New India Senior Citizen Mediclaim Policy
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New India Assurance Senior Citizen Mediclaim Policy

Established in 1919 by Sir Dorabji Tata, the New India Assurance Company is a Multinational General Insurance Company. It operates in 28 countries at present with its headquarter based in Mumbai, India. When we talk about insurance products, the New India Insurance Company has multiple domains. The company provides insurance for motor, health, travel, rural, marine, etc.

So, among all the insurance plans, we will be discussing the Senior Citizen Mediclaim Plan offered under the health insurance domain of New India Assurance Company. It is being offered to senior citizens to support them financially in old age when they frequently meet medical situations. Let us explore more about the plan.

Who Can Buy New India Assurance Senior Citizen Mediclaim Policy?

All senior citizen residents in India between the age of 60 years to 80 years are eligible to buy New India Senior Citizen Mediclaim Policy. The cover can be continued until 90 years of age subject to a condition that the policy is renewed on time and all the premiums are paid regularly.

Pre-acceptance Health Check-up

Pre-insurance health checkup is a mandate under the plan. The policy buyers need to undergo medical screening so that all the pre-existing diseases can be detected. The premiums are finalized accordingly.

The expenses of the medical tests are to be borne by the proposer. The health checkup expense is waived for the proposer who already has health insurance under the New India Assurance company.

Sum Insured Options

The New India Senior Citizen Health Insurance policy provides its policy buyers with the flexibility to choose among the following two sum insured options:

1. Rs.1 lakh

2. Rs.1.5 Lakhs

Features & Benefits Of New India Senior Citizen Policy

All the noticeable features of the New India Senior Citizen Health Insurance policy have been described henceforth:

  • Free-Look Period: Free-look period of 15 days is provided to the policy buyers of the plan. The policy buyer can cancel the policy in the case of any kind of dissatisfaction from the policy.
  • Policy Term: The New India Senior Citizen Health Insurance policy can be issued for one year.
  • Policy Renewal: The renewal of the policy is as important as paying the policy premiums. It is to keep the policy in force. A lapsed policy can not be claimed at the time of emergency. So, it is always safe to renew your policy. The policy can be renewed at the end of every policy year.
  • Discounts: The policyholders under the plan can get a family discount of 10% for insuring his/her spouse under the policy.
  • Reimbursement for Health Checkup: The policyholders of the New India Assurance Senior Citizen Mediclaim Policy get reimbursement for health checkup once in a block of 4 years. The 4 years policy period should be claim-free to cherish the benefit. The reimbursement amount is maximum up to 1% of the sum insured.
  • Tax Benefits: Tax rebate benefits are provided to the insured on the paid premiums as per section 80D of the Income Tax Act, 1961.
  • Cumulative Bonus: Under the cumulative bonus benefits, the insured gets a 5% increment in the sum insured for each claim-free year subject to a condition that the policy is in force without any break. Moreover, a maximum of 30% cumulative bonus can be provided under the plan.
  • Additional Premium For specified cover: In the case of any pre-existing disease, the insurance company charges an extra premium for the coverage. Diseases like hypertension and diabetes mellitus affect policy premiums. The increment in the premium amount is 10% of the sum insured for each medical condition.
  • Waiting Period For Specified Disease: There is a waiting period mentioned under the plan for a few of the specified diseases. Here is a table mentioning all the illnesses along with the waiting period.
    S. NoName of IllnessesDuration
    1Age-related osteoarthritis & osteoporosis48 Months
    2Stone in the urinary system18 Months
    3Joint replacement due to degenerative condition48 Months
    4Unknown congenital internal disease18 Months
    5Varicose veins and varicose ulcers18 Months
    6Pilonidal sinus, sinusitis and related disorders18 Months
    7Stone in the gallbladder and bile duct18 Months
    8Any skin disorder18 Months
    9Prolapsed intervertebral disc unless arising from an accident18 Months
    10Piles, fissure and fistula in anus18 Months
    11Non-infective arthritis18 Months
    12Hypertension18 Months
    13Hydrocele18 Months
    14Hernia of all types18 Months
    15Gout & rheumatism18 Months
    16Hysterectomy for menorrhagia/fibromyoma, myomectomy and prolapse of the uterus18 Months
    17Gastric/ duodenal ulcer18 Months
    18Diabetes mellitus18 Months
    19Cataract & age-related eye ailments18 Months
    20Benign prostate hypertrophy18 Months
    21Benign ear, nose & throat disorders18 Months
    22All internal & external benign tumours, cysts, polyps of any kind, including benign breast lumps18 Months
  • Co-payment: All the claims made under the New India Senior Citizen Mediclaim Policy are subject to co-payments. The insurance company’s liability in all the claims will be as follows:
    • Sum insured, or
    • 90% of the admissible claim amount.

