National Health Insurance

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National Health Insurance Overview

National Insurance Company Limited (NICL), India’s one of the largest and oldest general insurance company which provides tailor made and comprehensive insurance plans. 

The company has a series of cost efficient and best health insurance plans for individuals as well as for families which are namely:

  • Overseas Mediclaim Business and Holiday Plan
  • National Parivaar Mediclaim Plan.
  • National Parivaar Mediclaim Plus Plan.
  • Overseas Mediclaim Employment and studies Plan.
  • National Mediclaim Plus Plan.
  • Parivaar Medclaim Plan.
  • National Mediclaim Plan.

Now let’s have an overview of each plan:

Overseas Mediclaim Business and Holiday Plan:

This mediclaim plan covers basically the following group of travellers  namely 

  • Business and Holiday.
  • Employment and Study
  • Corporate Frequent Traveller.

The main features of the plan are:

  • This unique plan covers the risks of travelling abroad.
  • International Service Provider is available for claim support.
  • Other than the case of Employment, the premiums can be paid in Indian Rupees.
  • Service Providers makes payments in foreign currency to Doctors, Hospitals abroad.
  • Insured can claim reimbursement where cashless service is not available.

Eligibility:

Citizens of India, Nepal or Bhutan going abroad for holiday or business purpose or any Foreign Nationals working in India for Indian employers of multi-national organizations getting salary in Indian Rupees.

Coverage:

  • Travellers above 70 years of age and above 60 days of journey, there are certain medical reports from an MD Cardioloist which needs to be submitted with the proposal form which are ECG and fasting blood sugar or urine strip test.
  • In case where the travelers are unable to submit the medical reports, the cover is limited to USD 10000.
  • Traveller needs to incur first USD 100 from his own.

Benefits:

  • Plans which are there under this are Plan A  and Plan B for Business and Holiday which covers illness, medical evacuation, repatriation which starts from 50000 USD to 500000 USD under A1, A2, B1, and B2 plans.
  • Plan B is for Personal Accident and Disablement which starts from 10000 to USD 25000 USD under A1, A2, B1, and B2 plans.
  • Plan C is for Loss of Checked Baggage which starts from 1000 USD to 1000 USD under A1, A2, B1, and B2 plans.
  • Plan D is for Delay of Checked Baggage which starts from 100 USD to 100 USD underA1, A2, B1, and B2 plans.
  • Plan E is for Loss of Passport which starts from 150 USD to 250 USD under A1, A2, B1, and B2 plans.
  • Plan F is for Third Party Bodily Injury and Property Damage which starts from 200000 USD to 200000 USD under A1, A2, B1, and B2 plans.

National Parivaar Mediclaim Insurnace Plan

This plan is a floater plan which covers the entire family including self, spouse, dependent children and parents under one sum assured.

Features and Benefits

  • Pre and Post Hospitalization expenses upto 30 days and 60 days respectively.
  • 140 Plus Day care treatments where 24 hrs hospitalization is not required.
  • Organ Donor hospitalization expenses.
  • Domiciliary treatments are covered till 20% of Sum Insured with maximum limit of Rs 50000/-.
  •  Ayurvedic/ Homoeopathy treatments are also payable under this plan to the extent of full sum insured.
  • Coverage under Maternity New Born upto 10% of Sum Insured subject to Rs 30000 in case of normal delivery and Rs 50000 in case caesarean.
  • Infertility Treatment cover for Rs 50000/-.
  • Anti-rabies vaccination coverage upto Rs 5000/-.
  • Hospital cash benefit per insured person one day Rs 300 maximum of 5 days.
  • Ambulance expenses Upto Rs 1000/- per illness and Rs 2500/- Zone wise rating .
  • In addition to the Sum Insured, a Critical Illness Benefit amount varies from Rs 2 lakhs, RS 3 lakhs, Rs 5 lakhs and Rs 10 lakhs.
  • Good Health Incentive Check up Benefit is given after every 4 years of without claim  upto maximum of Rs 5000/-.
  • A  5 % discount on the base premium for each claim free year is allowed.

Discount

Eligibility & Tenure

Family including self, spouse, dependent children and parents under one sum assured of Rs 1 Lakh to Rs 10 lakhs for a period of minimum 1 year and maximum 3 years. This plan can be renewed life long.

