Cover Your Health in 5 mins
Compare Premium. Buy Now.
national health insurance
 Call to Expert
+917304332968
 Chat on Whatsapp
+917304332968

Compare
Individual Health Insurance Plans

Pincode is required. Pincode should be 6 digits. Pincode should be 6 digits.Only numbers are allowed.
Old quotation number is required. Invalid quotation number.Sample: PIBLHEL000000000000000000
  • {{r.Name}}
Insured Age Required.

National Senior Citizen Mediclaim Policy

The National Insurance Senior Citizen Mediclaim Policy is an indemnity health insurance policy for seniors with a higher maximum sum insured of 10 lakhs. The Policy covers reasonable and customary out-of-pocket costs for inpatient care (allopathy, ayurveda, and homoeopathy), as well as out-of-pocket costs for inpatient hospitalisation at home for the treatment of a disease or injury contracted or sustained during the policy period.

Depending on the plan selected, the Policy also covers pre- and post-hospitalization costs, 140+ day care procedures and surgeries, medical costs for organ donors, hospital cash, ambulance fees, doctor home visits, nursing and attendant fees during post-hospitalization, funeral costs, reinstatement of Social Insurance due to a traffic accident, and regular medical consultation fees. The policy comes in an Individual (Plan A) and Floater basis (Plan B).

Eligibility Criteria

Here are the eligibility criteria for the National Senior Citizen Mediclaim Insurance Policy.

ParametersDetails
Age

If Proposer is a Senior Citizen, Policy on Individual Basis can be availed for

  • Self only aged between 60 to 80 years at inception.
  • Self and Spouse, both aged between 60 to 80 years at inception

If Proposer is the Senior Citizen, Policy on Floater Basis can be availed for

  • Self and Spouse together, where the self is aged between 60 to 80 years and the spouse is aged between 50 to 80 years at inception.

If Son or Daughter is the Proposer, Policy on Individual Basis can be availed for

  • Either Father or Mother, aged between 60 to 80 years at inception
  • Father and Mother, both aged between 60 to 80 years at inception
Policy Period1 Year
SI (Sum Insured)

Plan A – 10 slabs, INR 1,00,000 to INR 10,00,000 in multiple of INR 1,00,000

Plan B – 10 slabs, INR 1,00,000 to INR 10,00,000 in multiple of INR 1,00,000

Pre Policy Checkup RequiredYes

Coverage Details

Here are the coverage details for the National Senior Citizen Mediclaim Insurance Policy.

Annual Increase in SIAnnual Increase in SI by 5% for each claim-free year up to a maximum of 50% of SI opted.
Pre-existing diseasesPre-existing diseases are covered after 2 years.
Optional coversOPD, Critical Illness, Personal accident & coverage of pre-existing Diabetes and Hypertension.
Cumulative BonusThe cumulative bonus allowed shall be an amount equal to 5% (five percent) of the sum insured

Key Features and Benefits of Choosing a National Senior Mediclaim Insurance Policy

The following are the key features and benefits of considering the National Senior Mediclaim Insurance Policy. 

  • Reinstatement of Sum Insured

If this National Senior Citizen Mediclaim insurance policy’s sum insured is used up due to a car accident, it is reinstated once during the policy period.

  • Preventive Health Check-ups

Depending on the chosen plan, policyholders can take advantage of a free preventive health checkup after every two claim-free years or every six claim-free months.

  • Cashless Hospitalization Facility

The National Insurance Company has provided cashless hospitalisation services to more than network hospitals throughout India.

  • Tax Benefits

Under Section 80D of the Income Tax Act, policyholders may claim a tax deduction for the National Senior Citizen Mediclaim policy premiums paid.

  • Cumulative Bonus 

The cumulative bonus is one of the renewal advantages available to you if you have the National Senior Citizen Mediclaim Policy. Up to a maximum of 50% of the current sum insured, it will rise by 5% for each year without a claim. If you file a claim during the policy period, the cumulative bonus will be reduced by 5% of the amount insured.

  • Grace Period

Payment can be made to renew or keep the Policy in force during the grace period, which is the first 30 days after the premium payment deadline, without affecting continuity benefits like the waiting period and coverage for pre-existing conditions. For the time that no premium is paid, coverage is not offered.

  • In-patient Hospitalization Expenses 

All expenses incurred during an inpatient hospital stay of at least 24 hours, including room and board, physician fees, nursing costs, surgical costs, ICU fees, anesthetist fees, anaesthesia, blood and oxygen costs, operating room fees, etc.

  • Daycare treatments/procedures

All daycare procedures for medical treatment and/or surgical procedures finished in less than 24 hours are now covered thanks to technological advancements. The daycare treatments and procedures policy does not apply to treatments received as an outpatient.

  • Pre and Post-Hospitalization

For a period of 30 days and 60 days, respectively, the insured is reimbursed for all medical expenses incurred before and after hospitalisation.

Exclusions Under the National Senior Citizen Mediclaim Policy

Here are the things not included under the National Senior Citizen Mediclaim policy.

