable premium.
Key Features
- High Sum Insured: Options ranging from 5lakh to 10lakh (and higher on request).
- Cashless Hospitalisation: Network of more than 6,000 empanelled hospitals across India.
- Pre and PostHospitalisation: Coverage for medical expenses incurred up to 30 days before and 60 days after hospitalisation.
- DayCare Procedures: Included under the sum insured without any deductible.
- Domiciliary Treatment: Medical care received at home when hospitalisation is not feasible.
- Live Organ Donation: Eligibility for expenses related to organ donation from a living donor.
- Renewable for Life: The policy can be renewed every year without medical underwriting.
- No Restriction on Age for Renewal: Even senior citizens can continue the cover.
Who Can Buy?
The plan is open to individuals aged 18 to 65 years at entry. A family floater option is also available for spouses and dependent children (up to 25 years, or up to 30 years for disabled children). Senior citizens (6065 years) can enrol as individuals and enjoy the same benefits.
Benefits Overview
| Benefit | Coverage Details |
|---|---|
| Hospitalisation | Room rent, ICU charges, surgeons fees, operation theatre, diagnostics, and consumables. |
| PreHospitalisation | Expenses up to 30 days prior to admission (e.g., doctor visits, investigations). |
| PostHospitalisation | Expenses up to 60 days after discharge (e.g., followup consultations, medicines). |
| DayCare Treatment | Procedures that do not require 24hour admission, fully covered. |
| Home Care | Allowed for patients who cannot be shifted to a hospital. |
| Organ Donation | Expenses incurred for live organ donation, including surgery and postop care. |
| Ayush Treatment | Coverage for AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, Homoeopathy) treatments as per hospital policy. |
| Emergency Ambulance | Reimbursement up to 5,000 per incident for ambulance services. |
| Health Checkup | Free health checkup after every 5 years of continuous coverage. |
Premium Calculation
Premiums are determined based on age, sum insured, and policy term. The plan uses a simple structure:
- Age bands: 1830, 3140, 4150, 5160, 6165.
- Sum Insured: Higher sum insured leads to proportionally higher premiums.
- Premium payment term: Yearly, halfyearly, quarterly, or monthly.
For an example, a 30yearold individual opting for a 5lakh cover pays roughly 5,200 per year (subject to underwriting and regional variations).
Claim Process Step by Step
- Notification: Inform LICs claim desk within 24 hours of admission (cashless) or postdischarge (reimbursement).
- Documentation: Submit the claim form, original hospital bills, discharge summary, doctors prescription, and diagnostic reports.
- Verification: LICs claim officer reviews the documents and may request additional information.
- Settlement: For cashless claims, the amount is settled directly with the hospital. For reimbursement, the approved amount is transferred to the policyholders bank account.
- Followup: The claim status can be tracked online via LICs portal or mobile app.
Advantages Over Competitors
- Large Network: One of the widest hospital networks in the country.
- Lifetime Renewal: No age limit for renewal, which is rare among private insurers.
- Additional Wellness Benefits: Health checkups and preventive care incentives.
- Stable Premiums: Premiums increase modestly with age, and there is a guaranteed increase ceiling.
Things to Keep in Mind
- The policy does not cover preexisting diseases for the first 24 months (standard waiting period).
- Cosmetic surgeries and procedures deemed elective are excluded.
- Claims for nonempanelled hospitals are reimbursable, but require original bills and may involve a longer processing time.
- Policyholders must disclose any ongoing medical conditions during the proposal stage.
How to Purchase
LIC Arogya Rakshak can be bought through the following channels:
- LIC Branches Visit any LIC office with identity proof, address proof, and passportsize photographs.
- Online Use the official LIC portal (licindia.in) to fill the application, upload documents, and make the first premium payment securely.
- Agents Authorized LIC agents can guide you through plan selection, premium payment, and documentation.
FAQs
1. What is the waiting period for preexisting illnesses?
There is a 24month waiting period for preexisting diseases. After this period, the policy will cover related expenses subject to the terms and conditions.
2. Can I increase the sum insured after buying the policy?
Yes. During the renewal window, you may opt for a higher sum insured, subject to acceptance and premium recalculation.
3. Is maternity coverage included?
Maternity expenses are not covered under Arogya Rakshak. However, a separate maternity rider can be purchased if required.
4. How is the claim amount settled for a family floater?
The aggregate claim amount for all members cannot exceed the total sum insured purchased for the family floater.
5. Does the plan provide coverage for COVID19?
Yes. Hospitalisation due to COVID19 is covered under the same terms as other illnesses, as per the policy wording effective from the date of purchase.
Conclusion
LIC Arogya Rakshak offers a robust and affordable health protection solution for individuals and families across India. With its extensive network, lifetime renewal option, and wide range of covered benefits, it stands out as a reliable choice for those seeking financial security against medical expenses. Prospective buyers should evaluate their coverage needs, consider the waiting period for preexisting conditions, and compare premium rates with other market players to make an informed decision.
For more details, visit the official LIC website or contact your nearest LIC branch.
