National Health Insurance

National Health Insurance can be the right choice for anyone looking for health coverage. National Insurance health insurance plans are designed to cater to the various insurance needs of the individuals and can be easily purchased online as well. The insurer comes with vast network hospital facility where one can avail cashless benefits PAN India. Health insurance policies are highly sought because of their unique features and benefits offered. Tax benefits, cashless benefits, add-on covers, overseas coverage etc. are some of the attractive features of National health insurance policies.

National Insurance Company Limited or NIC is fully backed by the Central Government of India. Founded in the year 1906 and nationalized in 1972, the company’s head office is in Kolkata. Being one of the oldest General Insurance Companies in India, the insurer claims to have a steady growth in terms of insurance business with a premium income of Rs 9000 Crores. The insurer is popular for offering health plans with comprehensive coverage and customizable as per one’s need.  From individual health insurance and floater plans to overseas medical insurance, the insurer tries its best to provide the best insurance solutions to the people from every walk of life. With around 1340 offices, the insurer has its global presence in Nepal as well. Its tie-ups with 6000+ network hospitals across India, enable the customers to avail cashless healthcare services without compromising on the quality and savings.


*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply.

National Health Insurance at a Glance:

Key Features

Highlights

Network Hospitals

6000+

Incurred Claim Ratio

115.55

Renewability

Lifelong

Waiting Period for Pre-existing Illness

4 years

List of National Health Insurance Plans

The various health insurance policies offered by National Insurance can be categorised as follows:

  • National Mediclaim Plus Policy
  • National Mediclaim Individual Policy
  • National Senior Citizen Mediclaim Policy
  • National Super Top-up Mediclaim Policy
  • Vidyarthi Mediclaim Policy for Students
  • Parivar Mediclaim Policy for Family
  • National Parivar Mediclaim Policy
  • National Parivar Mediclaim Plus Policy
  • National Critical Illness Policy
  • Varishtha Mediclaim Policy for Senior Citizens
  • National Overseas Mediclaim Policy
  • National Overseas Mediclaim Employment & Studies

Let’s have a detailed glance at these plans from National Health Insurance here:

  • National Mediclaim Plus Policy (Individual Plan)

    National Mediclaim Plus Policy is an individual health plan that offers extensive insurance coverage for in-patient treatment expenses, where  the sum insured ranges from Rs 2 lakhs to Rs 50 lakhs. The policy comes with three plan options i.e. Plan A, B and C with different SI slabs for each. One of the plan attractions is an annual increase of SI up to 5% for every claim-free year.

    Eligibility Criteria:

    The minimum eligibility criterion for availing this policy is:

    Minimum Entry Age

    18 years

    Maximum Entry Age

    65 years

    Who can be covered

    Self, spouse, children, parents and dependent siblings up to the age 25 years

    Features:

    The salient features of National Mediclaim Plus Policy include:

    • The policy comes with high sum insured option up to Rs 50 lakhs
    • Discounts for buying this policy online up to 10% for family and youth in c
    • Air ambulance, maternity cover, medical emergency reunion, hospital cash benefit, vaccinations for children
    • Optional cover Critical Illness Benefit up to a sum insured of Rs 25 lakhs
    • Annual increase in policy sum insured up to a maximum of 50% of the SI for every claim-free year

    Benefits:

