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National Health Insurance
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National Health Insurance 

National Health Insurance has carved a niche in the health insurance market in India. NICL offers a wide range of health insurance products such as individual health insurance policies, family floater plans, senior citizen plans, and even group Mediclaim policies. These plans are designed to satisfy the diverse needs of the individuals.

National Health Insurance plans can be purchased with lifetime renewability. These plans come with extensive coverage, access to a wide hospital network, and a number of exclusive features and benefits such as add-on covers and cashless claims.

 Health insurance plans are now a basic necessity. National Health Insurance plans are unique and cover the in-patient hospitalization, daycare treatment, and other medical expenses. 

About National Insurance Company 

An anchor in the Indian insurance industry, the National Insurance Company Ltd, also known as NICL, is a general insurance company owned by the Central Government of India. It ranks among the oldest general insurance companies in the country. It offers a wide array of customized health insurance plans and comprehensive health covers to the common people. NIC has been successful in creating flexible general insurance products that are tailored to meet the customers’ requirements and insurance needs.

National Health Insurance has about 1,340 offices not only all over India but even in Nepal. Over the years, NIC has striven to extend the reach of the general insurance industry to the untapped sectors of the society that have not been exposed to insurance as a financial product. It understands the diverse insurance needs of the Indian market and has set up its policies accordingly. 

National Health Insurance plan: Your Reasons to Buy! 

There are many players in the health insurance market. But NIC has made its own place and is renowned for its diverse product basket. Here are some of the reasons why you should zero-in for National Health Insurance plans:

  • The National Health Insurance plans cater to the needs of all kinds of people-individual insurer, family, senior people, students as well as employees. The plans are diverse and are tailored as per the needs of the customers.
  • There are no mandatory pre-policy medical check-ups before the purchase of a National Health Insurance policy, except when the insured is 40 years or above or the sum insured is at least Rs. 6 lakhs or he/she wants to opt for a Critical Illness cover.
  • If the insurance proposal is accepted, NIC reimburses 50% of the expenses to policyholders who have purchased a National Health Insurance policy.
  • National Health Insurance provides efficient customer service with a professional team of skilled executives. They are ready to assist customers with health insurance queries and services through email, online chat, and toll-free number.
  • The company offers a robust online portal to individuals, families, and groups for the National Health Insurance online renewals, purchases, and queries about its various plans. They make sure that the query process is prompt and hassle-free.
  • National Health Insurance plans offer cashless facilities across 6,000 authorized hospitals across India for facilitate its customers with optimum comfort.
  • All National Health Insurance plans are eligible for tax exemptions on premium payments as per Section 80D of the Income Tax Act.
  • The company has a good incurred claim settlement ratio of 107.64%. 

National Health Insurance Plans: Features and Benefits 

The various National Health Insurance plans are diverse in nature and come along with several wonderful features and benefits. When you compare plans, you will find that these plans are not only attractive in nature but also feasible and affordable to the general public.

Plan Features

  • The various National Health Insurance plans are catered to the diverse needs of customers from different sectors
  • Pre-policy medical tests are not mandatory in the case of every National Insurance Health policy
  • Policyholders with a history of pre-existing diseases need to follow a waiting period before exercising the benefits of their policy
  • The insurance cover includes an extensive range of network hospitals across India. This enables them to offer cashless treatment to their policyholders
  • Policyholders, 60 years and above, can opt for the co-payment benefit
  • NIC plans cover maternity expenditures for 2 deliveries after the waiting period is over
  • The policies are easily accessible online on the company portal for viewing the National Health Insurance claim status, purchasing online, and for plan renewals

