National Mediclaim Plus Policy
  • Understand the plan's features
  • Learn about the eligibility criteria
  • Find out the exclusions & claim process
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National Medicliam Plus Policy

National Medicliam Plus Policy is a high sum insured policy which indemnifies for In-patient treatment expenses and 140+ Day Care Procedures/surgeries, Ayurveda and homeopathy treatment, organ donorís medical expenses, maternity, hospital cash ambulance, air ambulance, medical emergency reunion, vaccination for children and medical second opinion. The policy also provides optional covers for Critical Illness and Out-patient Treatment. The policy covers medical expenses for 30 days of pre-hospitalization and 60 days of post-hospitalization.

National Arogya Mediclaim Plus Policy Specifications

Children Entry Age

Min: 3 Months, Max: 18 years

Adult Entry Age

Min: 18 years, Max: 65 Years

Sum Insured

2 L | 3 L | 4 L | 5 L | 7 L | 10 L| 15 L | 20 L | 25 L | 30 L | 40 L | 50 L

Plan Type

Individual/Family Floater

Policy Term

1 Year

Initial Waiting Period

30 Days*

*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.

Choose your National Mediclaim Plus Policy

With wide coverage options, National Mediclaim Plus Policy lets you customize your health insurance plan as per your needs and requirements:

In-patient & Out-patient coverage

Room Rent

1% of SI

ICU Charges

2% of SI

Pre-Hospitalization

Covered up to 30 days

Post-Hospitalization

Covered up to 60 days

Domiciliary Hospitalization

Not Covered

Daycare Treatment

140+ procedures

OPD Charges

Not Covered

Coverage Terms

COVID-19 Treatment

Not Covered

Cataract

Up to 15% SI

No Claim Bonus

Available up to 50% of SI

Automatic Restoration

Not Available

Daily Hospital Cash

INR 500 per day

Organ Donor

Covered

Maternity Cover

INR 30,000-50,000

New Born Baby Cover

Available

Alternative Treatments

AYUSH Treatment

Covered up to SI

IVF Treatment

Not Available

Modern Treatment

Up to 25% of SI

Emergency Coverage

Ambulance

Covered up to 2.5K

Air Ambulance

Available

Compassionate Travel

Not Available

Global Coverage

Not Available

Wellness Programmes

E-Consultation

Not Available

Health Check-Up

Available every 2 years

Second Medical Opinion

Available

Vaccination

Available

Limitations

Co-payment

Applicable

Sub-limits

Not Applicable

What is Room Rent?

The room rent limit is the maximum amount of bed charge that you can claim if you are hospitalized.

Common Room categories covered under room rent are:

  • Private Single AC Room
  • Twin Sharing
  • General Ward

Coverage status under National Mediclaim Plus Policy?

Under National Mediclaim Plus Policy, the room rent is covered up to 1% of the SI.

Under National Mediclaim Plus Policy, the room rent is covered up to INR 15,000 per day

Under National Mediclaim Plus Policy, the room rent is covered up to INR 20,000 per day

What are ICU Charges?

TIt is a special department in the hospitals where patients with serious medical conditions are treated.

Coverage status under National Mediclaim Plus Policy?

Under this plan, ICU charges coverage is available up to 2% of the SI.

Under National Mediclaim Plus Policy, the room rent is covered up to INR 15,000 per day

Under National Mediclaim Plus Policy, the room rent is covered up to INR 20,000 per day

What is Pre Hospitalization?

Medical expenses incurred before the hospitalization of the policyholder.

Coverage status under National Mediclaim Plus Policy?

This plan covers medical expenses incurred during pre-hospitalization for up to 30 days.

What is Post Hospitalization?

Medical expenses incurred after the discharge of the policyholder from the hospital.

Coverage status under National Mediclaim Plus Policy?

This plan covers medical expenses incurred during post-hospitalization for up to 60 days.

What is Domiciliary Hospitalization?

Home hospitalization arrangement for the insured person due to unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get financial coverage.

Coverage status under National Mediclaim Plus Policy?

Under National Mediclaim Plus Policy, domiciliary hospitalizations are not covered.

What is Daycare Treatment?

Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.

Coverage status under National Mediclaim Plus Policy?

This plan covers expenses of 140+ daycare procedures.

What are OPD charges?

Covers the cost of doctor consultation and prescribed medical tests that may not require hospitalization.

