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National Health Insurance

National Insurance Company Limited is one of the oldest and most renowned fully government organizations In India. The company commenced its operations in 1906 and has 1998 offices PAN India. It is one of the leading health insurance companies that offers personalized mediclaim policies with comprehensive health insurance coverage to individuals, families, groups and senior citizens.

The company offers highly sought after mediclaim policies with effective and useful features. The health insurance products are tailor-made to meet the different needs of the customers. You can easily buy and renew National Health Insurance policies from their online portal.

National Health Insurance at a Glance

Key Features Highlights
Incurred Claim Ratio  97.25%
Network Hospitals 6000+
Waiting Period  Available
Renewability  U/S 80 D

Key Features of National Health Insurance

  • Cashless hospitalization in more than  6000 network hospitals across India (subjected to policy terms and conditions)
  • Option to choose 1, 2 and 3 years of policy term
  • Lifelong Mediclaim policy renewal option
  • Comprehensive cover at an affordable premium
  • Both individual and family floater plans are available
  • Coverage to pre-existing diseases after the completion of the waiting period
  • Tax benefits on the premium paid
  • Special medical insurance plans for people below the poverty line

National Health Insurance Plans Comparison Table

Plan Name Entry Age Criteria Coverage Type Renewability   Sum Assured (Rs.)
Overseas Mediclaim Business and Holiday Plan N/A Individual As the case may be USD 50,000 to USD 500,000
National Parivar Mediclaim Plan Adult: 18 to 60 years

Children: 3 months to 25 years

Family Floater

 

Up to 65 years Up to 5 lacs.
National Parivar Mediclaim Plus Adult: 18 to 65 years

Children: 3 months to 18 years

Family Floater Lifelong 6 to 50 lacs. ( as per the plan chosen)
Overseas Mediclaim Employment and Studies N/A Individual As the case may be USD150,000 to USD 500,000
National Critical Illness Plan 20 to 65 years Individual/family Up to 65 years 5, 10, 20 & 25 lacs.
National Mediclaim Plus Policy Adult: 18 to 65 years

Children: 3 months to 18 years

Family Floater

 

Lifelong 2 to 50 lacs.
National Parivar Mediclaim Policy- Adult: 18 to 60 years

Children: 3 months to 25 years

Family Floater Up to 65 years Up to 5 lacs.
National Mediclaim Policy B/w 18 & 65 years Individual/family Lifelong 50,000 to 5 lacs.

Types of National Health Insurance Plans

  1. Overseas Mediclaim Business and Holiday Plan- This plan covers travel emergencies while you are travelling abroad. It is available for people who are travelling for holidays and business trips, for further study and employment and also for frequent corporate travelers.
  2. National Parivar Mediclaim Plan- It is a floater plan under which you can cover yourself and your family members including the parents, spouse, and dependent children.
  3. National Parivar Mediclaim Plus- This is a unique plan that offers sum assured as high as INR 50 lacs with a number of lucrative features. You can include your entire family including self, children, spouse, parents, and parents-in-law on floater basis.
  4. Overseas Mediclaim Employment and Studies– It is a package policy that covers travel emergencies while you are travelling overseas. It covers business trips, vacations, and study as well as employment trips. Moreover, it offers coverage to corporate travelers who frequently travel abroad.
  5. National Critical Illness Plan- National health insurance specially designed this plan to cover critical illnesses. There are two variants – Plan A covers 11 critical illnesses and Plan B covers 37 critical illnesses.
  6. National Mediclaim plus Policy- Expenses incurred on Allopathic, Homeopathic and Ayurvedic treatment are recompensed. It also provides maternity cover, newborn baby cover and vaccination cover for children. Additionally, you can opt for outpatient treatment and critical illness cover.
  7. National Parivar Mediclaim Policy- This plan offers protection to the entire family in case of any illness or accidental injuries. It is a floater policy wherein you can cover yourself, your two dependent children and spouse under a single plan.
  8. National Mediclaim Policy– All the hospitalization expenses are covered in this plan. Moreover, recompenses specified 140 daycare surgeries also.

Claim Procedure of National Health Insurance Company

The following steps are involved in general for Lodging and Settlement of Claims:

  1. In case of hospitalization immediately notify the insurer
  2. Collect the health claim form from the office or download it online
  3. Fill and sign the claim
  4. Now submit the claim form directly at the National Insurance issuing branch or ask an agent to do so on your behalf.
  5. Submit all the documents like doctor’s prescriptions, hospital reports, pathological reports, chemist bills, Receipts from the doctor and surgeon, certificate of admission and discharge, , as the case may be.
  6. A surveyor might be appointed to refer the case to panel doctors (as the case may be)
  7. The claim is settled by the issuing office and the amount is reimbursed. In cashless claims, the amount is paid directly at the hospital by the company.
  8. However, the cost of deductibles and any expenses beyond the scope of coverage needs to be paid by you.
  9. This is just an overview of the process that is followed. For detailed understanding please get in touch with the insurer.

National Health Insurance Renewal Process

The online Mediclaim renewal method is more convenient and time-saving; therefore, the National health insurance online renewal program is gaining more acceptance and popularity. You will be able to renew your existing National Insurance policy within a few minutes in a more safe and secure manner. In addition, the renewal can be done at any place including at the comfort of your home while time is not an issue.