Plan Benefits

  • You can avail of the hospital cash benefit in cases of hospitalization for more than 3 days. This amount depends upon the type of plan
  • You can get the benefits of add-on riders for out-patient treatment, pre-existing diabetes/ hypertension, and critical illnesses to your plan
  • NIC plans also cover non-allopathic treatments, like those for Homeopathic and Ayurvedic treatments as well
  • National Health Insurance plans to come along with a free-look period for a period of 15 days from the date of receipt of the policy
  • You get a grace period of 30 days from the date of National Health Insurance premium payment or from the due date of the policy for renewal
  • The company provides the portability option, i.e., you can switch to another insurance company. This process has to be completed at least 45 days before the date of expiry of the NIC policy 

National Health Insurance plans: Inclusions and Exclusions

Here is a list of things that are covered under this plan, along with the one that is excluded:

Plan Inclusions

  • The plan covers hospital room rent of 1% of the pre-determined sum insured, up to a maximum Rs. 5,000 per day
  • It also covers ICU room rent reimbursement for up to 2% of the sum insured, up to a maximum of Rs. 10,000 per day
  • In-patient treatment expenses such as doctor’s consultation fees, surgeon’s/specialist's fees, anesthetist charges, etc. are covered up to a maximum of 25% of sum insured
  • Medicines/ operations/ nursing/ OT expenses, blood, oxygen, etc. expenses are payable by the insurance company
  • The cover also includes reimbursement up to a certain percentage of the sum insured for specialized medical treatments like radiotherapy, chemotherapy, organ transplant, etc.

Plan Exclusions

  • All pre-existing disease/illnesses are not covered up to a specific period as per the plan chosen
  • Hospitalization charges incurred on account of diagnostic purposes
  • Any medical expenses or hospitalization due to intentional self-injury
  • Illness or injury due to drugs /alcohol abuse
  • Congenital disease/ venereal diseases, sterility, etc.
  • HIV AIDS
  • Dental / cosmetic treatment
  • Expenses for maternity-related needs and childbirth treatments
  • Traveling against Medical advice/for Medical treatment including routine check-up
  • Any injury/accident claims due to participation in defense services- Military, Naval, or Air force operations
  • Any claims due to suicide, intentional self-injury, mental disorder etc. are excluded
  • Any injuries/accidents due to participation in winter sports, mountaineering, adventure sports etc.  

Types of National Health Insurance plans

A unique selling point of National Health Insurance policy is the availability of a myriad of insurance plans that customers can choose from. NHI offers the following types of health insurance plans:

  • National Parivar Mediclaim
  • National Parivar Mediclaim Plus
  • Overseas Mediclaim Employment and Studies Policy
  • Overseas Mediclaim Business and Holiday Policy
  • National Critical Illness Policy
  • National Mediclaim Policy
  • National Mediclaim Plus Policy
  • Varishtha Mediclaim Policy for Senior Citizens
  • Vidyarthi Mediclaim Policy for Students
  • National Super Top-up Mediclaim Policy
  • National Senior Citizen Mediclaim Policy
  • Parivar Mediclaim Policy for Family 

We will discuss these National Health Insurance plans in detail below. You can compare plans to find the best one as per your requirements.

National Parivar Mediclaim

As the name suggests, National Parivar Mediclaim Policy is a floater policy, which covers the family of the insured. It provides an insurance coverage for self, children, spouse, and parents under a single sum insured. The policy has an initial waiting period for 30 days as applicable to all kinds of diseases, except accidental claim. After that, it has a waiting period for one year, two years, or four years for a list of different diseases as prescribed in the policy document. The National Health Insurance policy can be renewed for lifetime.