Coverage status under National Mediclaim Plus Policy?

Not covered under the plan.

What is COVID-19 Treatment?

COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. an approved center.

Coverage status under National Mediclaim Plus Policy?

COVID-19 treatment cover is not available under this plan.

What is Cataract Treatment?

A common eye condition in which your vision gets blurred.

Coverage status under National Mediclaim Plus Policy?

Under this plan, you are covered for cataract treatment for up to INR 60,000

Under this plan, you are covered for cataract treatment for up to INR 80,000

Under this plan, you are covered for cataract treatment for up to INR 1 L

What is a No-Claim Bonus?

For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as a no-claim bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain percentage that varies from plan to plan.

Coverage status under National Mediclaim Plus Policy?

The plan offers a maximum of up to 50% of the sum insured.

What is Automatic Restoration?

Automatic restoration is a benefit in which an insurance company restores the sum insured amount completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from plan to plan.

Coverage status under National Mediclaim Plus Policy?

The plan does not offer automatic restoration.

What is Daily Hospital Cash?

It is a cash amount that you receive each day during the time of hospitalization.

Coverage status under National Mediclaim Plus Policy?

The Daily hospital cash available under the plan is Rs. 500 per day, a maximum of 5 days per hospitalization

The Daily hospital cash available under the plan is INR 800 per day, max. of 5 days

The Daily hospital cash available under the plan is INR 1000 per day, max. of 5 days

What is an Organ Donor Cover?

It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body.

Coverage status under National Mediclaim Plus Policy?

Under the plan, Organ Donor expenses are covered up to the SI.

What is a Maternity Cover?

It refers to the cover that includes expenses for normal and c-section procedures deliveries.

Coverage status under National Mediclaim Plus Policy?

The maternity cover available under this plan is up to INR 30,000 for normal delivery and INR 50,000 for cesarean section.

The maternity cover available under this plan is up to INR 60,000 for normal delivery and INR 75,000 for cesarean section.

The maternity cover available under this plan is up to INR 80,000 for normal delivery and INR 1Lakh for cesarean section.

What is a New Born Baby Cover?

It takes care of the medical expenses that arise due to the hospitalization of the newborn baby in case of unforeseen circumstances. Some of the common treatments that are covered under the newborn cover are listed below and these common treatments can vary from plan to plan:

  • Congenital anomaly (conditions since birth)
  • Acute condition
  • Chronic condition
  • Premature delivery
  • Birth asphyxia
  • Day care treatment

Coverage status under National Mediclaim Plus Policy?

Covered which includes newborn baby vaccinations.

What is AYUSH Treatment?

Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.

Coverage status under National Mediclaim Plus Policy?

AYUSH treatment is covered under this plan up to SI.

What is IVF Treatment?

In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:

  • Full infertility
  • No fertility
  • Infertility diagnosis
  • Infertility diagnosis and limited fertility treatment
  • Medication (which may or may not include fertility drug prescriptions)

Coverage status under National Mediclaim Plus Policy?

Not available

What is a Modern Treatment?

Medical treatments that demand modern technology such as robotic surgeries, stem cell therapy, etc.

Coverage status under National Mediclaim Plus Policy?

Modern Treatment is covered for up to 25% of SI.

What is an Ambulance Cover?

An ambulance is used to move the patient from home to hospital, transfer to another hospital, and take them for different tests outside the hospitals.

Coverage status under National Mediclaim Plus Policy?

This plan covers ambulance charges up to INR 2500.

This plan covers ambulance charges up to INR 4000.

This plan covers ambulance charges up to INR 5000.

What is an Air Ambulance?

Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.

Coverage status under National Arogya Sanjeevani Plan?

This plan covers Ambulance charges up to 5% of SI.

What is Compassionate Travel?

Refers to the traveling expenses of a family member of the insured person in case the policyholders get admitted to a hospital outside his/her residential city.

Coverage status under National Mediclaim Plus Policy?

Not available

What is Global Coverage?

Any kind of medical/health emergency when you are outside of India.

Coverage status under National Mediclaim Plus Policy?

Not available

What is E-Consultation?

If a policy offers E-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.

Coverage status under National Mediclaim Plus Policy?

The plan does not cover the expenses for E-consultation.

What is a Health Checkup?

A facility where the policyholder can avail free health check-ups after fulfilling the company's policies.

Coverage status under National Mediclaim Plus Policy?

