National Senior Citizen Mediclaim Plan Online in India

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.

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

FAQs

Q1. Does a National Senior Citizen Mediclaim plan come with any sub-limits?

Ans: Yes. The National Senior Citizen Mediclaim policy applies sub-limits on in-patient hospitalization, domiciliary hospitalization, cataract treatment and treatment for benign prostatic hyperplasia.
Q2. Can a 70-year-old get health insurance?/a>

Ans: Yes. A 70-year-old person can buy the National Senior Citizen Mediclaim plan as it covers people between the age of 60 years and 70 years.
Q3. Can I enhance the sum insured of my National Senior Citizen Mediclaim plan?

Ans: Yes. You can enhance the sum insured of your National Senior Citizen Mediclaim policy at the time of renewal.
Q4. Does a National Senior Citizen Mediclaim plan cover treatments taken outside India?

Ans: No. The National Senior Citizen Mediclaim policy does cover the cost of medical treatments taken outside India.
Q5. Which documents should be submitted to raise a claim under the National Senior Citizen Mediclaim plan?
Ans: The following documents should be submitted to raise a claim under the National Senior Citizen Mediclaim plan:
- Claim form
- Doctor’s prescription advising hospitalization
- Hospital bills and payment receipt
- Investigation test reports
- Hospital discharge summary
- Surgeon’s certificate
- Operation theatre notes
- Medicine bills