National Insurance Mediclaim Plus Policy

Product Overview

National Mediclaim Plus Health Insurance Plan is an inpatient hospitalization policy, along with host of other benefits like - Day Care Treatments, Pre & Post Hospitalization expenses, Ayurvedic & Homeopathic Treatments, etc.

Unique Features of National Insurance Mediclaim Plus Policy

• Pre-Existing Disease are covered after 3 years
• Ayurveda and Homeopathy are covered
• Maternity Covered after 2 years
• Air Ambulance covered in Plan B & C
• Medical emergency reunion covered in Plan B & C
• Some Organ Specific are Covered after 1 year like ENT disorder etc.

Features of edit Edit Details

Critical features of National Insurance Mediclaim Plus Policy

• Room rent:
  Limits imposed towards room and ICU rent expenses
  This Product has 3 variants Plan-A, Plan-B, Plan-C

1. Plan A Room rent limit 1% and ICU 2% of the sum insured per day or maximum up to Rs 15000/- per day
2. Plan B Room and ICU rent is up to Rs 15000/- per day
3. Plan C Room and ICU rent limit is up to Rs 20000/- per day

• Co-Pay:
  Specific % of admissible claim amount to be borne by Insured

1. 20% copayment clause for treatment in non-network hospital
2. Limit for cataract surgery -Plan A- 15% of sum insured or INR 60,000 whichever is lower/Plan B- Up to INR 80,000 /Plan C-Up to INR 1,00,000

• No Claim Bonus:
  Health Insurance policies may offer Cumulative Bonus wherein for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal
  5% of basic sum insured up to a maximum of 50 % for each unclaimed year in case opted for (The cumulative bonus is reduced by 5% of sum insured once a claim is made)
• Pre-Existing Diseases:
  Means any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer

1. This plans has a waiting period of 3 years is case of pre-existing diseases
2. Maternity has a waiting period of 2 years

Eligibility Criteria

• Minimum Age of Entry:- Children - 3 months and 18 years / Adult - 18 years
• Maximum age of Entry:- 65 years
• Sum Insured:-
  Plan A - Rs 2/3/4/5/6/7/8/9/10 Lakhs
  Plan B - Rs 15/20/25 Lakhs
  Plan C - Rs 30/40/50 Lakhs
• Policy Tenure:- 1 year
• Premium Calculated on Basis of:- Age, Zone (i.e. sum Insured Choosen)

Add-ons

• Pre-existing Diabetes/Hypertension (as Floater):
  Pre-existing Diabetes & Hypertension –

1. First yr – up to 25% of SI
2. Second yr – up to 50% of SI
3. Third yr – up to 75% of SI

• Out-patient Treatment (as Floater in a policy year):
  The Company shall pay up to the limit, as stated in the schedule with respect of

1. Out-patient consultations by a medical practitioner
2. Diagnostic tests prescribed by a medical practitioner
3. Medicines/drugs prescribed by a medical practitioner
4. Out-patient dental treatment

• Critical Illness (per insured person in a policy year):

1. Critical illness means stroke resulting in permanent symptoms, cancer of specified severity, kidney failure requiring regular dialysis, major organ/ bone marrow transplant, multiple sclerosis with persisting symptoms and open chest CABG (Coronary Artery Bypass Graft), permanent paralysis of limbs and blindness.
2. Waiting Period of 90 days from the inception date of the policy.
3. Survival Period - The Insured needs to survive for a period of 30 days from the date of the diagnosis of the Critical Illness.

Additional Discounts

• Insured will get a Family discount of 10% if 2 or more members are covered under a single policy
• Insurance will get a Youth discount of 10% under this plan
• Discount for multi-year polices-4 % discount for opting 2yr policy tenure and for 3yrs tenure 7%((including premium for optional covers)