  • Domiciliary hospitalization shall not cover:
  • Treatment of fewer than three days
  • Expenses incurred before or after Domiciliary hospitalization for the same treatment
  • Expenses incurred for AYUSH treatment
  • Expenses incurred for any of the following diseases;
  • Asthma
  • Bronchitis
  • Chronic nephritis and nephritic syndrome
  • Diarrhoea and all type of dysenteries including gastroenteritis
  • Epilepsy
  • Influenza, cough and cold
  • All mental illnesses, psychiatric or psychosomatic disorders
  • Pyrexia of unknown origin for less than ten days
  • Tonsillitis and upper respiratory tract infection including laryngitis and pharyngitis
  • Arthritis, gout, and rheumatism
  • HIV/ AIDS

How to Buy National Senior Citizen Mediclaim Insurance Policy?

Though buying a National Senior Citizen Mediclaim Insurance policy is an ideal choice, it is unfortunately not available to buy via the National Insurance official website. Probus Insurance is still where you can make your purchase.

To meet the exploding demand of the populace, a dedicated insurance broker, Probus Insurance Broker Private Limited, operates throughout India and offers a wide selection of insurance plans (including life and non-life).

The steps for thinking about purchasing the National Senior Citizen Mediclaim plan through Probus Insurance are listed below.

  • On the right side of this page, find the “We Are Here” chatbot.
  • Before entering your full name, email address, and phone number and clicking the “Start Chat” button, you must first choose your department.
  • By clicking it, you can start a conversation with any of the company’s customer service representatives. After that, they will assist you in purchasing the National Critical Illness Policy by answering any questions you may have.

You still find it difficult to buy something, right? if so, don’t be alarmed! To purchase a National Senior Citizen Mediclaim Insurance Policy at Probus Insurance immediately, just get in touch with a customer service agent. Here are the details for getting in touch.

  • Via Call: +91 7304332968
  • WhatsApp: Say “Hi” to 7304332968
  • Via Mail: care@probusinsurance.com

How to File a Claim For National Senior Citizen Mediclaim Policy?

The claims for your National Senior Citizen Mediclaim policy can be settled via two methods:

For Cashless Facility:

Only accessible to policies that a Third-Party Administrator (TPA) services

  • As cashless is only available for empanelled network hospitals of the Company/TPA, make sure the hospital is included in the networked hospitals (Preferred provider network/other network Hospitals).
  • When hospitalisation is planned, notice must be given to the TPA/Company at least 72 hours in advance, along with information on the hospital’s name, address, and condition that will necessitate its use.
  • Within 24 hours of admission, a notice of an emergency hospitalisation must be sent to the TPA/Company.
  • Upon admission, the hospital will send a Pre-Authorization Request for Cashless to the TPA, duly signed by the insured and Hospital Authorities, detailing the admission, illness, suggested course of treatment, and estimated costs. After treatment, pre- and post-hospitalization costs may be claimed separately.
  • The TPA must receive all original documents within 15 days of the end of post-hospitalization care.

For Reimbursement Claims:

For emergency hospitalisations, written notice must be sent to TPA or Company within 72 hours of admission; for planned admissions, written notice must be sent to TPA or Company 72 hours before admission.

  • The hospital administration may be contacted to obtain the Discharge Summary, investigation report, and other pertinent documents before you leave the facility. Within 15 days of the discharge date, TPA / Office must receive all original documents.
  • After treatment, pre- and post-hospitalization costs may be claimed separately.
  • All original documents must be submitted within 15 days of the end of post-hospitalization care.

How to Renew Your National Senior Citizen Mediclaim Policy?

If a policyholder doesn’t renew their insurance, they will lose all of their benefits. If the policy is not renewed and the premium is not paid on time, the policy expires. This eliminates any uncertainty regarding the denial of claims made after the policy’s expiration. Therefore, it is crucial that you renew your National Senior Citizen Mediclaim policy.

Listed below are the steps to renew your National Senior Citizen Mediclaim policy.

  • Visit the National Insurance website.
  • “Quick Renewal” is displayed at the top. Toggle it on.
  • You will be taken to a page where you must first enter your policy number and then the “Captcha” code as soon as you click on it. Click “Renew Policy” after filling out all the fields.
  • After that, you must pay the renewal premium for your insurance. You can then renew your policy using a credit or debit card at that point.
  • Your registered email address and phone number will receive a message with information about your policy after you make the payment.

Frequently Asked Questions

Yes. When your National Senior Citizen Mediclaim policy is renewed, you can increase the sum insured.

Yes. Inpatient hospitalisation, in-home hospitalisation, cataract surgery, and treatment for benign prostatic hyperplasia are all subject to sub-limits under the National Senior Citizen Mediclaim policy.

No. The cost of medical care received outside of India is covered by the National Senior Citizen Mediclaim policy.

The National Insurance Company’s National Senior Citizen Mediclaim Policy has the following waiting periods:

  • Pre-existing conditions are covered following a two-year waiting period.
  • Initial 30-day waiting period for all claims except accidental injuries
  • A 90-day, 1-year, 2-year, or 4-year waiting period for certain diseases

Health Insurers

Health Insurance FAQ's

National Insurance FAQs