The plan offers health check-up benefits every 2 years.

What is a Second Medical Opinion?

If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the companyís network of medical practitioners.

Coverage status under National Mediclaim Plus Policy?

The plan covers the expenses for Second Medical Opinion.

What is Vaccination cover?

Coverage against the expenses incurred on vaccinations is provided by the insurance companies.

Coverage status under National Mediclaim Plus Policy?

The plan offers vaccination coverage for children up to the age of 12.

What is Co-payment?

In the co-payment clause, policyholders have to pay a portion of the hospitalization expense on their own and the insurer will pay the rest of the amount.

Status under National Arogya Sanjeevani Policy?

20% co-payment is applicable if treatment is taken in a non-network hospital.

What is the Sub limit?

Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder.

Status under National Arogya Sanjeevani Policy?

No sub-limits are available

National Mediclaim Plus Policy Riders

National Mediclaim Plus Policy offers two optional covers for critical illness and out-patient treatment.

The added advantage of critical illness means that the company shall pay the benefit amount, as stated in the schedule, provided that:

  • the insured person is first diagnosed as suffering from a critical illness (as defined) during the policy period, and
  • the insured person survives for at least 30 (thirty) days following such diagnosis.
  • diagnosis of critical illness is supported by clinical, radiological, histological and laboratory evidence acceptable to the company.

National Mediclaim Plus Policy Benefits

Tax Benefits

Get tax relief under section 80D

Discounts

Avail various discounts

Health Incentives

Get rewarded for your healthy lifestyle & avail regular health check ups

Optional Covers

Avail enhanced protection with additional coverage options

Post hospitalization doctor visit

Avail post hospitalization care

Tax Benefits

Amount paid towards the premium of this plan is eligible for tax relief under Section 80D of the Income Tax Act, 1961.

Discounts
  • Avail 10% discount for eligible family members.
  • Youth Discount- Avail 10% discount if the insured or spouse of the insured person is aged between 18 (eighteen) to 25 (twenty five) years.
  • Avail 5% discount on the purchase of National Mediclaim Plus.
Health Incentives

The plan lets the policyholder earn up to 50% of their SI as Health Returns if they follow a healthy lifestyle and stay fit. Expenses of health check up shall be reimbursed.

Optional Covers

The plan offers several optional covers that allow you to get enhanced coverage and help you to customize your plan as per your needs and requirements. Critical illness and outpatient treatment.

Post hospitalization doctor visit

The benefit of a doctor or nurse care post hospitalization can be availed under this plan.

National Mediclaim Plus Policy Exclusions

Cost of the organ to be transplanted.

Organ donorís pre and post-hospitalization expenses.

Psychological counseling or other kinds of psychotherapy under mental illness coverage.

Cosmetic dental treatment.

Explore National Health Insurance

Know more about National Health Insurance, its claim process, buying process, and contact details by clicking on the sections below:

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Renewal Process

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Explore other National Health Plans

National Health offers a wide range of health insurance plans to fulfill the medical needs of individuals, families, and senior citizens.

If you are looking for a policy that covers you for In-patient treatment expenses and 140+ Day Care Procedures then this plan is the right choice.

Unique Features

  • Avail cover up to 50 lakhs
  • Critical Illness benefit
  • 5% Increase in SI

This plan suits you best if you are a newly married individual or have dependents like kids or elderly parents as this health plan covers all of them along with you.

Unique Features

  • 12 Modern treatments
  • Maternity cover
  • Lifelong renewability

An affordable health plan, that offers 140+ day care procedures and covers pre-existing conditions like diabetes and hypertension.

Unique Features

  • Infertility treatment cover
  • Vaccination for children
  • Cataract Treatment Covered

National Parivar Mediclaim Plus Policy

If you are looking for a healthcare policy providing a high sum assured and covers your family members under one cover this is the right policy for you.

Unique Features

  • Cover up to 50 Lakhs
  • 5% No claim discount
  • Critical Illness Benefit

Standard indemnity health insurance product, having Sum Insured up to 10 Lakhs available in both individuals and floater type.

Unique Features

  • Individual/Floater
  • Online purchase discount
  • EMI facility available

National Super Top Up Mediclaim Policy

This policy covers your family members and offers high coverage at affordable prices. The policy has unique features that address all health-related concerns.