Policy Benefits 

The following benefits are offered under this policy:

  • Hospitalization expenses are covered
  • Organ donor expenses are covered
  • The total Sun Insured can be shared by all the members of the family included in the plan
  • The policy provides the sum insured options in a broad range of Rs 1 Lakh to Rs 10 Lakh
  • Term options for National Health Insurance available are 1, 2, and 3 years
  • Long-term National Insurance Parivar Mediclaim Policy, offers additional perks and discounts
  • Coverage for pre-existing diseases is provided after completion of 4 continuous policy years
  • Allopathy, Ayurveda, Homeopathy treatments are covered up to the limit of the sum insured
  • AYUSH treatment expenses are covered
  • Pre and post-hospitalisation expenses are covered for 30 days and 60 days respectively
  • Coverage for 140 daycare procedures and treatments
  • Ambulance charges are covered up to Rs 1000/illness and a total of Rs 2500 in a policy year
  • In the case of Domiciliary treatment, reimbursement up to 20% of sum insured, a maximum of Rs 50,000
  • This policy provides a free medical check-up up to Rs 5000 for being enrolled in the policy continuously for 4 years

National Parivar Mediclaim at a Glance 

Sum Insured

Rs 1 lakh to 10 lakh

Members to be Covered

Self, dependent children, spouse, and parents

Eligibility

Anyone in the range 18-60 years, dependent children from the ages of 3 months to 25 years, parents also part of the policy cover.

Policy period

1-3 years

Policy renewal

Lifelong

Maternity/ Newborn baby cover

Up to 10% of the sum insured,

·        Up to INR 30,000 in case of normal delivery

·        Up to INR 50,000 in case of cesarean section

Infertility treatment Cover

Up to INR 50,000

Anti-rabies Cover for vaccination

Up to INR 5,000

Policy Exclusions: 

The common exclusions of this policy are:

  • No claim will be entertained within the first 30 days of the policy
  • Pre-existing illnesses are covered after 48 months only
  • 1/2/3 years of waiting period for covering certain specific illnesses
  • Expenses incurred for treating HIV/AIDS
  • Drug/alcohol abuse
  • Cosmetic surgery
  • Dental treatment, unless it is accidental
  • OPD treatment expenses are excluded 

National Parivar Mediclaim Plus

National Parivar Mediclaim Plus Policy is among the extended family cover National Health insurance plans for the complete family including self, children, spouse, and parents and in-laws in one floater insured sum. The coverage is as high as Rs 50 Lakh with many interesting features. This policy has the additional benefits of traditional health insurance, along with a coverage for critical illness treatment expenses.  This policy comes as a relief to those looking for affordable health insurance plans with low premium rates. Available in 3 variants- A, B, and C, National Health Insurance Parivar Mediclaim policy comes with unique features such as non-allopathic treatment cover, higher sum insured, zone wise premium etc.

Plan Benefits 

Let us go through the distinct features and benefits of this National Health Insurance plan:

  • Pre-hospitalization and post-hospitalization charges are covered for 30 /60 days respectively
  • Organ donors’ expenses are covered
  • Maternity benefit is available after completion of two years
  • Infertility treatment costs up to Rs 50,000 is covered under the health plan
  • Homeopathy and Ayurveda treatment expenses are included in this plan, unlike the regular health insurance plans
  • Air ambulance and medical emergency expenses are also covered 
  • One medical second opinion for critical disorders is available within 1 policy period.

National Parivar Mediclaim Plus at a Glance 

Sum Insured

Rs 6 Lakh to 50 Lakh

Plan A: 6/7/8/9/10 lakh

Plan B: 15/20/25 lakh

Plan C: 30/40/50 lakh

Members to be covered?

Self, Spouse, dependent children, parents, and in-laws

Policy period

1-3 years

Policy renewal  

Lifelong

Maternity/ Newborn baby cover

As per the limit specified

 

Infertility treatment Cover

As per the limit specified

 

Air Ambulance expenses

Plan A – Not covered

Plan B – Up to 5% of the sum insured

Plan C – Up to 5% of Sum insured

Policy Exclusions 

The common exclusions of this policy are:

  • No claim will be entertained within the first 30 days of the policy
  • Pre-existing illnesses are covered after 36 months only
  • 1/2/3 years of waiting period for covering certain specific illnesses
  • Expenses incurred for treating HIV/AIDS
  • Drug/alcohol abuse
  • Cosmetic surgery
  • Dental treatment, unless it is accidental
  • OPD treatment expenses are excluded 

Overseas Mediclaim Employment and Studies

Overseas Mediclaim Employment and Studies Insurance policy is best suited for people who are traveling abroad for studies and employment. It includes Plan C and Plan D that cover illness/ repatriation/ medical evacuation from 50,000 USD to 500,000 USD. Claim assistance can be got from any International service provider from NHI.