Coverage Under New India Senior Citizen Policy

  • Pre-Hospitalization Cover: The insured gets coverage for pre-hospitalization medical expenses incurred during 30 days before the date of hospitalization. A maximum of 5% of the bill is covered under pre-hospitalization expense cover.
  • Post-Hospitalization Cover: The medical expenses incurred during 60 days after getting discharged from the hospital gets covered under post-hospitalization cover. A maximum of 10% of the bill is covered under this.
  • Ambulance Charges Cover: Ambulance charges cover is provided under the New India Senior Citizen Mediclaim Policy. There is a sub-limit of Rs.1000 applied to ambulance charges cover.
  • AYUSH Cover: The New India Senior Citizen Mediclaim Policy comes with a special feature of AYUSH cover. Under this, the insured gets cover for alternative treatments like:
    • Ayurvedic
    • Unani
    • Siddha
    • Homoeopathy
    The coverage provided will only be up to 25% of the sum insured. You can avail the facility only in case of hospitalization for 24 continuous hours or more.
  • Organ Donor Cover: All the expenses incurred during organ transplantation is covered under the policy. The coverage includes the treatment expenses of both the insured and the donor. The plan does not provide cover for the cost of the organ.
  • In-patient Hospitalization Cover: In-patient hospitalization cover is provided to the insured in the case of hospitalization for 24 continuous hours or more. All the OPD charges, doctor’s consultation fee, operation theatre charges, expenses of drugs and medicines consumed during hospitalization, etc are covered under this.

Sub-limits

There are sub-limits applied to certain treatment under the New India Senior Citizen Mediclaim Policy. Here is a detailed description of the sub-limits applied to specific treatments.

  1. Hospitalization Expenses Sub-limits:
    Hospitalization BenefitsSub-limits
    A
    1. Room & boarding expenses charged by the hospital/nursing home.
    2. In case admitted to the Intensive Care Unit (ICU).
    Up to 1% of the sum insured per day.
    Up to 2% of the sum insured per day.
    Overall limit: 25% of the sum insured.
    BSurgeon, anaesthetist, medical practitioner, consultants, specialists fees & nursing. expenses.Overall limit: 25% of the sum insured.
    CSurgical appliances, medicines, drugs, diagnostic material and x-ray, artificial limbs, chemotherapy, anaesthesia, blood, oxygen, operation theatre charges, radiotherapy, cost of a pacemaker, cost of stents & implants.Overall limit: 50% of the sum insured.
  2. Disease/ Treatment Specified Sub-limits
    Name Of DiseaseMaximum Charges(inclusive of the anaesthetist, doctor’s fees, room/ ICU/ OT charges/ surgeons, medicines, internal appliances and other charges incurred during the hospitalization period).
    Mastectomy (Radical)Rs.36,000/-
    Exploratory laparotomyRs.18,000/-
    AngiographyRs.12,000/-
    TonsillectomyRs.7,000/-
    Kidney stone/ lithotripsyRs.13,000/-
    ArthroscopyRs.10,000/-
    TympanoplastyRs.13,000/-
    FissurectomyRs.9,000/-
    FistulectomyRs.10,000/-
    HaemorrhoidectomyRs.8,000/-
    PID-discectomyRs.31,000/-
    Cataract with imported foldable lensRs.10,000/-
    HysterectomyRs.22,000/-
    AppendectomyRs.16,000/-
    CholecystectomyRs.18,000/-
    ProstateRs.18,000/-
    Hernia-inguinalRs.16,000/-
    Hernia - ventral/ incisionalRs.20,000/-
    SeptoplastyRs.9000/-

Senior Citizen Mediclaim Policy Premium Chart

The New India Senior Citizen Mediclaim Policy is available at affordable premiums. Here is a premium chart for your easy reference and comparison.

Sum Insured60 Years - 65 Years66 Years - 70 Years71 Years - 75 Years76 Years - 80 Years
Rs.1,00,000Rs.3850Rs.4250Rs.4700Rs.5150
Rs.1,50,000Rs.5720Rs.6310Rs.6980Rs.7650

Exclusions

  • Injury due to invasion, war or an act of the foreign enemy.
  • Medical situations arising out of nuclear weapons and radiation.
  • Vaccination and inoculation.
  • Self-inflicted injury.
  • Drug and alcohol abuse cases.
  • Suicide or attempt to suicide cases.
  • Any type of dental treatment.
  • Plastic surgery.
  • Any type of cosmetic surgery.
  • Hair transplant treatment.
  • Injury while participating in adventurous sports.
  • Any type of treatment related to STD and HIV AIDs.
  • Vitamins and tonics which have been taken by self without hospitalization.
  • Maternity expenses.
  • Any type of naturopathy treatment.
  • Any treatment took outside India.
  • Any domiciliary hospitalization.
  • Any unproven or experimental treatment.
  • Genetic disorders.
  • Stem cell transplantation.

Senior Citizen Mediclaim Policy Review

The New India Senior Citizen Mediclaim Policy has been a great relief to the senior citizens. The plan has been highly liked by both- people serving their retirement and the people planning their retirement. According to policyholders, this plan has been a great support to them while fighting medical situations.

Frequently Asked Questions

Yes, daycare treatment procedures are available under the plan.

Yes, there is loading applied under the New India Senior Citizen Mediclaim Policy on the following basis:

  • 10% loading is applied for renewal age between 81 years to 85 years.
  • 20% loading is applied for renewal age between 86 years to 90 years.

There is an initial waiting period of 30 days under the plan. Any disease diagnosed within the 30 days does not get covered under the plan. But the plan covers any injury due to accident during these 30 days.

No, you can buy the policy only for one-year policy tenure and you can get the policy renewed at the end of the first policy year.

Yes, portability facility is provided under the New India Senior Citizen Health Insurance policy.

Last updated on 12-11-2020