National Parivaar Mediclaim Plus Plan

This plan is a unique plan which covers not only the immediate family members but also the parent in laws as well. There are 3 plans available under these plans which are Plan A, plan B and Plan C. This plan offers a wide range of coverage from Rs 6 lakhs to Rs 50 lakhs.

PLAN A - Rs 6 lakhs- Rs 10 lakhs.

PLAN B - Rs 15 lakhs, Rs 20 lakhs, Rs 25 Lakhs.

PLAN C - Rs 30 lakhs, Rs 40 lakhs, Rs 50 Lakhs.

Features and Benefits

  • Pre and Post Hospitalization expenses upto 30 days and 60 days respectively.
  • 140 Plus Day care treatments where 24 hrs hospitalization is not required.
  • Ayurvedic/ Homoeopathy treatments are also payable under this plan to the extent of full sum insured.
  • Organ Donor hospitalization expenses.
  • Domiciliary treatments for Plan A – Rs 100000, Plan B – Rs 200000 and Plan C- 200000 are covered.
  • Coverage under Maternity New Born Under Plan A Rs 30000 in case of normal delivery and Rs 50000 in case caesarean and for Plan B and Plan C its actual
  • Coverage under Infertility Treatment under Plan A Upto Rs 50000, Plan B and Plan C upto Rs  100000.
  • Anti-rabies vaccination coverage upto Rs 5000/-.
  • Hospital cash benefit per insured person one day for Plan A is for Rs 500 maximum of 5 days, Plan B is for Rs 1000 maximum of 5 days, Plan C is for Rs 2000 maximum of 5 days
  • Ambulance expenses for Plan A 2500, Plan B 4000 and for Plan C 5000.
  • The  Plus features includes Air Ambulance expenses for Plan A is not covered, Plan B and Plan C upto 5% of Sum Insured.
  • Medical Emergency Reunion expenses for Plan A is not covered and under Plan B and Plan C there is no sublimit.
  • Vaccination for children : male upto 12 years  and female upto 14 years for Plan A  upto Rs 1000, for Plan B and Plan C its on the actual.
  • Post hospitalization expenses for Doctor’s home visit and nursing care for Plan A is not covered , for Plan B Rs 1000/ day  maximum of 10 days and for Plan C Rs 2000/ day  maximum of 10 days.
  • In addition to the Sum Insured, a Critical Illness Benefit amount varies from Rs 2 lakhs, RS 3 lakhs, Rs 5 lakhs , Rs 10 lakhs, Rs 15 lakhs, Rs 20 lakhs and Rs 25 lakhs.
  • Good Health Incentive Check up Benefit is given after every 2 years of without claim upto maximum of Rs 5000/- for Plan A, Rs 7500 for Plan B and Rs 10000 for Plan C.
  • Discounts  5% for new policies and 2.5% for renewal policies.

Eligibility & Tenure

Family including self, spouse, dependent children, parents and parent in laws can be covered for a period of minimum 1 year and maximum 3 years. This plan can be renewed life long.

National Overseas Mediclaim Employment and studies Plan

This plan covers basically the following group of travellers  namely 

  • Business and Holiday.
  • Employment and Study
  • Corporate Frequent Traveller.

The main features of the plan are:

  • This unique plan covers the risks of travelling abroad.
  • International Service Provider is available for claim support.
  • Other than the case of Employment, the premiums can be paid in Indian Rupees.
  • Service Providers makes payments in foreign currency to Doctors, Hospitals abroad.
  • Insured can claim reimbursement where cashless service is not available.

Eligibility:

Citizens of India, Nepal or Bhutan going abroad for holiday or business purpose or any Foreign Nationals working in India for Indian employers of multi-national organizations getting salary in Indian Rupees.