The salient features of National Health Insurance plan are as follows:

  • This policy provides coverage for medical and emergency when traveling abroad for employment or for studies
  • Plan C and D of the policy provide coverage for employment and studies abroad
  • The plan offers a comprehensive cover for medical expenses and repartition, delay or loss of checked-in baggage, loss of passport, personal accident /liability etc.
  • Overseas Mediclaim Employment and Studies plan by National Health Insurance offers a payout in the form of cashless and reimbursement while you are traveling abroad etc.
  • In the case of a personal accident, where the insured meets with an accident during the trip overseas, all the treatment expenses would be covered under the plan. This plan also provides coverage for the permanent total disability of the policyholder
  • In the case of personal liability cover, National Insurance Overseas Policy for Employment and Studies will pay up to the cover limit. The plan will also pay for accidental body injury / accidental damage to third-party in an incident during the policy tenure or the trip covered.
  • This policy provides adequate cover for all expenses associated with medical /physician services, hospital, local emergency, dental relief, and medical transportation, etc.
  • This overseas policy by National Health Insurance provides an efficient network of international service providers
  • You will be reimbursed or will be able to get cashless services abroad
  • The plan allows you to cancel the policy in case the trip is canceled. You can cancel within 14 days to receive partial refunds

Policy Benefits 

Under Plan C and Plan D-Employment & Studies

  • Section 1 A: Illness cover ranging from USD 150000 (Plan C), USD 1,50,000 (Plan D) and USD 500000 (Plan D1)
  • Section 1B: Medical evacuation expenses USD 10000 for three variants C, D and D1  
  • Section 1C: Repatriation cover of USD 10000 for three variants C, D and D1  
  • Section 1D: Medical Emergency cover of USD 5000 for three variants C, D and D1  
  • Section II: USD 750 as contingency Insurance cover for each month of study completed under three plan variants
  • Plan D1: Loss of checked-in baggage for USD 1000

Exclusions 

The common exclusions of the policy include:

  • Pre-existing disease/illnesses are not covered
  • If travelling against the advice of the treating doctor including routine checkup
  • Claims arising out of participation in various operations of Military, Naval or Airforce
  • Claims arising out of self-inflicted injuries such as suicide, attempt to suicide, mental disorder, alcohol or drug abuse
  • Expenses related to HIV related illness including AIDS
  • Claims arising out of participation in adventurous sports 

Overseas Mediclaim Business and Holiday

This National Health Insurance plan cover travel emergencies when someone is traveling abroad. It is available for 3 categories of travellers-Business and Holiday/Employment and Study/ Corporate Frequent Traveler.

Plan Benefits 

The salient features and benefits that you can derive from National Overseas Mediclaim Business and Holiday Insurance are offered under 5 variants:

  • Section A: Medical expenses & repatriation
  • Section B: Personal accident cover
  • Section C: Delay of checked-in baggage
  • Section D: Loss of checked-in baggage under
  • Section E: Loss of passport
  • Section F: Personal liability cover 

Policy Exclusions 

The policy doesn’t include the following: 

  • Pre-existing disease/illnesses are not covered
  • If travelling against the advice of the treating doctor including routine checkup
  • Claims arising out of participation in various operations of Military, Naval or Airforce
  • Claims arising out of self-inflicted injuries such as suicide, attempt to suicide, mental disorder, alcohol or drug abuse
  • Expenses related to HIV related illness including AIDS
  • Claims arising out of participation in adventurous sports 

National Critical Illness Policy 

This National Health Insurance policy provides a specialized cover for the cost of treatment as well as the expensive recovery process associated with life-threatening diseases and critical illnesses. National Critical Illness Policy provides sufficient coverage for expenses incurred by the insured person in case he gets inflicted with any of the listed critical illnesses. This Policy is available under two plan variants -Plan A and Plan B.

