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National Senior Citizen Policy
National Senior Citizen Mediclaim Policy is a plan designed for senior citizens, allowing them to live a relaxed life post-retirement. It c…
- Reinstatement of Sum Insured
- Cataract
- Ambulance Cover
National Health Insurance
National Insurance Group Mediclaim Policy
The plan caters to the basic healthcare needs of employer-employees an ...Read More
Up to 2 Crores
Sum insured
1
No. of plans
850+
Pan India presence
91.31%
Claim settlement ratio
🛡️ IRDAI Approved
⭐ 4.4/5 · 2,701 reviews
🏥 3,200+ hospitals
📊 -0.67 solvency ratio
✅ 91.31% claim settlement
About National Insurance Group Mediclaim Policy
A quick read on what this National Health Insurance plan covers and why it might be a fit for you.
Buying individual health insurance can be challenging due to high monthly premiums. A group mediclaim policy offers comprehensive health support benefits. The National Insurance Group Mediclaim Policy is an indemnity insurance product that provides coverage for a group of policyholders. The plan caters to the basic healthcare needs of employer-employees and non-employer-employees. Individuals can be covered under this policy as part of a group. A separate sum insured applies to each individual insured under the group policy, whether it's a family group or an employer-employee group.
This plan has a wide sum insured ranging from INR 50,000 to INR 10 Lakhs in 15 slabs. The sum insured is available in two ranges:
- Sum Insured: INR 50,000 - INR 5 Lakhs (in multiples of INR 50,000)
- Sum Insured: INR 6 Lakhs - INR 10 Lakhs (in multiples of INR 1 Lakh)
Additionally, the policy covers 140+ daycare procedures, along with in-patient hospitalisation (for allopathic, homoeopathic, and Ayurvedic treatment), pre-hospitalisation (30 days prior to hospitalisation), post-hospitalisation (60 days from the date of hospital discharge), and illnesses contracted during the policy tenure.
The plan also extends coverage to 12 modern treatments, including advanced treatments like HIV/AIDS, mental illness, morbid obesity, refractive error correction, organ donor expenses, and ambulance services. This plan includes sub-limits that apply to certain expenses as per the policy schedule. For example, sub-limits may apply to room rent charges, doctor's consultation fees, and procedures like hemodialysis, radiotherapy, and chemotherapy, as specified in the schedule.
This page details the benefits and specifications of the National Insurance Group Mediclaim Policy.
Plan at a glance
Eligibility, sum insured options and policy mechanics — pulled straight from the policy wording.
Entry age
Min- 3 Months, Max- No Limit
Plan type
Group Health Insurance
Sum insured options
₹50 L, ₹70 L, ₹1 L, ₹10 L
Waiting period
30 days
Renewability
Lifetime
Policy term
1, 2, 3 Years
*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
Pros & cons
A quick honest summary — the strengths and the trade-offs.
Pros
- 140+ daycare procedures
- HIV cover
- Affordable premiums
- AYUSH cover
Cons
- Treatment outside India
- OPD diagnostics
- Adventure sport injuries
- Injuries due to illegal activity
What's covered
Every CMS-driven coverage flag from the plan wording — only items with a published value render below.
Hospitalization
- Room rent Covered
- ICU charges Covered
- Pre-hospitalization Covered
- Post-hospitalization Covered
- Domiciliary hospitalization Not covered
- Day-care treatment Covered
- OPD charges Not covered
- Covid-19 treatment Covered
- Cataract Covered
Bonuses & restoration
- No-claim bonus Not covered
- Automatic restoration of SI Not covered
- Daily hospital cash Not covered
Family & special care
- Maternity cover Covered
- New-born baby cover Covered
- IVF treatment Not covered
- AYUSH treatment Covered
- Organ donor expenses Covered
Modern & preventive care
- Modern treatment Covered
- Road ambulance Covered
- Air ambulance Not covered
- E-consultation Not covered
- Health check-up Not covered
- Second medical opinion Not covered
- Vaccination Not covered
Conditions & global
- Co-payment Covered
- Sub-limits Covered
- Compassionate travel Not covered
- Global coverage Not covered
Benefits of National Group Mediclaim Policy
Here are the key benefits of the National Group Mediclaim Policy:
-
Hospitalisation Benefits with Sub-limits
The policy covers hospitalisation expenses such as ICU charges, room rent, doctor's/consultation fees, and modern treatments, subject to applicable sub-limits. Hospitalisation charges for hemodialysis, chemotherapy, and radiotherapy are also subject to sub-limits.