Features and Benefits:

  • Plans which are there under this are Plan C  and Plan D for Employment  and Studies which covers illness under Section 1A  which starts from 150000 USD to 500000 USD under C, D, D1,  plans.
  • Section 1B covers for medical evacuation which starts from 10000 USD to USD 25000 USD under C, D, D1, plans.  
  • Section 1C covers for Repatriation which starts from 10000 USD to 10000 USD under under C, D, D1, plans.
  • Section 1D covers for Medical Emergency which starts from 5000 USD to 5000 USD under under C, D, D1, plans.
  • Section II is Contingency Insurance for Sponsored Students is USD 750 for each month of study completed under under C, D, D1, plans.
  • Plan F is for Third Party Bodily Injury and Property Damage which starts from 200000 USD to 200000 USD under under C, D, D1, plans.
  • Plan D1 also includes loss of checked in baggage USD 1000 and delay in checked in baggage USD 100.

Coverage:

  • Travellers above 70 years of age and above 60 days of journey, there are certain medical reports from an MD Cardioloist which needs to be submitted with the proposal form which are ECG and fasting blood sugar or urine strip test.
  • In case where the travelers are unable to submit the medical reports, the cover is limited to USD 10000.
  • Traveller needs to incur first USD 100 from his own.

National Mediclaim Insurance Plus Plan

With increasing costs in medical expenses and rising overheads expenses in every medical sphere, one needs full financial protection for himself and for his family. National Mediclaim Plus Plan therefore provides a full protection against all the unforeseen health emergencies which one might face at point of time. The Policy has three plans which are as follows:

Plan A With Sum Insured of Rs 2 lakhs to  Rs 10 Lakhs

Plan B With Sum Insured of Rs 15 lakhs, Rs 20 lakhs and Rs 25 Lakhs

Plan C With Sum Insured of Rs 30 lakhs, Rs 40 lakhs  and Rs 50 Lakhs

Features and Benefits

  • Pre and Post Hospitalization expenses upto 30 days and 60 days respectively are covered under Plan A , B and C respectively.
  • Ayurvedic/ Homoeopathy treatments are also payable under this plan to the extent of full sum insured under all plans.
  • Organ Donor hospitalization expenses.
  • Pre existing disease is covered after 36 months under all plans.
  • Room/ ICU Charges : Under Plan A room is covered upto 1% of Sum Insured , ICU upto 2% of Sum Insured subject to maximum of Rs 15000/-, under Plan B Rs 15000 and under Plan C Rs 20000/-.
  • Cataract Surgery is covered upto 15% of Sum Insured or Rs 60000 whichever is lower under Plan A, Rs 80000 under Plan B and Rs 100000 under Plan C.
  • Coverage under Maternity New Born Under Plan A Rs 30000 in case of normal delivery and Rs 50000 in case caesarean, for Plan B  it is Rs 60000 in case of normal delivery and Rs 75000 in case caesarean and for Plan C its Rs 80000 for normal delivery and Rs 100000 for caesarean.
  • Hospital cash per day is Rs 500 for Plan A, Rs 800 for Plan B and Rs 1000 for Plan C.
  • Ambulance expenses for Plan A 2500, Plan B 4000 and for Plan C 5000.
  • Air Ambulance expenses for Plan A are not covered, Plan B and Plan C upto 5% of Sum Insured.
  • Medical Emergency Reunion expenses for Plan A is not covered and under Plan B and Plan C its Rs 20000.
  • Vaccination for children :Upto 12 years  Plan A, B and C  upto Rs 1000.
  • Post hospitalization expenses for Doctor’s home visit and nursing care for Plan A is not covered , for Plan B Rs 750/ day  maximum of 10 days and for Plan C Rs 1000/ day  maximum of 10 days.
  • In addition to the Sum Insured, a Critical Illness Benefit amount varies from Rs 2 lakhs, RS 3 lakhs, Rs 5 lakhs , Rs 10 lakhs, Rs 15 lakhs, Rs 20 lakhs and Rs 25 lakhs.
  • Good Health Incentive Check up Benefit is increase in Sum Insured by 5% of Sum Insured per year upto 50% of Sum Insured under all plans.
  • Discounts  5% for new policies and 2.5% for renewal policies.

Eligibility & Tenure:

Family including self, spouse, dependent children and parents are covered. The entry age of the proposer should be minimum 18 years and maximum 65 years. Children aged 3 months to 18 years are also covered. For additional members the coverage is 18 years to 65 years. This plan can be renewed life long.

