Aarogya

Aarogya health insurance in India usually refers to government-backed schemes like Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) or specialized policies such as Arogya Pragati Plus by New India Assurance. PM-JAY is the world’s largest government health insurance program, offering ₹5 lakh coverage per family per year, while Arogya Pragati Plus is a top-up plan designed for middle-class families seeking extended protection.

Coverage: ₹5,00,000 per family per year for secondary and tertiary hospitalization.

Eligibility: Poor and vulnerable families identified under SECC data.

Benefits:

Cashless treatment across empanelled hospitals nationwide.
Covers consultation, medicines, diagnostics, surgery, ICU, implants, accommodation, and food.
Pre- and post-hospitalization: 3 days before and 15 days after hospitalization.
Pre-existing diseases covered from day one.
No family size limit — covers unlimited members.
Portability: Benefits available across India.

Procedures Covered: ~1,929 medical procedures including cancer, cardiac surgery, organ transplants.

Type: Top-up health insurance policy (floater or individual basis).

Eligibility: Entry age 18–65 years (children from 3 months).

Threshold Limit: ₹5–50 lakh (policy kicks in after this limit is crossed).

Sum Insured: ₹1–50 lakh (up to 4x threshold).

Benefits:

Room Rent: 1% of sum insured or single AC room.
ICU Charges: 2% of sum insured or actuals.
Pre-hospitalization: 30–60 days; Post-hospitalization: 60–90 days.
Cataract Surgery: ₹50,000–₹1,00,000 per eye.
Modern Treatments: Covered up to 100% of sum insured.
Critical Illness & AYUSH: Included.
Air Ambulance: Available under Platinum plan.
Discounts: Loyalty (5%), floater (up to 15%), digital (10%

Scheme	Coverage	Target Audience	Unique Features
PM-JAY	₹5 lakh per family	Poor & vulnerable families	No family size limit, nationwide portability, covers all pre-existing diseases
Arogya Pragati Plus	₹1–50 lakh (top-up)	Middle-class & salaried families	Threshold-based, modern treatments, air ambulance, discounts

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330, Ganpati Plaza, MI Road, Jaipur, Rajasthan 302001

Second Floor, Office no 31, Transport Nagar, Punjabi Bagh, West Delhi, New Delhi – 110026

Optisure Insurance Brokers Pvt. Ltd. | Reg. Office – 330, 3rd Floor Ganpati Plaza, MI Road, Jaipur (Raj.)-302001 | IRDAI Direct Insurance Broker (Life & General) | License No.- 1116 | Valid Till – 18/11/2028 (Renewable) Code No. -IRDAI/INT/BRK/DB 1266/2025 CIN NO. – U66220RJ2025PTC104577 | IBAI Membership No.-519 Standard T&C Apply*
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Aarogya

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