-
Pre-existing Disease (PED) Cover
Pre-existing diseases, as specified in your policy schedule, are covered after a waiting period of 4 years.
-
Co-payment Discounts
Opting for a 5% co-payment provides a 4% discount on premiums. Choosing a 10% co-payment offers an 8% discount on premiums.
-
Modern Treatment Cover
Coverage is provided for 12 listed modern treatments. For hospitalisation related to these, a maximum of 25% of the sum insured is applicable.
-
Optional Covers
The plan offers two optional covers:
- Modern Treatment: Coverage for 12 modern treatment procedures, subject to 50% of the sum insured for each treatment.
- Maternity Benefits: Up to INR 50,000 for each delivery or medically necessary termination of pregnancy in a policy year.
-
Tax Benefits
Premiums paid for the National Group Mediclaim Policy are eligible for tax benefits under Section 80D of the Income Tax Act, 1961.
Inclusions & exclusions
What the plan pays for, and what it doesn't.
Exclusions
- Investigation and evaluation
- Rest cure, rehabilitation and respite care
- Obesity/weight control treatment
- Change-of-gender treatments, cosmetic or plastic surgery, and unproven treatments
- Birth control, sterility and infertility
- Hazardous or adventure sports
- Breach of law, drug/alcohol abuse, self-inflicted injury, suicidal act, and non-prescription drug
- Hormone replacement therapy, general debility, congenital external anomaly, and dental treatment
- Domiciliary hospitalisation & Out-patient Department (OPD) treatment
- Massages, steam baths, alternative treatment (Other than Ayurveda and Homeopathy)
- Treatment taken outside the geographical limits of India
- Permanently excluded diseases.
Who can buy this plan
Eligibility criteria pulled straight from the policy wording.
- Entry Age: 3 Months
- Maximum Entry Age: N/A
- Sum Insured: INR 50,000 to INR 10 Lakhs
- Waiting Period: 30 days
Other features & benefits
Summary
The National Insurance Group Mediclaim Policy is a comprehensive indemnity insurance that offers extensive coverage to policyholders. Coverage benefits include pre and post-hospitalisation, in-patient care (Allopathy, Ayurveda, and Homoeopathy), modern treatments, daycare procedures, mental illness coverage, and more.
Safeguard yourself and your family with the National Insurance Group Mediclaim Policy. Don't wait, buy a health policy now!
For more details, contact our customer care executives at 18003450330 or visit PolicyX.com.
National Insurance Group Mediclaim Policy: FAQs
The 5 most-asked questions about National Insurance Group Mediclaim Policy, answered.
In-patient care (Allopathic, Ayurveda and Homoeopathy), day care treatment, pre-hospitalisation (30 days) and post-hospitalisation (60 days) expenses, 140+ day care procedures, mental illness treatment, HIV/ AIDS treatment, organ donor’s medical expenses, ambulance charges & Morbid Obesity Treatment.
The maximum sum insured of this plan goes up to INR 10 Lakhs of which SI ranging from INR 50,000 - 5 Lakhs comes in a multiple of INR 50,000. Whereas, SI of INR 6-10 Lakhs is available in the multiples of INR 1 Lakh.
Yes, daycare procedures are covered up to the sum insured under this plan.
Yes, 12 kinds of modern treatment within the sub-limit are available under the plan.
The National Insurance group mediclaim policy is curated to provide basic health care support for a group of people either as an employer-employee or a non-employer-employee.
Conclusion
A comprehensive high-coverage health plan with maternity, AYUSH, and advanced hospitalisation benefi
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