Parivaar Medclaim Plan by National Insurance

This plan provides protection against the expenses in hospitals for illness/ disease/ accidental injury. Parivaar Mediclaim Plan is a floater Policy which includes self, spouse and two dependent children under a single floater sum insured.

Features and Benefits

  • Room, Boarding and RMO expenses – 1% of sum insured per day for normal room and 2% of sum insured per day for ICU.
  • Surgeon, Medical Practitioner, Consultant, Specialist Fees, Anesthetist and Nursing expenses.
  •  Pre and Post hospitalization expenses for 15 & 30 days respectively.
  • Expenses incurred for blood, oxygen, OT charges, surgical appliances, X-ray, chemotherapy, radiotherapy, artificial limbs, diagnostic material, and dialysis.
  • One can get cashless facility through TPA.

Eligibility & Tenure

Individuals aged between 18 years to 60 years can apply for this plan. Children aged 3 months to 25 years are also covered. For additional members the coverage is 18 years to 65 years. This plan can be renewed upto 65 years.

National Mediclaim Plan by National Health Insurance

This plan provides protection against the expenses in hospitals for illness/ disease/ contracted injury. Parivaar Mediclaim Plan is a floater Policy which includes self, spouse and two dependent children under a single floater sum insured.

Features and Benefits

  • Room, Boarding and RMO expenses – 1% of sum insured per day for normal room and 2% of sum insured per day for ICU subject to an overall limit of 25% of the sum insured.
  • Surgeon, Medical Practitioner, Consultant, Specialist Fees, Anesthetist and Nursing expenses subject to an overall limit of 25% of the sum insured.
  •  Pre and Post hospitalization expenses for 15 & 30 days respectively.
  • Expenses incurred for blood, oxygen, OT charges, surgical appliances, X-ray, chemotherapy, radiotherapy, artificial limbs, diagnostic material, dialysis and hospitalization expenses of organ donor subject to an overall limit of 50% of the sum insured.
  • Ambulance Charges upto 1% of the sum insured subject to a maximum of Rs 2000/- in a policy period.
  • One can get cashless facility through TPA in more than 6000+ network hospitals.
  • 140 + Day care expenses are covered.
  • Ayurveda and Homeopathy treatments are also covered upto 20% of sum insured.
  • One can enjoy a family discount of 10%.
  • Good health Incentives are applicable here

Eligibility & Tenure

Individuals aged between 18 years to 65 years can apply for this plan. Dependent parents can be covered and  children aged 3 months to 18 years are also covered provided one of the parents is also covered simultaneously. This plan can be renewed upto 65 years.

National Health Insurance - FAQs

1. How to pay a premium? What are the modes of payment available?

The National Insurance Company offers 2 modes of premium payment namely:

  • Cash payment at the branch
  • Online Payment

For the online payment mode, the policyholder can pay via;

  • Credit Card,
  • Debit Card
  • Net banking

2. How can I check policy status for National health insurance?

To check policy you can log into thee-Portal with your valid credentials.

3. What is the policy renewal process for National health insurance?

Registered policyholders can pay online in 3 easy steps
Step1: Enter your Policy Number and Date of Birth to login into e-portal
Step2: Select the payment option- Debit/Credit Card or Net Banking
Step3: Print/save the premium deposit receipt upon successful payment
Alteranatively, you can renew by Mobile

4. What is the company’s process to settle claim for National health insurance?

You need to fill the claim form and attach it with relevant documents to the Policy issuing office either directly or by an authorised Agent. Upon satisfactory evaluation, the claim will be settled in full within a few days.

5. What is the policy cancellation process for National health insurance?

Walk into your nearest branch with your policy documents and a duly filled surrender form. Upon successful acceptance at the counter, your policy will be cancelled and refunds directly credited in your bank account.

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National Health Insurance Reviews

TOTAL REVIEWS (1)
Gajendra
Surat
December 20, 2015

Good Plan!!

My health insurance policy has been taken from National Health Insurance. I had undergone with an accident which got covered by National health insurance. The insurance also covered all kinds of major diseases. The premium I used to pay was 2000 on the yearly basis. The customer services provided by them are also good and the whole procedure is simple and easy to great into.