In today’s fast-paced world, health is a vital worry, and the Jeevan Arogya LIC policy enables you and your family members to get coverage against any medical concerns. The Life Insurance Corporation of India’s LIC Jeevan Arogya plan 904 is a non-linked health insurance policy.
The LIC Jeevan Arogya policy is a LIC Mediclaim policy that covers specified medical expenses and gives the policyholder cash support. Let’s take a closer look at the LIC Jeevan Arogya scheme.
Read more: LIC Jeevan Lakshya Plan
What is LIC Jeevan Arogya Plan 904?
The LIC Jeevan Arogya plan 904 is a non-participating health insurance plan that provides coverage for certain medical expenses. This plan protects the policyholder’s family financially in the event of a medical emergency. The LIC Jeevan Arogya plan 904 addresses the rising expense of healthcare, which is a major worry for individuals.
The plan includes expanded health coverage, a lump sum benefit to the No Claim Bonus (NCB), and the flexibility benefit of several premium payment alternatives. By purchasing this plan you can cover yourself, your spouse, children, and parents, as well as your mother-in-law and father-in-law, making it a type of comprehensive health insurance policy for the entire family.
Moreover, this plan pays you an amount regardless of the treatment costs and can act as a backup to your health insurance plan, providing additional coverage for some of the incidental expenses during hospitalization.
Eligibility Conditions of LIC Jeevan Arogya Plan 904
The Jeevan Arogya LIC policy is available to all Indian citizens who meet the following eligibility conditions:
Criteria | Minimum | Maximum |
Age at entry for self/spouse | 18 years | 65 years |
Age at entry for children | 91 days | 17 years |
Age at entry for parents | 18 years | 75 years |
Age at maturity | – | 80 years |
Daily hospitalization benefit | Rs.1000 a day excluding ICU | 4000 a day excluding ICU |
Major surgical benefit | Rs.1,00,000 | Rs.4,00,000 |
Key Features of LIC Jeevan Arogya Plan 904
Some of the important key features of the Jeevan Arogya LIC Policy are given below.
- The LIC Jeevan Arogya plan 904 is a comprehensive health insurance policy that protects your parents, spouse, children, and in-laws.
- The plan provides financial security for medical bills.
- It provides a benefit payout regardless of medical expenditures.
- It provides no claim benefit.
- The plan has variable premium payment choices as well as a customizable benefit limit.
- The plan’s coverage can be expanded to include new family members.
- The plan can be used in conjunction with existing medical coverage for the same medical condition.
- The health coverage under this plan can be enhanced by 5% each year until it reaches 150% of the original coverage level.
- Fast Pay Facility is accessible on hospitalization under the LIC Jeevan Arogya plan, rather than waiting to claim the benefit after discharge. LIC provides a 50% advance payment under Fast Cash (for 57 surgeries performed in-network hospitals)
Benefits of LIC Jeevan Arogya Plan 904
The LIC Jeevan Arogya Plan 904 offers important financial protection in the event of a medical emergency, such as hospitalization or surgery. It is medical insurance that includes annual improvements in health coverage and offers a lump sum reward regardless of actual medical expenditures. In addition, the Jeevan Arogya LIC policy has a variety of coverage features such as:
- Hospital Cash Benefit (HCB)
- Major Surgical Benefit (MSB)
- Day Care Procedure Benefit (DCPB)
- Other Surgical Benefit (OSB)
- Ambulance Benefit
- Premium Waiver Benefit
- No Claim Benefit
- Tax Benefits
Apart from the above-mentioned eight major benefits, Term Assurance Rider and Accident Benefit Rider can be availed under the LIC Jeevan Arogya plan, as per the wish of the policyholder.
1. Hospital Cash Benefit (HCB)
If the insured individual or any member of his or her family covered by the plan gets hospitalized due to illness or an accident, they will be eligible for the Hospital Cash Benefit. This reward will be distributed in multiples of Rs. 1000 under the basic plan of Jeevan Arogya plan 904.
For the policyholder or any family member, the minimum initial daily hospital cash benefit for any ward other than ICU is Rs. 1000 (If the principal sum insured is Rs. 1000). However, the maximum initial daily cash benefit for a ward other than the ICU is less than or equal to the policyholder’s or their family members’ principal sum insured. (If the insured principal is Rs. 4000)
However, the first day of hospitalization is not covered, and the maximum ICU hospitalization days are 15 days in the first year and up to 45 days in the following years.
The hospital cash benefit is available for up to 30 days in the first coverage year and up to 90 days in following years, including ICU days. Furthermore, the maximum lifetime benefit duration is 720 days, including ICU days for a total of 360 days.
2. Major Surgical Benefit (MSB)
In the event of a major operation during the policy period, the policyholder will receive an amount equivalent to 100 times the initial HCB set as part of this benefit. This benefit provides the policyholders if they require surgery during the policy period.
Further, the major surgery benefit is always 100 times the hospital cash benefit (ADB) and ranges from Rs. 1 lakh to Rs. 4 lakh.
In a given year, the maximum Surgical Benefit applicable to each insured is 100% of the Major Surgical Benefit total insured. Furthermore, the maximum benefit payable to each insured in a lifetime is 800% of the MSB sum insured.
