National Mediclaim Plus Policy

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National Mediclaim Plus Policy

National Mediclaim Plus Policy is a comprehensive health insurance plan by National insurance company in India which goes beyond the traditional plan (basic plan with hospitalisation cover only). The plan offers the required protection against rising health care costs. It makes healthcare-associated services easy and accessible. It offers coverage against hospitalisation's expenses, pre & post hospitalization, daycare treatment, maternity expenses, newborn and vaccination among others. It even offers coverage against expenses associated with allopathic, ayurvedic and homoeopathic treatment.

National Mediclaim Plus Policy: Eligibility

Entry age 3 months to 65 years
RenewabilityLifelong
Sum insured 2 lacs to 50 lacs
Co-payment 20% of the claim
Policy tenure1 year
Grace period30 days

Key Features

National Mediclaim Plus Policy is a suitable health insurance plan that allows the insured to get quality treatment in the hour of need. Below is a list of such effective features that will help you to understand National Mediclaim Plus Policy better.

Comprehensive Cover: The plan offers coverage to people of age groups up to 65 years. It even provides an optional cover for critical illness and outpatient treatment.

Inpatient Treatment: Expenses such as room rent, ICU charges, nursing care charges, anaesthesia, oxygen, blood, diagnostics, medical practitioner, OT charges, prosthetic charges and other devices (if implanted internally in case of a surgical procedure) are taken care by this plan.

Pre & Post Hospitalization: The plan is also liable to offer pre-hospitalization (up to 30 days) and post-hospitalization cover (up to 60 days).

Cashless Facility: The plan allows you to grab the cashless facility at any network hospital. Under the same, you don't have to pay a single penny from your pocket to get the treatment done.

Daycare Procedures: National Mediclaim Plus Policy offers coverage against 140+ day care procedures which require less than 24 hours hospitalization.

Cumulative Bonus: The plan will offer a cumulative bonus to the insured for every claimless year. It will increase by 5 to 50 % every year for continuous policy years.

Sum Insured Enhancement: The plan allows you to enhance the sum insured at the time of renewal. You can even change the plan if you want to.

Health Checkup: It will reimburse the cost of health check-up once at the end of a block of every 3 claim-free years.

Medical Emergency Reunion: In case of hospitalisation away from the place of residence under any life-threatening situation, the expenses associated with a round trip journey of a family member is payable.

Tax Benefits: The premium that you paid towards your health insurance policy is liable to get the helpful tax benefits under section 80D of the Income Tax Act, 1961 (up to Rs.15000-25000).

Medical Second Opinion: In the case where you get diagnosed with a serious disease, a medical second opinion from World Leading Medical Centre will be arranged. It will cover up to 160+ diseases.

Organ Donor Cover: There are many cases when you need organ replacement treatment. This plan offers the required cover against the organ donor's medical expenses in the hour of need.

Optional Covers: The plan comes out with multiple optional covers that help you to enhance the basic cover at a nominal cost such as critical illness, good health incentives and outpatient treatment among others.

Lifetime Renewability: To assist you for a long tenure, the plan offers the lifelong renewability option to all policyholders.

Cover Multiple Treatments: The plan offers required coverage to you against expenses of multiple treatments that include ayurvedic, allopathic, and homoeopathic.

Additional Benefits

FeaturesPlan APlan BPlan C
Medical Second Opinion (MSO) in case of any major issueOne MSOOne MSOOne MSO
Cumulative bonusIncrease in SI by 5% of SI per year up to 50% of SIIncrease in SI by 5% of SI per year up to 50% of SIIncrease in SI by 5% of SI per year up to 50% of SI
Health checkup (every 2 years )Up to INR 1,000Up to INR 2,000Up to INR 3,000
Optional covers---
Critical IllnessINR 2,00,000/ 3,00,000/ 5,00,000/ 10,00,000/ 15,00,000/ 20,00,000/ 25,00,000.
Outpatient TreatmentINR 2,000/ 3,000/ 4,000/ 5,000/ 10,000.

Why You Should Opt for National Mediclaim Plus Policy?

To enjoy a healthy and safe future, it is important to invest in an adequate health insurance policy from a reliable company. And National Mediclaim Plus Policy is one of the best out there. With a long list of features and affordable price, it has become the first choice of customers. With the trust of the National Insurance Company, this plan has made a lot of things easier for the customer. It also allows you to grab several discounts on insuring your family under the same. National Mediclaim Plus Policy is a pocket-friendly yet effective health insurance plan that you should add in your investment portfolio.

Major Exclusions

  • Treatment associated with HIV, AIDS, STD, etc.
  • Run-down condition, general debility, sterility, convalescence, etc.
  • Treatment-related to obesity.
  • Genetic disorders treatment.
  • Plastic surgery, cosmetic treatment, hormone replacement and change of sex.
  • Experimental treatment and naturopathy.
  • Drug/alcohol abuse.
  • Contact lens, spectacles, hearing aid and cochlear implants.

National Mediclaim Plus Policy: Claim Process

When it comes to applying a claim, policyholders love a simple and hassle-free process. National Insurance Company understands the same and that's why it made the entire process easier for its customers. There are two options from which people can choose- cashless and reimbursement. Let's explore them in detail.

Cashless

It is one of the most preferred options when it comes to claiming National Mediclaim Plus Policy. This process allows the insured to get the required cover without paying a single penny from his/her pocket. To file a cashless claim, you need to inform the insurer about the same as soon as possible or connect with the TPA along with required documents. In case of an emergency, you should inform them within 24 to 48 hours and in case of a planned hospitalization at-least 3 to 4 days before. The insurer or the TPA will take care of the rest of the procedure and you can completely focus on your treatment rather than expenses.

Reimbursement

This is the process under which you have to pay all your medical bills in the first place and then you can file for the reimbursement. For the same, you need to immediately inform the insurer. You need to submit a claim form with all the required documents that include all medical bills, prescriptions, discharge card, medical investigations reports and other documents related to the treatment. The insurance company or accessor can ask for additional documents if required. He/she will analyze all the reports and will share results with you. If it gets approved, the company will transfer the claim amount directly to your account or in case of rejection, you will receive a reason for the same.

National Mediclaim Plus Policy: FAQ

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.

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

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

Yes, with the help of portability feature you are allowed to port your plan from one insurer to another. You will receive all the existing benefits that you are entitled to.

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.

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

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

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

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Last updated on 20-02-2020