National Health Insurance Top Up & Super Top up Plan

National Super Top-up Mediclaim is a high threshold insurance policy. National Super top-up policy reimburses hospitalization expenses when a specific threshold amount is exceeded or when the Sum insured limit of the existing health insurance policy is fully utilised. This policy provides plans for individuals as well as families with a floater basis. It can be purchased even without a base health insurance policy.

For Individual plans both Sum insured and the deductible applies to each insured person. For Family floater plans both Sum insured and the deductible applies on a floating basis for all the insured family members.

Eligibility Criteria

Features	Specifications
Sum Insured	Rs 3 lakh to Rs 20 lakh
Deductible Amount	Rs 2 lakh to Rs 10 lakh
Minimum Entry Age	Individual Policy: 18 years Family Floater Policy: 3 months
Maximum Entry Age	Adults- 65 years Dependent children- 18 years
Pre-existing Disease Waiting Period	48 months
Day Care Treatments	140

Interested individuals should make use of the National Health Super Top-up Premium Chart in order to determine the amount of premium payable. For further details of the policy, please refer to the National Health Super Top-up Plan Brochure.

Key Benefits of National Super Top-up Mediclaim Policy

Helps in mitigating the risk of increasing healthcare costs
No sub-limits for reimbursement for room rent, doctor’s fees, etc.
Cashless hospitalization is available at more than 6000 network hospitals in over 12 cities.
Package rates for specific surgeries available in-network hospitals.
5% annual increase in Sum Insured for each claim-free policy year. This is up to 50% of Sum Insured opted
National Insurance Health claims settlement ratio of 85.47% seems quite promising

Inclusions of National Super Top-up Mediclaim Policy

National Super top-up mediclaim policy covers the following medical expenses:

Ayurveda, Allopathy, and Homeopathy treatments are covered
In-patient treatment expenses including ICU charges, room rent, medical practitioners, surgeon, specialist’s fees, anaesthetist, etc., are covered.
Bariatric surgery and maternity cover up to the sum insured
Organ donor’s medical expenses, pre & post hospitalization expenses covered up to Sum Insured.
Correction of eyesight and treatment for morbid obesity after specified waiting periods.
Mental illness, HIV/AIDS, Genetic disorders are also covered
Treatment-related to participation as a non-professional in hazardous or adventure sports subject to sub-limits

The National Health Super Top-up premium chart provides detailed information about premium payments and rates available under various categories. One may refer to it for complete information.

Pre-existing Diseases

All pre-existing diseases included after a waiting period of 12 months from the policy inception as follows:

Period from Inception	Percentage of the admissible claim
13-24 months	50%
25-36 months	75%
After 36 months	100%

Exclusions of National Super Top-up Mediclaim Policy

National Super top-up mediclaim policy does not cover the following medical expenses:

Non-prescription drug
Vitamins, tonics
Alcohol or Drugs abuse
Self-inflicted injury
Home visit charges
OPD treatment

*For a complete list of exclusions, please refer to the National Super Top-up Mediclaim Policy Terms and Conditions

For more information about exclusions, please refer to the plan brochure or the policy document. If you are planning to buy this policy or any other National health insurance plans then you can write to us at care@policybazaar.com or call us at 1800-708-8787.

FAQs

Q1. Are modern treatment expenses covered under the National Health Insurance Top-up plan?

Yes. Twelve modern treatments like oral chemotherapies, robotic surgery, immunotherapies, etc., are covered.
Q2. Is Dental treatment covered under the National Health Top-up plan cover?

No. Dental treatment is not covered unless arising out of an accident and requiring hospitalization.
Q3. Which are the expenses covered during the cooling period?

If any accident occurs during the cooling period leading to injury, only that will be covered by the plan.
Q4. Does the National Health Top-up plan cover change-of-gender treatment expenses?

No. Change-of-gender treatments are not covered in this policy.
Q5. Is a Health check-up required before purchasing the National Super Top-up plan mediclaim policy?

Health Check-Up is required for first-time applicants above 50 years of age (including dependants. It is not required for existing policyholders, covered under any retail health insurance policy for 3 years or more, on a continuous basis.