3. Day Care Procedure Benefit
The LIC Jeevan Arogya plan provides a lump sum benefit payable to the insured for any Day Care operations performed by the policyholder in India that do not require continuous hospitalization. The lump payment value might be up to five times the ADB (Applicable Daily Benefit).
This benefit is available to policyholders of the Jeevan Arogya LIC policy for up to three surgical procedures per year. Furthermore, each insured is limited to a lifetime benefit. This benefit is available to the policyholder for up to 24 surgical operations during the policy’s term.
Other Surgical Benefits
If the policyholder or a family member needs surgery that is not covered by the Major Surgical Benefit, the expense will be covered by other surgical benefits. The daily benefit amount, on the other hand, is up to double the ADB principal sum insured.
This benefit is available to the policyholder for a maximum of 15 days in the first insurance year and up to 45 days per year in subsequent years. Further, the plan benefit is available to the policyholder of the LIC Jeevan Arogya plan for a maximum of 360 days during the policy’s tenure.
5. Ambulance Benefit
If the policyholder is hospitalized as a result of an accident or illness and is eligible for Major Surgical Benefit, he or she can also use the Ambulance benefit. Nevertheless, the benefit is only available if an emergency ambulance is used to transfer the insured to the hospital. Ambulance benefits are limited to a maximum of Rs. 1000.
6. Premium Waiver Benefit
If a LIC Jeevan Arogya plan participant undergoes any major surgery for which they have obtained Major Surgical Benefit, they can receive a premium waiver benefit. The premium waiver benefit allows the insured to receive a total waiver of the one-year payment from the policy’s due date following the operation date.
7. No Claim Benefit
The insured will be eligible for the No Claim Bonus if he or she does not file any insurance claims during the LIC Jeevan Arogya plan year or between two automatic renewal dates. The no-claim benefit amount, however, will be 5% of the original daily benefit for each policyholder.
8. Tax Benefit
The premiums for the Jeevan Arogya LIC policy are tax deductible under Section 80D of the Income Tax Act.
Other Benefits of Jeevan Arogya LIC Policy
Besides the benefits listed above, there are a few more benefits and options for Jeevan Arogya LIC Policy that are as follows:
1. Adding New Members
The spouses and in-laws can add to the plan if the policyholder marries after the purchase of the insurance. These additions can be made within six months of the marriage. However, the coverage will not begin until the next policy anniversary. The premium increase will take effect on the following renewal date as well.
Additionally, if the child is 90 days old, you can enroll him or her in the LIC Jeevan Arogya plan. However, the coverage will not begin until the next policy anniversary. The premium increase will take effect on the following renewal date as well. Adopted children can also get included in the plan as well.
The additions of parents or current in-laws can be made only at the beginning of the LIC Jeevan Arogya plan.
2. Quick Cash Facility
In the case of Category 1 or Category 2 Major Surgery in a LIC Network Hospital, the applicant is eligible for 50% of the payment while still in the hospital. They do not have to wait till the hospitalization is over to receive the total amount.
3. Rider Benefits
Two optional riders are available under the LIC Jeevan Arogya plan. The first is the LIC New Term Assurance Rider, which protects against death within the policy’s term. In this rider, if the primary insured person or spouse dies during the term of the plan, the rider will pay the coverage available under the Major Surgical Benefit. The LIC Accident Benefit Rider is the second rider in the LIC Jeevan Arogya plan. This rider provides an additional sum assured if the insured is killed in an accident during the policy’s term.
Read more: LIC Jeevan Saral Plan
Exclusions of Jeevan Arogya LIC Policy
The exclusions of the LIC Jeevan Arogya plan 904 are listed below.
- Pre-existing conditions
- Epidemic conditions
- Plastic surgery
- Cosmetic treatments
- Beauty treatments
- Attempted suicide
- Injuries from self-harm
- Abuse of drugs
- Congenital conditions
- Pregnancy conditions
- Childbirth conditions
- Radioactive conditions
- Injuries from natural catastrophe
- Injuries incurred from participating in dangerous sports.
Conclusion
The LIC Jeevan Arogya plan 904 is a Mediclaim policy with fixed benefits that pays a flat sum regardless of actual medical expenses. We hope this advice has assisted you in determining whether or not to purchase the Jeevan Arogya LIC policy.
LIC Jeevan Arogya Plan – FAQs
Is the LIC Arogya Jeevan plan 904 subject to a waiting period?
Ans. Yes, except in the case of accidental hospitalization or surgery, the LIC Jeevan Arogya policy has a 90-day waiting period from the date of the policy’s beginning.
Can I add my parents later to my Jeevan Arogya LIC policy?
Ans. No, adding parents or existing in-laws will be permitted only at the time of insurance purchase and not afterward.
What happens if the primary insured member passes away?
Ans. No death benefit would be paid if the primary insured member died. If the primary insured chooses such an option while purchasing the insurance, the spouse can become the primary insured. The spouse can then continue to be the primary insured on the policy, and the rates will vary.
How is the premium for the LIC Jeevan Arogya Insurance calculated?
Ans, The premium for a Jeevan Arogya LIC policy is decided by age, gender, insurance cover, principal sum insured, and other factors. The premium will also be determined by the level of the Hospital Cash Benefit selected, as well as whether the insured member is the principal insured or a co-insured. Even if they are the same age and have the same insurance coverage, the premiums for the principal insured and the other life insured will be different.