National Senior Citizen Mediclaim Plan

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      National Senior Citizen Mediclaim Plan

      The National Senior Citizen Mediclaim plan is designed to cater to the health needs of senior citizens up to the age of 80 years. This senior citizen health insurance policy provides coverage for in-patient hospitalization, ambulance charges, HIV/AIDS, domiciliary hospitalization, mental illness and funeral expenses. It also comes with a cumulative bonus and reinstatement of the sum insured benefit in case of accidents.

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      National Senior Citizen Mediclaim Plan: Key Highlights

      Categories Specifications
      Sum Insured Rs 1 lakh to Rs 10 lakh
      Policy Tenure 1 year
      Network Hospitals 6000+
      Incurred Claim Ratio (2020-21) 101.09%
      Pre-policy Medical check-up Required
      Pre-existing Diseases Waiting Period 4 years
      Discount 10% direct sale discount
      Co-payment Up to 25% on pre-existing diabetes/hypertension optional cover

      Benefits of National Senior Citizen Mediclaim Plan

      Check out the key benefits of a National Senior Citizen Mediclaim plan:

      1. Reinstatement of Sum Insured

      The sum insured of this National health insurance policy gets reinstated once in a policy period if it gets exhausted due to an accident on the road.

      2. Cumulative Bonus

      A cumulative bonus of 5% is granted to the policyholder in case no claims are raised in the previous policy year. This bonus can be used to enhance the sum insured without increasing the premium amount.

      3. Preventive Health Check-up

      Policyholders can avail free preventive health check-up facility after every two claim-free years or every 6 claim-free months depending on the chosen plan.

      4. Cashless Hospitalization Facility

      The National Insurance Company offers cashless hospitalization facilities at more than 6000 network hospitals across India.

      5. Tax Benefits

      Policyholders can avail tax deductions on the premium paid for the National Senior Citizen Mediclaim policy under Sec 80D of the Income Tax Act.

      National Senior Citizen Mediclaim Plan Eligibility Criteria

      Take a look at the eligibility criteria for buying a National Senior Citizen Mediclaim policy:

      Parameters Eligibility Criteria
      Minimum Entry Age 60 years
      Maximum Entry Age 80 years
      Coverage Type Individual/ floater
      Relationships Covered Self, spouse and parents
      Renewability Lifetime

      Types of National Senior Citizen Mediclaim Plan

      The National Senior Citizen Mediclaim plan comes in two types:

      • Plan A – This plan offers coverage for hospitalization, day care procedures, organ donor’s expenses, domiciliary hospitalization and cataract treatment amongst others. It offers preventive health check-up facility after every two claim-free years.
      • Plan B – This plan offers hospital cash, funeral expenses, reinstatement of sum insured for road traffic accidents, etc. in addition to Plan A. It offers preventive health check-up facility after every 6 claim-free months.

      Inclusions of National Senior Citizen Mediclaim Plan

      The following coverage are included under the National Senior Citizen Mediclaim plan:

      • In-patient Treatment
      • Pre-hospitalization Expenses
      • Post-hospitalization Expenses
      • Domiciliary Hospitalization
      • Day Care Procedure
      • Ayurveda and Homeopathy Treatment
      • HIV/AIDS Cover
      • Mental Illness Cover
      • Organ Donor’s Medical Expenses
      • Ambulance Charges
      • Reinstatement of Sum Insured due to Road Traffic Accident
      • Hospital Cash Benefit
      • Post-hospitalization Doctor’s Home Visit/ Aya/ Nurse/ Attendant Charges
      • Funeral Expenses

      Optional Covers:

      • Pre-existing Diabetes/ Hypertension Cover
      • Outpatient Treatment
      • Critical Illness Cover
      • Personal Accident Cover

      Exclusions of National Senior Citizen Mediclaim Plan

      The National Senior Citizen Mediclaim plan excludes the following coverage:

      • OPD Treatment
      • Pregnancy
      • Dental treatment
      • Obesity treatment
      • Sexually transmitted disease
      • Congenital external anomaly
      • Infertility and sterility
      • Self-inflicted injury
      • Stem cell surgery
      • Cosmetic or plastic surgery
      • Treatment for alcoholism or drug addiction

      National Senior Citizen Mediclaim Plan Waiting Periods

      Here are the waiting periods applicable under the National Senior Citizen Mediclaim plan:

      Category Waiting Period
      Initial Waiting Period 30 days
      Specific Illness Waiting Period 1 year/ 2 years
      Joint Replacement/ Osteoarthritis/ Osteoporosis 4 years
      Pre-existing Diseases Waiting Period 4 years

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