National Insurance Varishtha Mediclaim for Senior Citizens

Product Overview

National Varistha Mediclaim for Senior Citizen Health Insurance Plan specially designed for customers above the age of 60yrs. It offers an inpatient hospitalization policy, along with host of benefits like - day care procedure, pre-existing diseases covered after 1yr, etc.

Unique Features of National Insurance Varishtha Mediclaim for Senior Citizens

• Under this plan Pre-existing disease are covered after a waiting period of 1 year.
• Health Check Up (2% of the Sum Insured) - Expenses of health checkup will be reimbursed once at the end of a block of three continuous policy periods provided no claims
• Pre-existing Diabetes and Hypertension diseases will be covered from the inception of the policy by paying additional premium
• Some Organ Specific Diseases are Covered after a waiting period of 1 year. For e.g. Cataract ,ENT disorder, etc

Features of edit Edit Details

Critical features of National Insurance Varishtha Mediclaim for Senior Citizens

• Room rent:
  Limits imposed towards room and ICU rent expenses

1. Room Rent - 1% of the Sum Insured.
2. ICU - 2% of the Sum Insured.
3. 25% of the sum insured per illness/ injury

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

1. 10% Copayment of all admissible claims
2. Insured may also opt for 2% co-payment which will entitle him for a premium discount of 10%
3. Additional co-payment of 10% of admissible claim would be required in case claim arises out of a pre-existing disease
4. Sub-limits on Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees- 25% of the chosen sum assured per hospitalisation
5. Anaesthesia, oxygen, medicines, blood, disposable surgical equipment, consumables, prosthesis (pacemakers, artificial limbs, stents etc.) - Up to 50% of the chosen sum assured per hospitalisation
6. Limitation on Cataract is up to Rs. 10000/- and that of Benign prostatic hyperplasia is up to Rs. 20,000/- only.
7. Co-payment of 10% shall apply to all the admissible claims other than claims arising due to Cataract and Benign prostatic hyperplasia

• 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 10 % 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 1 years is case of pre-existing diseases
2. Pre-existing Diabetes and Hypertension covered from inception of the policy by extra premium

Eligibility Criteria

• Minimum Age of Entry:- 60 years
• Maximum age of Entry:- 80 years
• Sum Insured:- 1 lakh & 2 lakhs for critical illness
• Policy Tenure:- 1 year
• Premium Calculated on Basis of:- Age, (i.e. sum Insured Choosen)

Add-ons

• 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.

Exclusions

• Vaccination and Inoculation of any kind unless it is post-animal bite
• General debility and Run down conditions
• Circumcision, Cosmetic surgery, Plastic surgery.
• HIV/AIDS
• Psychiatric and psychosomatic disorders
• Injury arising out of drug/alcohol abuse
• War, act of foreign enemy, ionizing radiation and nuclear weapon.
• Naturopathy
• Experimental or unproven treatment
• All external equipments.
• Dental treatments
• Medical Expenses relating to any hospitalisation primarily and specifically for diagnostic, X-ray or laboratory examinations and investigation senses relating to any hospitalisation primarily and specifically for diagnostic, X-ray or laboratory examinations and investigations

Note: Any claims arising out of or attributable to any of the following is not covered

Tax Benefits

When you pay the premium for your health insurance policy, you are liable to get a tax rebate under section 80D of the Income Tax Act, 1961.

Claim Process

In case you would like to know about the Claim Process or would like to register a Claim please click the link below

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