    • The benefits of this policy are mentioned below:
    • Pre and Post Hospitalization expenses up to 30 days and 60 days respectively 
    • Ayurveda/ Homoeopathy treatments are also payable under this plan to the extent of the full sum insured under all plans
    • Organ Donor hospitalization expenses
    • Pre-existing disease is covered after 36 months under all plans
    • Room/ ICU Charges: 
      • Plan A- 1% of Sum Insured
      • Plan B- Rs 15000 
      • Plan C Rs 20000
    • Cataract Surgery is covered up to a limit as per mentioned in the policy brochure
    • 140-daycare procedures are also covered under this plan
    • Coverage is provided for maternity, new-born baby care, and vaccinations
    • Hospital cash per day limit is Rs 500 for Plan A, Rs 800 for Plan B and Rs 1000 for Plan C
    • The coverage limit for Ambulance expenses for Plan A is Rs 2500, Plan B is Rs 4000 and for Plan C is Rs 5000
    • Air Ambulance expenses for Plan A are not covered, Plan B and Plan C offer coverage up to 5% of the Sum Insured
    • Medical emergency reunion expenses cover under Plan B and Plan C is up to Rs 20,000
    • The policy also covers post-hospitalization expenses for doctor’s home visit and nursing care during post hospitalisation
    • In addition to the Sum Insured, Critical Illness Benefit is offered and the sum insured ranging from Rs 2 lakhs, Rs 3 lakhs, Rs 5 lakhs, Rs 10 lakhs, Rs 15 lakhs, Rs 20 lakhs to Rs 25 lakhs
    • Good health incentive check-up benefit after four claim-free years
    • Tax-rebate under Section 80D of the Income Tax Act
  • National Mediclaim Individual Policy

    National Mediclaim Individual is a health insurance policy that offers extensive insurance coverage for in-patient treatment expenses, where the sum insured ranges from Rs 50,000 to Rs 5 lakhs. It is an individual policy where the policyholder can include its spouse, children, parents, parents-in-law, dependent brother and sister.

    Eligibility Criteria:

    Minimum Entry Age

    18 years

    Maximum Entry Age

    65

    Who can be covered?

    Self, spouse, children, parents and dependent siblings up to the age 25 years

    Features:

    Some of the features of this plan are mentioned below:

    • The policy comes with high sum insured available up to Rs 5 lakhs
    • Free health check-up facility is offered once a year after completion of four claim-free year
    • 10% discount for purchasing the policy for your family
    • Tax-rebate under Section 80D of the Income Tax Act
    • Pre policy health check-up is required for applicants after the age of 50 years 
    • Annual increase in policy sum insured up to a maximum of 50% of the SI for every claim-free year
    • The policy can be renewed for a lifetime

    Benefits of National Mediclaim Individual Policy

    Some of the alluring benefits of National Mediclaim individual policy are:

    • Allopathy treatment expense up to 100% of SI, Ayurveda and Homeopathy expense cover up to 20% of the total sum insured
    • In-patient expenses cover including room rent/ICU charges, Medical practitioners’ expenses, anaesthetist, surgeon, consultants, specialist’s consultation fees up to a certain limit of the sum insured
    • The policy covers Ambulance charges 
    • Organ Donor’s expenses covered up to specific SI
    • Pre-hospitalisation expenses are covered for 30 days
    • Post hospitalisation expense are covered for 60 days from the date of discharge
    • Cashless facility is available at any of the network hospitals of National Insurance only through TPA
    • Pre-negotiated package rates for specific surgeries or medical procedure in-network hospitals
    • The insured can enjoy the benefits of lifelong renewability
    • The insurer allows policy portability from/to similar product
  • National Senior Citizen Mediclaim Policy

    National Senior Citizen Mediclaim Policy is an indemnity health insurance plan for aged people above the age of 60 years. The coverage can be availed for self or self and spouse both. Check out what the plan has to offer in detail below:

    Eligibility Criteria:

    Entry Age

    60-80 years

    Sum Insured

    Rs. 1 lakh to Rs. 10 lakhs

    Coverage Type

    Individual/Floater

    Features:

    • The policyholder can cover spouse within the age group of 50 to 80 years in the same plan
    • Discounts on the online purchase without any intermediary
    • Pre-medical screening is required
    • NCB ranging from 5% to 50% for claim-free years
    • Pre-existing diseases are covered after a waiting period of 2 years
    • The plan is renewable for lifetime

    Benefits:

