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National Health Group Mediclaim Policy vs Mediclaim Policy

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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:

  • Sum Insured: INR 50,000 - INR 5 Lakhs (in multiples of INR 50,000)
  • Sum Insured: INR 6 Lakhs - INR 10 Lakhs (in multiples of INR 1 Lakh)

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


Mediclaim Policy

Premium Including GST
Product Type Group Health Insurance Individual and Family Health Insurance
Key Features
(Key features of the plan)
  • Coverage for modern treatment
  • Covers HIV/AIDS treatment
  • Covers 140+ daycare procedures
  • Wide Coverage Options
  • Same Rates of Premium
  • Key Features and Benefits
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 Not 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 3000
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 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 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 Not Covered
Co-pay
(Mentioned %, if any is to be borne by Insured and rest will be borne by insurer)
Covered Covered
Plan Entry Age Min- 3 Months, Max- No Limit 18 Year to no age limit
Plan Premium Entry Age and S/A 1,404 5,691
Plan Waiting Period 30 30
Plan Coverage In-patient hospitalisation expenses, Pre and post hospitalisation cover, Daycare procedures, Organ donor and ambulance expenses -
Plan Sample Premium 1,404 5,691
Plan Brochure Brochure URL Brochure URL
Policy Term 1, 2, 3 Years 1 Year
ICU Charges Covered Covered
Covid-19 Treatment Covered Covered
Cataract Covered Covered
Automatic Restoration Not Covered Not 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 90.73
Solvency Ratio -0.67 1.91
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