Features & Benefits

  • Any person in the age group of 18 to 65 years can purchase the policy
  • This policy can be taken by an individual or as a family floater cover for the entire family
  • Sum insured can range from Rs 1 lakh to 75 lakh
  • The policy provides a provision for covering pre-existing illnesses at an additional premium
  • Plan A covers 11 critical illnesses while Plan B covers 37 critical illnesses
  • The policy comes with lifelong renewability
  • Pre-policy medical check-up is required for applicant above the age 45 years
  • 90-days waiting period to be applied to avail the benefits
  • 30-days survival period to be served from the date of diagnosis

National Critical Illness Policy at a Glance 

Eligibility Age 20-60 years
Sum Insured Cover Rs 5/10/20/25 lakh
Critical illnesses covered Plan A: 11
 
Plan B: 37
Illnesses covered Reimbursement for treatment costs for Coronary Artery Surgery, Cancer, Kidney Failure, Stroke, and any major Organ Transplant subject to survival for 30 days post-diagnosis

Policy Exclusions

The list of exclusions includes:

  • No claim is entertained within first 3 months of the policy
  • No pre-existing illness cover unless it is opted with an additional premium
  • Pregnancy
  • Non Prescribed Drug & Drug Addiction
  • Self-Inflicted Injury
  • AIDS, HIV
  • Cosmetic Treatment, Plastic Surgery, Sex Change, Hormone Replacement Therapy 

National Mediclaim Policy 

The National Mediclaim policy is a comprehensive and complete health insurance plan that covers hospitalization expenses for illness, disease, or any injury. It is a floater policy that comes with an adequate cover for your family members –self, spouse, and 2 dependent children.

Plan Benefits 

Some of the features and benefits of this National Mediclaim policy are:

  • It covers more than 140-day care procedures/ surgeries
  • This is a family plan for the self, spouse; dependent children between the ages of 3 months to 18 years can be covered
  • This policy does not require any pre-medical tests for up to 50 years
  • 50% reimbursement of medical screening is offered to the clients or employees of National Health Insurance

National Mediclaim Policy at a Glance  

Sum Insured Rs 50,000 to Rs 5 lakh (in multiples of Rs 25,000)
Renewability Lifelong
Policy Tenure 1-3 years
Free Health Check-ups After every fourth No Claim years,
 
Up to 1% of the average Sum insured
Other Benefits Cumulative Bonus: 5% of the sum insured for each claim-free year upon immediate renewal. Ambulance Expenses: 1% of sum insured, maximum of Rs. 2,000, for each insured person.

Policy Exclusions 

Some of the policy exclusions include:

  • No pre-existing illness cover offered up to 48 months
  • No claim except accidental is entertained during 30-days initial waiting period
  • Claims arising out of self-inflicted injuries such as suicide, attempt to suicide, mental disorder, alcohol or drug abuse
  • Expenses related to HIV related illness including AIDS
  • Claims arising out of participation in adventurous sports 

National Mediclaim Plus Policy

This comprehensive National Health Insurance policy provides protection against increasing medical costs. This is a high sum insured policy that provides extensive coverage for In-patient treatment expenses (minimum 24-hour hospitalization) and 140+ Day Care Procedures on a Cashless/ Reimbursement basis during the policy period. There are also various additional benefits as per the plan opted by the insured.

