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National Senior Citizen Mediclaim Health Insurance

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National Health Insurance
National Senior Citizen Mediclaim
Claim SettlementDedicated Team
Claim Settlement Ratio83.78%
Network Hospitals6,000+
RenewabilityLifelong
Starting Premium for 5 lac SIRs.586/month
Starting Premium for Rs. 5 lakhs SIRs. 586/month

About National Senior Citizen Mediclaim Health Insurance

National Senior Citizen Mediclaim Policy is an indemnity-based medical insurance policy especially designed for senior citizens aged between 60 years and 80 years (50 years to 80 years for the spouse if added on a family floater basis). The policy comes in two plan variants namely Plan A and Plan B, with sum insured options ranging between Rs. 1 Lakh and Rs. 10 Lakh in multiples of Rs. 1 Lakh, on individual or family floater sum insured basis. If covered under National Senior Citizen Mediclaim Policy, you can avail several coverage benefits. Some of these include in-patient treatment for allopathy, ayurveda, and homeopathy, domiciliary hospitalisation, more than 140 day care procedures, 30 days pre-hospitalisation and 60 days post-hospitalisation expenses, organ donor expenses, road ambulance expenses, correction of refractive error, etc.

National Senior Citizen Mediclaim Policy is one of the few health insurance plans that offer cover for mental illness as well. Another highlight of the policy is that it covers you for modern treatments as well, such as immunotherapies, robotic surgery, etc. If covered under the policy, you can avail portability benefits, tax benefits under Section 80D of the Income Tax Act, 1961, lifelong renewability benefit, and free look period. Kindly note that the initial waiting period under the policy is of 30 days (except for accidental injuries), after which you can start availing the coverage benefits.

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Key Inclusions and Exclusions of the Plan

What's Included

  • Road ambulance expenses are covered under this plan
  • In-patient hospitalisation expenses
  • Allopathy, Ayurveda, and Homeopathy treatments
  • Domiciliary hospitalisation expenses for up to 20% of the sum insured
  • 30 days pre-hospitalisation and 60 days post-hospitalisation expenses
  • 12 modern treatments such as robotic surgery, immunotherapies, robotic surgery, etc.

What's Not Included

  • Claims arising due to accidents payable in the first 30 days after policy purchase
  • Pre-existing diseases until 24 months of policy purchase
  • Change of gender treatments, cosmetic surgery, etc.
  • Any drugs purchased without any prescription
  • Expenses related to home visit
  • Dental treatment unless necessitated due to accident and requires hospitalisation

Claim Process at National Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 72 hours prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 72 hours and for planned hospitalisation intimate within 72 hours prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

FAQs on National Senior Citizen Mediclaim Health Insurance Plan

  • What is the eligibility for National Senior Citizen Mediclaim Policy if purchased on individual or family floater basis?

    Senior citizens can buy National Senior Citizen Mediclaim Policy on an individual basis, if they are aged between 60 years and 80 years at inception. Also, they can buy it when self and spouse are both aged between 60 years and 80 years at the time of inception. On family floater basis, the policy can be availed for self and spouse together, where self is aged between 60 years and 80 years and spouse is aged between 50 years and 80 years at inception. 

  • Will I get cumulative bonus if I get covered under National Senior Citizen Mediclaim Policy?

    Yes. One of the renewal benefits that you can enjoy if covered under National Senior Citizen Mediclaim Policy is cumulative bonus. It will increase by 5% for every claim free year, subject to a maximum of 50% of existing sum insured. The cumulative bonus shall decrease by 5% of the sum insured, in case you make a claim during the policy period. 

  • Is there any optional cover under the National Senior Citizen Mediclaim Policy offered by the National Insurance Company?

    Yes. If covered under the National Senior Citizen Mediclaim Policy offered by the National Insurance Company, you can avail the following optional covers: 

    • Critical illness
    • Outpatient treatment
    • Personal accident
    • Pre-existing hypertension and/or diabetes
  • What is the sum insured range offered under National Senior Citizen Mediclaim Policy offered by the National Insurance Company?

    National Senior Citizen Mediclaim Policy is available for sum insured on both, i.e. individual basis and family floater basis. Plan A and B come with 10 slabs, between Rs. 1 Lakh and Rs. 10 Lakh in multiples of Rs. 1 Lakh. Whereas, Plan B comes with additional features like hospital cash, no sub-limits for room rent, reinstatement of sum insured, funeral expenses etc. 

  • What are the waiting periods under the National Senior Citizen Mediclaim Policy offered by the National Insurance Company?

    National Senior Citizen Mediclaim Policy offered by the National Insurance Company comes with the following waiting periods: 

    • Pre-existing diseases are covered after a waiting period of 2 years
    • Initial waiting period of 30 days for any claim except accidental injuries
    • Waiting period of 90 days/one year/two years/or four years for specific diseases

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