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National Mediclaim Plus Policy

Eligibility  
Entry Age (years)  
Minimum 18
Maximum 65
Maximum Policy Renewal Age (years) The policy can be renewed annually throughout the lifetime of the insured person by mutual consent before the expiry of the policy.
Coverage Type Policy can be issued to individuals on individual sum insured basis. The Policy offers three plans with varying covers Plan A:INR 2 lac to INR 10 lac in multiples of 1lac Plan B:INR 15 lac, INR 20lac,INR 25 lac Plan C: INR 30 lac, INR 40 lac ,INR 50 lac
Sum Insured (Rs)  
Maximum 50 Lakh
Minimum 2 Lakh
Cumulative Bonus Increase in SI by 5% of SI (excluding CB) per year up to 50% of SI (excluding CB)
Policy Term (years) 1
Pre Policy Medical Check Up Pre policy checkup is required for individual 40 (forty) years and above or opting for SI INR 6,00,000 and above, irrespective of age of the individual or opting for Critical Illness optional cover, between the age of 18 (eighteen) years and 65 (sixty five) years. The company shall reimburse 50% (fifty percent) of the expenses incurred for pre policy checkup, if the proposal is accepted and the premium has been realised.
Policy Termination The company may cancel the policy (on grounds of fraud, moral hazard, misrepresentation or noncooperation) by sending the insured person 30 (thirty) days notice by registered letter at insured person’s last known address and in such event the company shall not allow any refund. The insured person may at any time cancel the policy and in such an event the company shall allow refund of premium after charging premium at company’s short period rate as applicable
PLAN APLAN BPLAN C
Sum insured (SI)INR 2/ 3 /4 / 5/ 6/ 7/ 8/ 9 /10 LacINR 15/ 20 /25 LacINR 30/ 40/ 50u00A0Lac
Coverage
Hospitalisation, Pre (30 days) and Post (60 days), Hospitalisation, Daycare procedureCoveredCoveredCovered
Pre existing diseaseCovered after 36 monthsCovered after 36 monthsCovered after 36 months
Room/ ICU charges (per day)Room - Up to 1% of SI, ICU-Up to 2% of SI subject to max. of INR 15,000Up to INR 15,000Up to INR 20,000
Limit for cataract surgery (for each eye)Up to 15% of sum insured or INR 60,000 whichever is lowerUp to INR 80,000Up to INR 1,00,000
Allopathy, Ayurveda and HomeopathyUp to sum insuredUp to sum insuredUp to sum insured
Organ donoru0092s medical expensesCoveredCoveredCovered
MaternityUp to INR 30,000 for normal delivery and INR 50,000 for caesarean sectionUp to INR 60,000 for normal delivery and INR 75,000 for caesarean sectionUp to INR 80,000 for normal delivery and INR 1,00,000 for caesarean section
Hospital cash per day (max. of 5 days)INR 500INR 800INR 1,000
Ambulance (in a policy period)Up to INR 2,500Up to INR 4,000Up to INR 5,000
Air ambulance (in a policy period)Not coveredUp to 5% of SIUp to 5% of SI
Medical emergency reunion (in a policy period)Not coveredUp to INR 20,000Up to INR 20,000
Doctoru0092s home visit and nursing care during post hospitalization per day, max. of 10 days (in a policy period)Not coveredINR 750INR 1,000
Vaccination for children (up to 12 years) in a policy periodUp to INR 1,000Up to INR 1,000Up to INR 1,000
Other benefits
Medical Second Opinion (MSO) for each new diagnosis of any of the major illnesses, in a policy periodOne MSOOne MSOOne MSO
Good Health Incentives
Cumulative bonusIncrease in SI by 5% of SI per year up to 50% of SIIncrease in SI by 5% of SI per year up to 50% of SIIncrease in SI by 5% of SI per year up to 50% of SI
Health checkup (every 2 years irrespective of claims)Up to INR 1,000Up to INR 2,000Up to INR 3,000
Copayment
Copayment of 20% of admissible claim if treatment undergone in non-networku00A0providerApplicableApplicableApplicable
Optional covers
Critical IllnessINR 2,00,000/ 3,00,000/ 5,00,000/ 10,00,000/ 15,00,000/ 20,00,000/ 25,00,000
Outpatient TreatmentINR 2,000/ 3,000/ 4,000/ 5,000/ 10,000
ObjectiveThe objective of this policy is to offer protection against high health care costs and make health care and related services easy and accessible.
Suited forhis policy can be bought by an individual for self or for family on an individual sum insured basis or as a floater cover.
What does it do?The Policy provides for expenses of hospitalisation, pre & post and day care treatment. Expenses of Allopathic, Ayurvedic and Homeopathic treatment are payable up to the sum insured. The Policy covers expenses of maternity, for new born and vaccination for children. Expenses for medical emergency reunion, air ambulance and hospital cash are also payable. In the event of being diagnosed with a serious illness, a medical second opinion from World Leading Medical Centres will be arranged. In addition, optional covers for Critical illness and Outpatient treatment can also be availed.
ProsThis policy can be bought online.The policy offers various discounts such as Family, Youth and Online discount.The policy can be renewed lifelongPremium paid towards the policy is exempt from Income Tax under section 80D of Income Tax Act.
ConsThere are sub-limits on the policy benefits.