Plan Benefits

Some of the benefits to be paid under this plan are discussed below:

  • Any person in the age group 18 to 65 years is eligible to buy this policy. It can also be taken for children from 3 months to 18 years
  • The sum insure range is highly varied:
  • Plan A – 9 slabs, 2lakh to 10lakh in multiple of 1lakh
  • Plan B – 3 slabs, 15lakh/ 20lakh/ 25lakh
  • Plan C – 3 slabs, 30lakh/ 40lakh/ 50lakh
  • Lifelong National insurance renewal allowed
  • The premium will be calculated based on age, the sum insured and optional covers opted by an individual
  • Pre and post hospitalization expenses covered for 30 days and 60 days respectively
  • It covers ICU and Organ Donor hospitalization costs
  • It covers pre-existing diseases after 36 months
  • You can also avail of Ayurvedic or Homoeopathy treatments
  • Ambulance (including Air Ambulance) charges and expenses are covered under the plan
  • Hospital room rent, fees/expenses incurred on doctors, medical practitioners, surgeons, anesthetists, consultants, etc. and other charges are covered as per limits mentioned in the policy
  • It provides coverage for maternity /newborn expenses and vaccination up to a mentioned limit
  • The doctor's home visit and nursing care expenses are also covered by this National Insurance health policy
  • 5% discount for purchasing new policies and 2.5% discount on renewal
  • This policy also provides a portability feature i.e. migration from/too similar products as per IRDAI guidelines
  • Tax rebates to be availed under Section 80D of the Income Tax Act 1961 for the premium paid
  • This policy also provides 5%-10% discounts for purchasing a policy online, for family and by young people
  • Annual increase of SI by 5% for every claim-free year 

National Mediclaim Plus Policy at a Glance 

Sum Insured

Rs 2 lakh to 50 lakh

Entry Age

18-65 years

Pre-existing Illness Cover

After 36 months

Free Health Check-ups

After every 2 years irrespective of claim reported

Up to 1% of the average Sum insured

Other Benefits

Cumulative Bonus: 5% of the sum insured for each claim-free year upon immediate renewal. Ambulance Expenses: 1% of sum insured, maximum of Rs. 2,000, for each insured person.

Policy Exclusions

The common exclusions of this policy are: 

  • Claim arising within 30 days of the policy will not be covered
  • Pre-existing illnesses are not covered up to 3 years
  • Claims arising out of self-inflicted injuries such as suicide, attempt to suicide, mental disorder, alcohol or drug abuse
  • Expenses related to HIV related illness including AIDS
  • Dental treatment unless it is an accidental injury 

National Varishtha Mediclaim Policy for Senior Citizens 

National Varishtha Mediclaim offers insurance coverage for senior citizens up to the age of 80 years. First-time applicants need to undergo medical screening to get insured under this scheme. The policy comes with unique features like NCB ranging from 5% to 50% of the sum insured, critical illness ad-on benefit, lifelong renewability.

Plan Benefits

  • In-patient hospitalisation and domiciliary expense cover up to the sum insured Rs 1 lakh
  • Expenses of medical practitioner, room rents, ICU charges, surgeon fees, specialist fees up to a specified limit
  • Cataract treatment expense up to Rs 10,000
  • Emergency ambulance cover
  • Lifelong renewability option
  • Optional critical illness cover for 8 diseases with a sum insured of Rs 2 lakh 

Plan at A glance 

Entry age

60 years

Maximum entry age

80 years

Medical Check-up

Availing the for the first time

No check-up for continuing the policy for three years

Pre-existing Illness

After 1 year

Plan Exclusions

  • No claims will be entertained up to 30 days, except accidental claims
  • Pre-existing illness will not be covered for 1 year
  • Co-payment for all admissible claims, other than for BHP and cataract
  • Expenses incurred for HIV, AIDS, STD, Sterility, infertility, Maternity & assisted conception
  • Intentional self-inflicted injury
  • Cosmetic, plastic surgery
  • Dental treatment and OPD treatment 

