National Senior Citizen Mediclaim Plan | PolicyX
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National Senior Citizen Policy

National Senior Citizen Mediclaim Policy is a plan designed for senior ...Read More

Up to 2 Crores
Sum insured
1
No. of plans
850+
Pan India presence
91.31%
Claim settlement ratio
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🛡️ IRDAI Approved
⭐ 4.4/5 · 2,705 reviews
🏥 3,200+ hospitals
📊 -0.67 solvency ratio
✅ 91.31% claim settlement

About National Senior Citizen Policy

A quick read on what this National Health Insurance plan covers and why it might be a fit for you.

National Senior Citizen Mediclaim Policy is a plan designed for senior citizens, allowing them to live a relaxed life post-retirement. It covers expenses for in-patient treatment (allopathy, ayurveda, and homeopathy), domiciliary hospitalization, and treatment of a disease or injury during the policy period.

The policy offers a sum insured up to INR 10 Lakh under both Individual and Floater Basis for two plans: Plan A and Plan B. Plan B includes additional features like hospital cash, reinstatement of sum insured, no sub-limits for room rent, and funeral expenses.

This versatile plan offers modern treatments, HIV and mental illness coverage, treatment for morbid obesity, hospital cash, lifelong renewability, and more.

Plan at a glance

Eligibility, sum insured options and policy mechanics — pulled straight from the policy wording.

Entry age
60 to 80 Years
Plan type
Senior Citizen Health Insurance
Sum insured options
₹1 L, ₹3 L, ₹5 L, ₹8 L, ₹9 L, ₹10 L
Waiting period
30 days
Renewability
Lifelong
Policy term
1 Year

*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

  • Reinstatement of Sum Insured
  • Cataract
  • Ambulance Cover

Cons

  • Obesity
  • Adventure Sports
  • Illegal Activities

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 Covered
  • Day-care treatment Covered
  • OPD charges Covered
  • Covid-19 treatment Covered
  • Cataract Covered

Bonuses & restoration

  • No-claim bonus Covered
  • Automatic restoration of SI Not covered
  • Daily hospital cash Covered

Family & special care

  • Maternity cover Not covered
  • New-born baby cover Not 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 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

Video reviews

Walkthroughs from the PolicyX team — pros, cons, real claim experiences and who should buy.

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Sample premium

Indicative premium examples — your actual quote depends on age, declared medical history, sum insured and add-ons.

Sample Premium Illustration of National Senior Citizen Mediclaim Plan

To understand the premium amount, refer to the example below illustrating sample premiums.

Plan A - Premium Table for Individuals / Senior Most Member (Floater Policy)

Sum Insured (in Rs.) 1 Lakh 4 Lakhs 8 Lakhs 10 Lakhs
Premium Payable 7,313 16,456 30,809 33,360

Plan B - Premium Table for Individuals / Senior Most Member (Floater Policy)

Sum Insured (in Rs.) 1 Lakh 4 Lakhs 8 Lakhs 10 Lakhs
Premium Payable 10,419 23,443 43,893 47,526

Inclusions & exclusions

What the plan pays for, and what it doesn't.

Exclusions

  • Mediclaim policy for senior citizens has the following exclusions:
  • Permanent diseases or health conditions not covered under the plan include:
  • Hospitalization due to war, riot, strike, and nuclear weapons
  • Intentional self-injury
  • AIDS
  • Miscarriage and abortion
  • Congenital disease
  • Infertility and in vitro fertilization
  • Certain diseases and treatments are covered after a waiting period:
  • Listed ailments after 12 months
  • Pre-existing diseases after 1/2/4 years

Who can buy this plan

Eligibility criteria pulled straight from the policy wording.

  • Min entry age: 60 Years
  • Max entry age: 80 Years
  • Initial Waiting Period: 30 Days
  • Sum Insured: Up to 10 L

Other features & benefits

  • Hospital Cash
  • Doctor's Home Visit
  • Funeral Expenses

National Senior Citizen Policy: FAQs

The 9 most-asked questions about National Senior Citizen Policy, answered.

The entry age is 65 years.
You can avail of INR 1 Lakh under the National Senior citizen health plan.
The maximum sum insured under the National Senior Citizen health plan is INR 10 Lakhs.
Yes, an initial waiting period of 30 days is applicable under the National Senior Citizen health plan.
Yes, it is as you can opt between 2 plan options under the National Senior Citizen health plan.
A medical check-up may be required before purchasing the National Senior Citizen Mediclaim Policy, depending on the applicant’s age, health condition, and insurer guidelines at the time of policy issuance.
Yes, pre-existing diseases are covered under the policy, but only after completing the specified waiting period mentioned in the policy terms. Claims related to these conditions are not payable during this period.
Yes, the policy covers hospitalization expenses incurred due to illness or injury, including room charges, doctor’s fees, medicines, nursing care, and other medical costs during in-patient treatment.
Yes, the policy covers several day-care treatments that do not require 24-hour hospitalization, provided they are medically necessary and performed in a recognised hospital or healthcare facility.

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Written and reviewed by

PolicyX content is researched in-house and reviewed by an IRDAI-certified insurance specialist before publication.

Written by Simran saxena — Health and Term Insurance Reviewed by Raj Kumar — Health Insurance
Last updated: 7 Aug 2023 · Originally published: 8 Nov 2024

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