National mediclaim insurance online renewal process is quite simple and easy. Just follow the simple steps-

  • Firstly, log onto their online portal, enter the policy number and select the medical insurance plan that you want to renew online
  • Now fill all the required fields
  • Now make the payment online using your debit card/ credit card/ internet banking
  • Once the transaction is completed, you will get the online receipt and your policy renewal will be done.

Before renewal Mediclaim policy, you must read the National Health Insurance reviews online and know that the customers have to say about their products and services.

Inclusions- What is covered in National Health Insurance Plans?

Here’s an overview of the expenses that are usually reimbursed by the insurer-

  • Expenses incurred 60 days before hospitalization and 90 days after the hospitalization
  • Specific day care medical procedures
  • Organ donor expenses
  • Domiciliary expenses
  • Fees charged by the doctors, specialists, surgeons and anesthetists
  • Option to cover maternity expenses
  • Air Ambulance charges are also covered in some plans
  • Coverage for Ayurveda and Homoeopathy treatments
  • Cost of chemotherapy, X-ray, radiotherapy, dialysis, and cost of pacemaker
  • Ambulance charges
  • Critical illness cover

Exclusions-What is not covered in National Health Insurance Plans?

  • Any diseases that are diagnosed within 30 days of policy inception, except for accidental claims.
  • Pre-existing diseases unless the waiting period is completed
  • Pregnancy -related complications
  • Treatment for obesity and genetic disorders.
  • Cosmetic treatment and hormone replacement therapies
  • Treatment for STD
  • Hospitalization required for unproven treatments
  • Psychosomatic & psychiatric disorders
  • Any illness/injury/hospitalization resulting due to consumption of alcohol or drugs
  • Dental care treatments are not covered
  • Cost of hearing aids, spectacles, cochlear implants etc. are not recompensed
  • Self-inflicted injuries or any type of mental disorders
  • Medical expenses incurred on treatment of HIV/AIDS infection
  • Any type of plastic or cosmetic surgeries
  • Treatment for injuries arising due to war conditions, terrorist attacks, an act of foreign enemy or army

Benefits of National Health Insurance Plans

The major benefits of National medical insurance plans are mentioned below-

  • You can avail cashless treatment in the listed hospitals
  • The plans provide financial compensation in case of medical emergencies
  • National senior citizen health insurance plans are tailor-made for elderly people
  • Easy renewal and claim process
  • Personalized insurance plans
  • Health insurance cover for both individuals and families
  • There are plans that cover daycare expenses and help you save a lot of money

National Health Insurance Premium Calculation

To derive the cost of health insurance premium for National mediclaim policies, the following factors are considered-

  1. Selected sum assured
  2. Plan opted for
  3. Number of members who are covered
  4. Age of all the members/eldest member
  5. Occupation
  6. Geographical location
  7. Medical history

To know the premium instantly, you can also use the National health insurance premium calculator online.

Why Buy National Health Insurance Policy?

The growing medical inflation proves to be nerve wracking for any middle-income household in India. While we are already juggling with routine expenses, any unforeseen health issue can prove to be devastating both emotionally and financially

And in case of serious illnesses, hospitalization expenses can drain out all of your savings and can even indebt anyone, if the funds are not sufficient.  If the hospitalization expenses come out to be more than what you are able to provide? What will you do in such a situation? That is why having a health insurance plan is of utmost importance in today’s time.

National Health insurance plans provide coverage to you and your loved ones in the most affordable manner.

Documents Required for National Health Insurance Claims

Submit the following documents while lodging a claim for your National mediclaim policy-

  • Duly filled and signed claim form. You can take the form directly from their office or download it from their site.
  • Medical reports
  • Hospital bills, receipts, and memos
  • FIR report in accidental cases
  • Doctor’s prescripts and chemist bills
  • Case summary
  • Hospital admission and discharge report
  • Clearance/other documents

National Health Insurance FAQs

Q1. How to buy a National Health Insurance policy?

Follow the below steps to buy a National mediclaim policy –

  • Visit the nearest branch office or get in touch with an agent
  • Collect and fill the proposal form
  • Submit the duly filled proposal form
  • In some cases, pre-medical tests are conducted and based on that the policy is issued
  • You can get the premium estimates at any of their computerized offices
  • The policy will be issued directly or will be sent via registered post on your address

Q2. Which plan should I buy for my family?

Go for National Parivar mediclaim policy, as it covers all the people aged between 18 & 60 years. It covers the organ donor expenses. On the other hand, it also recompenses the cost of anti-rabies vaccination given to children under the age of 5 years and the limit of sum assured is up to Rs 5000. Moreover, you can claim for daycare treatments as well.

Q3. What are the special features of National mediclaim plus plan?

Basically, all the travelling risks are covered in this plan. It covers for lost baggage when travelling. A delay in checked baggage is charged for 100 US dollars while a loss in a checked baggage goes at 1000 US dollars. In case of a claim, the initial 100 dollars have to be paid by you.

Q4. What are the special features of National Mediclaim policy?

This plan is available for people between the ages of 18 and 65 years. It also recompenses the cost of homeopathy treatments – up to 20% of the total expenses. It also covers 15 days of pre-hospitalization expenses and 30 days of post- hospitalization expenses. In addition, 140 daycare procedures are also covered. In this policy, you can also cover your family members such as children and spouse

Q5. How to cancel my National mediclaim policy?

To cancel a policy, you can go to their branch office and submit the surrender form. Once the cancellation request is accepted, your health insurance policy will be canceled. Upon cancellation, the refund amount will be credited to your bank account.