Arogya Raksha Scheme (AR): Eligibility & Benefits

The Aarogya Raksha scheme is a health insurance policy that provides comprehensive coverage to residents of Andhra Pradesh (AP). This article explores the eligibility, coverage and benefits of the Aarogya Raksha, along with other essential details.

What is Aarogya Raksha?

Aarogya Raksha is a health insurance initiative launched by the Government of Andhra Pradesh to ensure that families, regardless of their income levels, have access to quality healthcare. Arogya Raksha is particularly beneficial for senior citizens and those seeking health insurance plans with extensive coverage.

Features and Benefits of Aarogya Raksha

The Aarogya Raksha policy has specific features and benefits, making it a preferred choice for many. Here are some Arogya Raksha card benefits:

1. Cashless hospitalisation.
2. Extensive network of hospitals.
3. Affordable premiums tailored to different income groups.
4. Senior citizen health insurance.
5. Coverage for pre- and post-hospitalisation expenses.
6. Coverage for critical illnesses and surgeries.
7. Follow-up treatments.
8. Ayurvedic treatment.

Arogya Raksha premium and beneficiaries

Arogya Raksha offers three plans based on age, the number of beneficiaries covered, and the sum insured, ranging from ₹1 lakh to ₹10 lakhs.

1. Plan A covers the account holder, spouse and two dependent children, with an exit age of 35 years. Premiums range between ₹2,000 to ₹14,500.
2. Plan B covers the account holder, spouse and two dependent children, with an exit age of 70 years. Premiums range between ₹3,000 to ₹25,500.
3. Plan C covers the account holder, spouse, two dependent children and dependent parents, with an exit age of 70 years. Premiums range between ₹5,000 to ₹62,500.

Inclusions and exclusions under Aarogya Raksha scheme

Policyholders must understand what is covered and what is not under the Aarogya Raksha scheme:

Inclusions:

1. Hospitalisation expenses.
2. Daycare procedures.
3. Ambulance charges.
4. Maternity benefits.
5. Pre-existing disease coverage after a waiting period.

Exclusions:

1. Cosmetic treatments or plastic surgery.
2. Obesity treatment.
3. Alternative therapies.
4. Psychiatric disorders.
5. Injuries from illegal activities.
6. Attempted suicide or suicide.

Eligibility criteria of Aarogya Raksha

The eligibility criteria for the Aarogya Raksha scheme are as follows:

• Families residing in Andhra Pradesh, both Above Poverty Line (APL) and Below Poverty Line (BPL).
• The applicant must be between 18 and 65 years old.
• Applicants must present valid identification and proof of address.

How to enrol for Aarogya Raksha?

You can enrol in the Aarogya Raksha scheme through:

1. Through the insurance agents/insurance company website/Arogya Raksha AP government portal online portal

• Visit the official website of the preferred insurance provider.
• Navigate to the Aarogya Raksha
• Fill out the application form with the required details.
• Make the necessary payment to complete the process.
• After making the payment, you will receive a confirmation, and you can click on the Arogya Raksha card download

How to apply for Aarogya Raksha health card

Once enroled in the Aarogya Raksha scheme, beneficiaries receive a health card for cashless treatment at empanelled hospitals. To apply for Arogya Raksha card, follow these steps:

On the AP government portal

1. Input your Aadhaar number and click ‘Go.’
2. Enter the mobile number connected to Aadhaar and click ‘Send OTP.’
3. Input the OTP received and click ‘Verify.’
4. Select the family member’s name and click ‘Download Health Card’ to obtain the Aarogya Raksha card.

At the local kiosk:

• Carry your Aadhaar card and an active mobile number linked to it.
• Provide your Aadhaar number to the kiosk operator to receive a One-Time Password (OTP).
• Share the OTP with the operator to complete the registration.
• The operator will print your Arogya Raksha card upon completion.

Claim process of Aarogya Raksha

The Aarogya Raksha scheme offers a streamlined claim process to ensure beneficiaries receive timely medical care:

1. Pre-authorisation: For planned treatments, obtain pre-authorization by submitting necessary documents to the network hospital.
2. Emergency admission: In emergencies, inform the insurance provider or Third-Party Administrator (TPA) within 24 hours of hospitalisation.
3. Cashless treatment: Present the Aarogya Raksha card at the network hospital for cashless services.
4. Claim settlement: The hospital coordinates with the insurance provider/TPA for claim approval and settlement.

How to check the claim status of Aarogya Raksha policy

Beneficiaries can track their claim status through the following methods:

• Online Tracking: Visit the insurance provider’s official website or TPA, enter the claim reference number to access the ‘Track Claim’ feature.
• Customer Support: Contact the insurance provider’s customer service or TPA helpline to inquire about the claim status.

Note: For your convenience, you can visit the official website and click on the Arogya Raksha policy download option to access your policy details anytime.

Aarogya Raksha toll-free number and address

For grievance assistance, beneficiaries can reach out to:

• E-mail: grievance officer at customercare@uiic.co.in
• Website:uiic.co.in
• Toll free: 1800 425 333 33
• Courier: Customer Care Department, Head Office, United India Insurance Co. Ltd., 19, IV Lane Nungambakkam High Road, Chennai, Tamil Nadu- 600034
• Implementing Agency: United India Insurance Company Limited (UIIC)
• Registered Office: 24 Whites Road, Chennai – 600014

FAQs

1. How can I renew my Aarogya Raksha policy?

You can renew the policy online through the insurance provider’s portal or by visiting authorised centres.

2. What are the documents required for enrollment?

Documents required include your Aadhaar card and an active Aadhar-linked mobile number.

Conclusion

The Aarogya Raksha scheme is a reliable, comprehensive health insurance plan for AP residents with extensive coverage and numerous benefits. If you are looking for individual, family or senior citizen health insurance, this scheme ensures financial security and access to quality healthcare in Andhra Pradesh.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.