    • HIV treatment & Mental illness hospitalization covered
    • Pre-existing diseases are covered after a waiting period of 2 years
    • The policyholder can also avail optional cover for expenses incurred on Critical illnesses, OPD, Personal accident, Hypertension and pre-existing medical conditions
    • Allopathy, Ayurveda, and Homeopathy expenses are also covered
    • This unique plan also offers coverage for mental illnesses and HIV treatment expenses
  • National Super Top-up Mediclaim Policy

    Eligibility Criteria:

    Entry Age

    18 to 65 years

    Sum Insured

    Rs. 3 lakhs to 10 lakhs (as per the threshold)

    Coverage Type

    Individual/Floater Basis

    Features:

    • It can be purchased with a base policy and without a base policy
    • Cashless hospitalization cover is provided
    • Lifetime policy renewal option is provided
    • No sub-limits are applicable on room rent charges
    • Pre-medical screening is required for applicants above the age of 50-years

    Benefits:

    • The policy also offers coverage for commonly excluded diseases such as HIV/AIDS, Obesity- bariatric surgery etc.
    • Organ donor expenses are also reimbursed
    • In-patient medical expenses, ICU, surgeon fees etc. are a paid by the insurer
    • Coverage is provided to self, spouse, parents, in-laws, and new-born baby
    • Pre-existing diseases can be covered after a waiting period of 1-year only
  • Vidyarthi Mediclaim Policy for Students

    Vidyarthi Mediclaim plan is a health insurance policy for Students. It offers medical insurance cover as well as Personal accident cover to the insured students. The policy is worth buying as it also offers education cover to the insured student in the event of permanent total disability and accidental death of the guardian. The policy details are given below:

    Eligibility Criteria:

    Entry Age

    3-35 years for students and one legal guardian

    Sum Insured

    RS. 50,000 to Rs. 2 lakhs

    Coverage Type

    Features:

    • Pre-policy medical check-up is required
    • Student from any Registered Educational Institution that is affiliated to a Govt. Statutory Authority, State Board, or AICTE within India can buy this policy
    • Educational Institutions can also buy this as Group Policy

    Benefits:

    • Hospitalization expenses for students are covered up to SI
    • Personal Accident Cover for parents and insured students is also offered
    • The insurer compensates for doctors and surgeon fees, ICU charges, room rent charges, and the likewise
    • Cumulative Bonus of 5% is offered
    • Accidental death and bodily injuries are also covered
  • National Parivar Mediclaim Policy for Family

    National Parivar Mediclaim is a health insurance policy that covers all the covers all family members under a single health plan. The coverage is provided for In-patient treatment expenses that require more than 24-hours of hospitalization. The policy offerings are mentioned below:

    Eligibility Criteria:

    Entry Age

    18-65 years

    Sum Insured

    Rs 2 lakhs and Rs 5 lakhs

    Coverage Type

    Family Floater

    Features:

    • Self, spouse, and two children can be covered under the same plan
    • Pre-policy medical check-up is not mandatory
    • Lifetime policy renewal option is provided
    • Cashless medical treatment at network hospitals

    Benefits:

    • Pre and post hospitalization expenses are covered for 15 days and 30 days respectively
    • 140 day-care procedures are covered too
    • Add-on cover for hypertension and pre-existing diabetes is also offered on payment of an additional premium
    • In-patient medical expenses, ICU, surgeon fees etc. are a paid by the insurer
  • National Parivar Mediclaim Policy

    National Parivar Mediclaim is a health insurance policy that covers self, spouse, children, and parents under a single plan. If the insurance cover has been acquired by one person, it can as well be used to cover the whole family. This cover, provided by the National Health Insurance has the following features and benefits:

    Eligibility Criteria:

    Entry Age

    18 -60 years

    Sum Insured

    Rs. 1 lakh to Rs. 10 lakhs

    Coverage Type

    Family Floater

    Features:

    • The premium subscribers are offered a discount of 5% annually
    • The insurer offers health incentive check-up benefit

    Benefits:

    • The National Health Insurance scheme covers the expenses of people wishing to donate their organs
    • In case of any complication when donating organs; the insurance cover pays for all the expenses
    • Expense incurred on the anti-rabies vaccine for children are covered up to the limit of Rs. 5000
    • Besides, day care treatments are also covered
    • It also offers a cover for ambulance expenses for around Rs 1000 for every illness.
    • Maternity expenses including the new-born baby are also recompensed up to a specified limit
  • National Parivar Mediclaim Plus Policy

    National Parivar Mediclaim policy is a high sum insured health insurance policy. It has a unique feature, this is because not only does it cover the family members, but it covers the in-laws also.