Vidyarthi Mediclaim Policy for Students 

Vidyarthi Mediclaim plan is designed for students. It offers health insurance cover and personal accident cover to the insured students, along with an education coverage in case of permanent total disability and accidental death of the parent. The sum insured ranges from Rs 50,000 to Rs 2,00,000

Plan Benefits

Some of the policy benefits to be availed are:

  • Hospitalization expenses for students are covered up to sum insured
  • Personal Accident Cover for parents and insured students is also offered
  • The insurer compensates for doctors and surgeon fees, ICU charges, room rent charges, and the likewise
  • Cumulative Bonus of 5% for every claim-free year
  • Accidental death and bodily injuries are also covered
  • No pre-medical health check-up is required
  • Tax rebate for premiums paid towards the plan
  • Additional coverage at no extra cost 

Plan at a Glance 

Minimum entry age

3 years

Maximum entry age

25 years

Sum Insured

Rs 50,000- Rs 2,00,000

Medical check-up

No

Cumulative bonus

5% of every claim-free year

Policy Exclusions

The policy doesn’t cover the following conditions:

  • Only accidental claims are registered for first 30 days of the policy
  • Pre-existing illnesses are not covered up to 36 months
  • For covering specific illnesses, a two year waiting period needs to be served
  • Expenses incurred for HIV/AIDS
  • Cosmetic, plastic surgery
  • Drug/alcohol abuse
  • Dental treatment
  • Out Patient Department treatment 

National Super Top-up Mediclaim Policy

This policy from National Health Insurance can be availed as individual or floater basis, where medical expenses are reimbursed up to a limit. 

Benefits

The plan benefits are described as below:

  • Pre and post hospitalisation expenses are covered up to 30/60 days respectively
  • Organ donor expenses are covered up to sum insured
  • Pre-negotiated package rates for healthcare services
  • Pre-existing diseases can be covered after a waiting period of 1-year only
  • The policy comes with lifetime renewal option 

Plan at a Glance 

Entry Age

18 to 65 years

Sum Insured

Rs 3 lakh to 10 lakh (as per the threshold)

Coverage Type

Individual/Floater Basis

Exclusions

The policy doesn’t cover the following conditions:

  • Initial 30 days of waiting period to register any claim, except accidental one
  • 12 months waiting period to cover pre-existing illnesses
  • Specific illnesses are covered after 1, 2 and 3 years
  • No dental treatment expense
  • Cosmetic, plastic surgery
  • Drug/alcohol abuse 

National Senior Citizen Mediclaim Policy 

National Senior Citizen Mediclaim Policy, an indemnity health insurance plan, offers insurance coverage for aged people above the age of 60 years. The policy can be availed as a discounted rate if purchased online. The policy comes with features such as NCB ranging from 5% to 50%, pre-existing illness cover after 2 years of waiting period etc.

Plan Benefits

  • National Senior Citizen Mediclaim Policy offers following benefits:
  • Coverage for HIV treatment & mental illness hospitalization expenses
  • Optional insurance cover for critical illness, OPD, personal accident, pre-existing health condition, hypertension etc.
  • The policy covers expenses incurred for Allopathy, Ayurveda, and Homeopathy 

Plan at a Glance 

Entry Age

60-80 years

Sum Insured

Rs 1 lakh to Rs 10 lakh

Coverage Type

Individual/Floater

Plan Exclusion

Any claim arising out of the following will entertained with conditions only:

  • Pre-existing disease are not covered up to 2 years
  • 30-days initial waiting period for claiming the policy, except accidental claim
  • Claims arising out of self-inflicted injuries such as suicide, attempt to suicide, mental disorder, alcohol or drug abuse
  • Expenses related to HIV related illness including AIDS
  • Claims arising out of participation in adventurous sports 

Parivar Mediclaim Policy for Family 

Parivar Mediclaim Policy for Family is a floater plan designed for your family, covering self, spouse and two dependent children. This policy comes in handy for nuclear family to cover all members. It reimburses medical expenses including in-patient expenses, 140 day care treatment, pre-existing diabetes and hypertension cover at additional premium etc. 

