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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:
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 DETAILS |
National Health Group Mediclaim Policy |
Arogya Top Up Policy |
| Product Type | Group Health Insurance | Individual and Family Health Insurance |
| Key Features (Key features of the plan) |
|
|
| OPD Details (In some policies, OPD (Out patient department) expenses are also covered.) |
Not Covered | Not Covered |
|
Room Rent (A limit of room rent cover during hospitalization if any) |
Covered | Covered |
| Domicillary Hospitalization (It is the expenses incurred on treatment of the patient at home) |
Not Covered | Covered |
| Pre-hospitalization (Expenses before the insured is hospitalized) |
Covered | Covered |
| Post-hospitalization (Expenses after discharge from the hospital) |
Covered | Covered |
| Day Care Treatment Covered (Day care treatments refers to the treatments that do not necessarily require 24hrs of hospitalization like MRI.) |
Covered | Covered |
| Hospital_network (Number of Hospital Network in city) |
3200 | 6000 |
| Organ Donor Expenses (Expenses incurred on organ donor in case of organ transplants) |
Covered | Covered |
|
Hospital Daily Allowance (Some plans offer daily allowance to take care of expenses like food, etc) |
Not Covered | Not Covered |
| Ambulance Charges (Expenses incurred on ambulance charges) |
Covered | Covered |
|
Maternity Benefits (All Hospitalization cost covered at the time of pregnancy.) |
Covered | Covered |
| New Born Baby Covered (Newborn babies can be covered under the insurance plan after a certain period) |
Covered | Not Covered |
| Health Checkup (An added benefit of one time full health checkup of policy holder.) |
Not Covered | Covered |
|
Sub Limit (Sub-limit is a monetary capping that applies on specific diseases like cataract) |
Covered | Covered |
| Co-pay (Mentioned %, if any is to be borne by Insured and rest will be borne by insurer) |
Covered | Not Covered |
| Plan Entry Age | Min- 3 Months, Max- No Limit | 3 Months to 65 Years |
| Plan Premium Entry Age and S/A | 1,404 | 200 |
| Plan Waiting Period | 30 | 30 |
| Plan Coverage | In-patient hospitalisation expenses, Pre and post hospitalisation cover, Daycare procedures, Organ donor and ambulance expenses | Individual/Family Floater |
| Plan Sample Premium | 1,404 | 200 |
| Plan Brochure | Brochure URL | Brochure URL |
| Policy Term | 1, 2, 3 Years | 1 / 2 / 3 year |
| ICU Charges | Covered | Covered |
| Covid-19 Treatment | Covered | Covered |
| Cataract | Covered | Covered |
| Automatic Restoration | Not Covered | Covered |
| Ayush Treatment | Covered | Covered |
| Modern Treatment | Covered | Covered |
| E Consultation | Not Covered | Not Covered |
| Air Ambulance | Not Covered | Not Covered |
| Global Coverage | Not Covered | Not Covered |
| Claim Ratio | 91.31 | - |
| Solvency Ratio | -0.67 | 2.03 |
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