    Eligibility Criteria:

    Entry Age

    18-65 years

    Sum Insured

    Rs. 2 lakhs to Rs. 50 lakhs

    Coverage Type

    Individual/Family Floater

    Features:

    • It offers Allopathy, Ayurveda, and Homeopathy Cover
    • It has a minimum coverage of 1 year and a maximum of 3 years
    • The policy is renewable for lifetime
    • Children can also be covered in the same plan
    • Option to avail air ambulance facility

    Benefits:

    • ICU patients with this plan are charged 2% lower of the summed cost than those without this kind of plan
    • It also covers the pre and post-natal charges and when the new-born arrives, they get free vaccination
    • Children over 12 years of age are also vaccinated under this plan
    • Airlifted patients who are in plan A are not covered by this national insurance Mediclaim plus policy
    • However, those who fall in plan B and C are covered and therefore they get these services at a reduced cost by 5%
    • In addition to this, patients undergoing catalyst surgery in plan A, plan B and plan C get a 15% discount, therefore they don’t have to worry about their payments because they get to pay almost half of their hospital bills
    • Another feature is for those in plan A, their medical reunion expense in this plan are not covered
    • Optional critical illness cover, maternity and the new-born baby cover is also provided
  • National Critical Illness Policy

    National Critical Illness is a health insurance policy that covers expenses incurred on the treatment of life-threatening conditions. The plan comes in two variants and its features and benefits are listed below:

    Eligibility Criteria:

    Entry Age

    20-65 years

    Sum Insured

    Rs. 1 lakh- Rs. 75 lakhs

    Coverage Type

    Individual/Family Floater

    Features:

    • The policy is renewable until 65 years of age
    • Pre-medical screening is required only for applicants above the of 45 years

    Benefits:

    • This policy offers coverage to self, spouse, parents, and dependent children
    • 11 critical illnesses are covered under Plan A
    • 37 critical illnesses are covered under Plan B
    • Pre-existing diseases can be covered on paying an additional premium
    • Lumpsum payment is made upon diagnosis of the listed critical illnesses
  • National Varishtha Mediclaim Policy for Senior Citizens

    National Varishtha Mediclaim is a health insurance policy for senior citizens up to the age of 80 years. First-time applicants need to undergo medical screening to get insured under this scheme. Check out the policy features and benefits in detail below:

    Eligibility Criteria:

    Entry Age

    60-80 years

    Sum Insured

    Rs. 1 lakh for domiciliary hospitalization

    Rs. 2 lakhs for Critical Illness Optional Cover

    Coverage Type

    Features:

    • A specific plan for elderly people
    • It also offers critical illness add-on cover
    • The policy is renewable for lifetime
    • No-claim Bonus offered ranging from 5% to 50% of the sum insured
    • Tax rebate is provided to the policyholder under section 80D

    Benefits:

    • Hospitalisation expenses and Domiciliary Hospitalisation expenses are covered up to Rs. 1 lakh
    • This health scheme also pays for fees charged by a medical practitioner, room rents, ICU charges, surgeon fees, specialist fees up to a specified limit
    • The coverage limit for cataract surgery is up to Rs10, 000 and Rs 20,000 for Benign Prostatic Hyperplasia (BHP)
    • Domiciliary Hospitalisation expenses are covered up to 20% of the sum insured
    • The policy covers up to 8 specific critical illnesses and the sum insured limit is up to Rs 2 lakhs
    • Health Check-up facility up to 2% of SI after completion of 3-years of the policy term
  • Overseas Mediclaim Business and Holiday

    National Overseas Mediclaim Business and Holiday is a packaged insurance policy for people who travel abroad. The policy covers the medical emergencies while travelling abroad. The policy can be availed in three categories namely: Business & Holiday, Employee & Study and Corporate Frequent Flyer.