Unique Features

  • Organ donation covered
  • Morbid obesity treatment covered
  • Portability allowed

Overseas Mediclaim Business and Holiday

This plan is essential for those who like to travel, a package policy that covers travel emergencies while traveling abroad.

Unique Features

  • Coverage for business travel
  • Coverage for education abroad
  • Medical evacuation available

Overseas Mediclaim Employment and Study Plan

A plan beneficial for students who are traveling abroad for education, it is designed to cover medical evacuation, illness, and more.

Unique Features

  • Medical Evacuation
  • 5k USD medical emergency cover
  • Mental illness cover

National Critical Illness Policy

A unique benefit policy that covers expenses in the event of the insured person being affected with any of the listed critical illnesses.

Unique Features

  • Cover up to 75 Lakhs
  • Covers pre-existing conditions
  • 37 critical illnesses covered

National Senior Citizen Mediclaim Policy

If you are looking to secure your parents future this policy is a good choice, providing medical coverage to senior citizens between the age group of 60 to 80 years

Unique Features

  • 5% increase in SI
  • 2 Plan options
  • Covers spouse

Vidyarthi Mediclaim Policy for Students

Mediclaim for Students is a unique policy designed to provide health and personal accident cover to students.

Unique Features

  • Covers parents and students
  • Eyesight correction
  • Genetic disorders covered

This policy focuses on protecting the policyholders against the treatment expenses resulting due to COVID-19 infection.

Unique Features

  • Covers spouse and dependants
  • 5% discount for healthcare workers
  • 10% discount on online purchases

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National Mediclaim Plus Policy: FAQ's

1. Is it allowed to cancel National Mediclaim Plus Policy and receive a refund?

You will get a free-look period of 15-30 days under National Mediclaim Plus Policy. If you cancel your plan within this period, you would receive the entire amount after a few nominal deductions.

2. How many times can I file a claim under National Mediclaim Plus Policy?

There is no restriction for repetitive claims under National Mediclaim Plus Policy for hospitalization. You can file a claim multiple times within your sum insured limit

3. Does the plan offer portability benefits?

Yes, the plan comes with the portability benefit. As per the IRDAI guidelines, customers can port their plan from one insurer to another.

4. Can any claim be rejected or refused under National Mediclaim Plus Policy?

Yes, there are a few conditions under which the insurer can reject your claim. In case you are not satisfied with the reasons, you can represent the insurance company within 15 days of such denial.

5. I am already having a National Mediclaim Plus Policy and want to increase the sum insured. Is that possible, what should I do?

If you are already insured under National Mediclaim Plus Policy, you can easily increase the sum insured at the time of renewal if you want.

6. What will happen in the case where the National Mediclaim Plus Policy lapses while I am hospitalized?

It allows you to avail of the treatment and charge as per the rules and regulations of the policy. However, terms and conditions are applied.

7. I bought National Mediclaim Plus Policy in Delhi. Can I use it in Bangalore?

Yes, you can use your National Mediclaim Plus Policy all over India, no matter where you bought it.

8. What type of discount will I get under my National Mediclaim Plus Policy?

National Mediclaim Plus Policy offers discounts on insuring your spouse, kids, or the entire family under the same insurance plan.

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March 14, 2022

My father in law lives alone in jalandhar and we wanted an insurance company that take cares of him in our absence. They are very good with their commitment and service.

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September 1, 2021

I bought my health plan from National a while back. Recently had to make a claim for hospitalization. I was a little worried but the response time was at best amazing! Thanks guys

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August 18, 2021

I have bought health insurance from National Health Insurance and I am very impressed by their services and attention towards customers.

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May 10, 2021

I will recommend everyone to buy health insurance plan from this company because I am very happy with the plan I purchased from the company. I am using my insurance from two years and till now ...

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October 26, 2020

I want to portability of United India insurance company individual health mediclaim policy taken since December 2005 and falling due for renewal on 06-12-2020

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May 6, 2018

I hold a National Parivar Mediclaim insurance plan with National Insurance from last 3 years, i am happy with the coverage value of this policy.

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alok kumar de

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October 16, 2017

my varistha mediclaim policy number of which is-150100501610012195 renewed this year but when i want to know my claim claim status online it says wrong policy number then what is the corect num...

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Sabhadiya nareshbhai govindbhai

Surat

September 30, 2017

My father has been admitted in hospital but ypur company not receive my call I inform you for admitted my father date 30/09/2017

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