Plan Benefits 

Parivar Mediclaim Policy for Family comes with the following benefits:

  • The policy offers coverage with a sum insured ranging from Rs 2 lakh to 5 lakh
  • The policy only covers allopathy treatment while expenses are reimbursed for in-patient cover, day care treatment of 140 procedures etc.
  • No pre-policy medical check-up required
  • Tax rebate as per Section 80D of the Income Tax Act 

Plan at a glance 

Entry age

18-65 years

Sum insured

Rs 2 lakh to Rs 5 lakh

Renewability

Lifelong

Restricted Illness

Up to 50% of SI

Policy Exclusions

The common exclusions of this policy include:

  • One can claim only for accidental claim within the initial 30 days of the policy
  • Pre-existing illnesses are covered after 48 months of waiting period
  • No claim for non-allopathic treatment
  • Expenses incurred for HIV/AIDS/STD are not covered
  • Claim arising out of drug/alcohol abuse
  • Dental treatment 

Eligibility Criteria to Apply for National Health Insurance plans 

The minimum eligibility criterion for availing this policy is mentioned as below:

Minim Entry Age

90 days to 18 years

Maximum Entry Age

65 years

Dependent Son

Up to the age 25 years

Dependent Daughter

Until Marriage

National Health Insurance: FAQs

  • Q: How does Health Insurance differ from Life Insurance?

    Ans: A life insurance policy differs from a health insurance policy in terms of policy benefits. While a life cover secures the financial future of the family in case of the sudden demise of the insured, a health insurance cover reimburses the medical expenses incurred while hospitalized due to an illness or accident. Unlike life insurance, health Insurance does not involve any kind of payout on maturity and needs to be renewed every year.

  • Q: How can I check my National Health Insurance claim status?

    • In order to check the National Health Insurance claim status of your policy, you need to visit the official website of the company
    • You need to log in with your valid credentials and then type your policy number
    • The status of your claim will be displayed on the screen
  • Q: Does a National Health Insurance policy also cover Homeopathy and Naturopathy treatments?

    Ans: Yes, your National Health Insurance policy also covers Homeopathy and Naturopathy. However, the treatments should be undertaken by any of the following:

    • Government hospital
    • Any health center recognized by the government
    • Any health centers accredited by the National Accreditation Board of Health or Council of India
  • Q: How can I find my National health insurance premium amount when buying or renewing a policy?

    Ans: You can easily find your National health insurance premium amount by accessing the official website of National Health Insurance. The website will have an online premium calculator. Based on this information, you can choose a policy from the drop-down box. Once you enter your personal details such as DOB, location, email ID, phone number, and the sum insured, click on 'Calculate Premium'. You will get an instant quote on your chosen insurance policy with the premium amount including tax being displayed on the screen.
  • Q: How can I pay my premium for my National Health Insurance policy?

    Ans: You can pay your National Health Insurance premium either online or at the nearest NIC branch office where you need to make cash payment. To make the National Health Insurance online payment, you can log in to the official website and make the premium payment using debit or credit card or net banking,
  • Q: How can I cancel my National Health Insurance policy?

    Ans: You will get a free-look period within which you can return the policy, if find is insufficient. To do so, you need to submit a filled surrender form with the policy document in the nearest branch office. Once approved, this will cancel your health insurance policy.
  • Q: What do you mean by a Pre-policy check-up and when is it required?

    Ans: Some health plans offered by National Health insurance require a pre-policy check-up. You need to get a medical check-up done in the prescribed format provided by the company before applying for a health plan with National Health insurance.

    This will be required when the individual applying for the policy is: 

    • a)       40 years and above, or
    • b)       The Sum insured option opted out is Rs 6 lakhs and above
    • c)       In case of Critical Illness optional cover
Written By: Paisawiki - Updated: 10 July 2020

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