    Eligibility Criteria:

    The policy can be purchased by the following individuals:

    For Indians

    Citizens of India, Nepal or Bhutan going abroad for holiday or business purpose

    For Foreign Nationals

    Foreign Nationals working in India for Indian employers of multi-national organizations getting salary in Indian Rupees

    Features of this Plan

    • Some of the features of Overseas Mediclaim policy are:
    • This unique plan covers the various risks associated while travelling to a foreign country including medical emergencies
    • International Service Provider is available for claim support
    • Other than the case of Employment, the premiums can be paid in Indian Rupees
    • Service Providers to make payments in foreign currency to the Doctors, and Hospitals abroad
    • Insured can claim reimbursement where cashless service is not available
    • Delay in Checked-in Baggage cover only for outbound I-international flight and the delay should be for over 12 hrs
    • Travellers above the age of 70 years where the travelling duration is above 60 days will have to submit certain medical reports such as ECG and Fasting Blood Sugar or Urine Stripe Test

    Benefits of Overseas Mediclaim Policy

    • Available in 5 plan sections, the benefits to be availed under this plan include the following:
    • Medical expenses & repatriation under Section A
    • Personal accident cover under Section B
    • Delay of checked-in baggage under Section C
    • Loss of checked-in baggage under Section D
    • Loss of passport under Section E
    • Personal liability cover under Section F
  • Overseas Mediclaim Employment and Studies

    This policy comes in handy in covering travel-related emergencies while abroad. Available in three categories namely: Business & Holiday, Employee & Study and Corporate Frequent Flyer, the maximum sum insured offered under this policy for covering illnesses is USD 5,00,000.

    Eligibility Criteria:

    The policy can be purchased by the following individuals:

    For Indians

    Citizens of India, Nepal or Bhutan going abroad for holiday or business purpose

    For Foreign Nationals

    Foreign Nationals working in India for Indian employers of multi-national organizations getting salary in Indian Rupees

    Features:

    • The key features of this plan are as follows:
    • This unique plan covers the risks of travelling abroad such as medical emergency
    • International Service Provider is available for claim support
    • Other than the case of Employment, the premiums can be paid in Indian Rupees
    • Service providers to make payments in foreign currency to doctors, hospitals abroad
    • Insured can claim reimbursement where cashless service is not available
    • Travellers above the age of 70 years where the travelling duration is above 60 days will have to submit certain medical reports such as ECG and Fasting Blood Sugar or Urine Stripe Test

    Benefits:

    The list of benefits under this plan are mentioned below:

    Under Plan C and Plan D-Employment & Studies

    • Section 1 A: Illness cover ranging from 150000 USD (Plan C), 1,50,000 (Plan D) and 500000 USD (Plan D1)
    • Section 1B: Medical evacuation expenses 10000 USD for three variants C, D and D1  
    • Section 1C: Repatriation cover of 10000 USD for three variants C, D and D1  
    • Section 1D: Medical Emergency cover of 5000 USD for three variants C, D and D1  
    • Section II: Contingency Insurance cover of USD 750 for each month of study completed under three plan variants

    Plan D1: Loss of checked-in baggage for USD 1000


*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply.

National Health Insurance Claim Process

The insurer provides seamless claim settlement so that the customers don’t face any difficulty in the hour of need. National health insurance offers both cashless and reimbursement claim facility.

Cashless Claim: This type of claim can be availed only at network hospitals of the insurer. The claim is registered only through a TPA at the hospital. The steps for filing the claim are as mentioned below.

  • In case of the planned hospitalization, the insurer needs to be informed 72 hours prior to the admission
  • If it is an emergency hospitalization then you need to inform the TPA within 24 hours of the hospitalisation
  • On admission, the insured has to fill pre-authorisation letter and duly get it signed by the treating doctor(s) and submit it to the TPA. This is for seeking permission to avail cashless hospitalization benefits
  • All documents are to be submitted along with the claim form
  • Upon receiving the request, the insurer conveys its decision to the hospital authority with 72 hours. If it is confirmed, the hospital bills are settled directly by the insurer.

Reimbursement Claim: This type of claim requires the insured to pay the hospital bills initially and register a reimbursement claim later. The insurer has to be informed through mail/fax/written intimation about the hospitalization.

  • The insurer needs to be intimated 72 hours prior in case of planned hospitalization and after 72 hours in case of an emergency hospitalization
  • The bills are to be paid at the bill desk at the time of discharge and collect the necessary receipts, certificates, reports etc.
  • All the documents in original are required to be submitted along with the claim form duly filled by the insured. All these are to be handed over to the TPA within 15 days from the date of discharge
  • One can claim pre and post hospitalisation expenses separately. In this regard, documents are to be submitted after 15 days from completion of post-hospitalization treatment

National Insurance Mediclaim Premium Calculator

National Insurance Mediclaim Premium Calculator helps you decide on the right plan that best fits your requirements. The national insurance premium calculator has a pre-determined set of the algorithm, which is designed to evaluate the payable premium depending on the insurance policy that you’re purchasing. A premium calculator makes the process easier. All you need to do is to fill your requirements and get the results online.

The premium calculator is a useful tool, which helps you understand the health insurance policy terms to some extent. It estimates the premium amount that has to be paid by taking these terms into consideration. Below are some of the benefits of using National Insurance premium calculator:

  • Comparison: National Insurance premium calculator allows you to compare different plans and make a wise decision regarding the purchase of the policy.
  • Comprehensive Estimate: You can estimate the premium payable during the term of your policy using the premium calculator. This will assist you in managing future payment deductions.
  • Discounts: Attractive discounts can be availed while buying a policy online. The premium calculator gives you a rough idea of the premium amount and gives you a direct link to buy the policy.
  • Reliability: National Health Insurance Premium Calculator is a reliable online tool. Your premium is evaluated basis the policy terms and the details you have fed.

Steps to Renew National Health Insurance Online 

In order to ensure that you and your family members are covered for future contingencies, do consider National insurance Mediclaim renewal a prime necessity of yours.

To renew the National insurance Mediclaim policy, you need to provide your existing policy number along with certain personal details, such as your name, current age, gender, and updated contact details. Since National insurance Mediclaim renewal can be done online, it goes without saying that National health insurance policy renewal process is smooth and quickly assists you with the instant policy renewal.

The mentioned below are the steps to renew National health insurance online.

  • To renew National Insurance Mediclaim policy online, visit the official website of National Insurance Company
  • Go to the ‘Renewal’ option from the dropdown menu on the home page
  • This will lead you to a page asking for your policy details
  • Mention the policy number and other related information
  • Select a payment mode from different given option such as internet banking or Debit/Credit Card
  • On successful payment of premium, a confirmation notification will be received from the insurer, confirming the renewal of the policy and same will be mailed to the registered id
  • The policy soft copy or receipt can be downloaded easily online

National Health Insurance Customer Care:

National health insurance customer care is responsible for providing information regarding your National health insurance policy, how to register a claim, assist you in claim settlement, handling phones regarding queries, updating insurance records etc. To reach out to National Health customer care- call @ 22831705 or mail them at customer.relations[at]nic.co.in.

National Health Insurance - FAQs

Written By: PolicyBazaar - Updated: 12 November 2020
Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.
Average Rating
(Based on 1 Reviews)

National Health Insurance Reviews & Ratings

4.3 / 5 (Based on 1 Reviews)
(Showing Newest 1 reviews)
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.

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