National Health Insurance 2026 – Mediclaim Plans, Benefits & Network Hospitals

National Individual Mediclaim Policy 

National Mediclaim Policy (Individual) is a comprehensive health insurance plan tailored to offer extensive coverage for medical expenses incurred by the insured individual. The policy provides a sum insured ranging from Rs.1 lakh to Rs.10 lakh, ensuring financial security during times of medical emergencies. 

Features and Benefits: 

• Hospitalization – Covers room charges, doctor's fees, and related medical costs.
• Chemotherapy & Radiotherapy – Covers treatment expenses for critical illnesses like cancer.
• Specific Illnesses – Covers HIV/AIDS, morbid obesity, and refractive errors.
• Mental Illness & Hazardous Sports – Covers mental health treatments and hazardous sports injuries.
• Ambulance & AYUSH – Covers ambulance charges, funeral expenses, and AYUSH treatments.
• Preventive Health Check-ups – Available after every 4 claim-free years for early health detection.
• Cumulative Bonus – 5% bonus per claim-free year, up to a maximum of 50%.
• Sum Insured Reinstatement – Available for plans with sum insured of Rs.6L and above, enabling multiple claims without exhausting coverage.

National Parivar Mediclaim Plan

The National Parivar Mediclaim policy is specifically designed to provide comprehensive coverage for the medical expenses of the entire family on a floater sum insured basis. With a sum insured ranging from Rs.1 lakh to Rs.10 lakh, this policy ensures that your family's health needs are well taken care of. 

Features and Benefits: 

• In-patient & Domiciliary Hospitalization – Covers room charges, doctor's fees, and home-based treatment costs.

• AYUSH Treatments – Includes Ayurveda, Yoga, Unani, Siddha, and Homeopathy therapies.

• Maternity & Infertility – Covers childbirth expenses and fertility treatments.

• Vaccinations & Second Opinions – Anti-rabies vaccination and medical second opinion costs covered.

• Specific Illnesses – Covers morbid obesity, hazardous sports injuries, and refractive errors.

• Health Check-ups – Available once every 4 years for preventive monitoring.

• Optional Add-ons – OPD cover, critical illness cover, and PED (diabetes/hypertension) cover available.

National Senior Citizen Mediclaim Policy

The National Senior Citizen Mediclaim policy is a specialized health insurance plan tailored to meet the medical needs of senior citizens aged 60 years and above. This policy offers a sum insured option ranging from Rs.1 lakh to Rs.10 lakh, ensuring adequate coverage for the healthcare requirements of elderly individuals. 

Features and Benefits: 

• Hospitalization & Day Care – Covers in-patient expenses (room, doctor's fees) and day care procedures.

• Domiciliary Hospitalization – Covers home-based medical treatment costs.

• Specific Illnesses – Covers morbid obesity, refractive errors, and adventure sports injuries.

• Ambulance & Funeral Expenses – Covers hospital transportation and funeral costs.

• Road Traffic Accident – Sum insured reinstated following a road traffic accident.

• Cumulative Bonus – 5% bonus added to sum insured for every claim-free year.

• Preventive Health Check-ups – Regular screenings encouraged with check-up benefits.

• Optional Add-ons – PED (diabetes/hypertension), OPD, personal accident, and critical illness covers available.

National Super Top-Up Mediclaim Policy

Offers additional coverage beyond the base policy, with sum insured ranging from Rs.3L–Rs.20L and deductible of Rs.2L–Rs.10L.

Features and Benefits:

• Hospitalization & Modern Treatments – Covers in-patient care, day care procedures, and advanced medical treatments.
• Specific Illnesses – Covers AIDS, refractive errors, and adventure sports injuries.
• Maternity & Morbid Obesity – Covers maternity expenses and obesity-related treatments.
• Post-Hospitalization Home Care – Covers doctor, nurse, and attendant visits at home after discharge.
• Cumulative Bonus – 5% bonus added to sum insured for every claim-free year.
• Daily Hospital Cash – Up to Rs.2,000/day for hospitalizations exceeding 3 days.

National Mediclaim Plus Policy

The National Mediclaim Plus policy is a comprehensive and all-encompassing health insurance plan tailored to provide extensive coverage for individuals against a wide array of diseases and medical conditions. With a sum insured range of Rs.2 lakh to Rs.50 lakh, this policy ensures that individuals are adequately protected and financially secure in the face of unforeseen medical expenses. 

Features and Benefits: 

• Comprehensive Hospitalization – Covers hospitalization costs, ambulance charges, and modern medical treatments.

• Maternity & Child Vaccination – Covers maternity expenses and children's vaccination costs.

• Specific Conditions – Covers hazardous sports injuries, morbid obesity, and refractive errors.

• Emergency Reunion & Second Opinion – Covers medical emergency reunion expenses and second opinion costs.

• Health Check-ups – Available once every 2 years for preventive care.

• Cumulative Bonus – 5% bonus per claim-free year, up to a maximum of 50%.

• Optional Add-ons – OPD cover and critical illness cover available for customized protection.

National Family Floater Mediclaim Policy

The National Parivar Mediclaim Plus policy is a comprehensive and inclusive health insurance plan that offers coverage for the entire family on a floater sum insured basis. With a sum insured ranging from Rs.6 lakh to Rs.50 lakh, this policy ensures that the family members are well-protected and financially secure in the face of medical contingencies. 

Features and Benefits: 

• Hospitalization & Emergency Reunion – Covers hospitalization expenses and medical emergency reunion costs.

• Maternity, Newborn & Infertility – Covers maternity expenses, newborn care, and infertility treatments.

• Second Opinion & Sum Insured Reinstatement – Covers medical second opinion costs; sum insured reinstated for road traffic accidents.

• Specific Conditions – Covers adventure sports injuries, refractive errors, and morbid obesity treatments.

• Health Check-ups – Available once every 2 years for the entire family.

• Optional Add-ons – Critical illness, OPD, and PED (diabetes/hypertension) covers available for customized protection.

National Vidyarthi Mediclaim Policy

The National Vidyarthi Mediclaim policy for students is specifically tailored to cater to the healthcare needs of students, providing health insurance and personal accident coverage. With a sum insured amount ranging from Rs.50,000 to Rs.2 lakh, this policy ensures that students have access to comprehensive coverage during their academic journey. 

Features and Benefits: 

• Hospitalization – Covers in-patient, pre-hospitalization, and post-hospitalization expenses.

• Specific Illnesses – Covers HIV/AIDS and refractive error treatments.

• Mental Illness & Morbid Obesity – Covers mental health and obesity-related treatments.

• Personal Accident & Repatriation – Covers accidental injuries and repatriation expenses for students and guardians.

• Cumulative Bonus – 5% bonus per claim-free year, up to a maximum of 50%.

• No Pre-Policy Medical Check-Up – Easy enrollment with no medical check-up required.

National Critical Illness Policy

The National Critical Illness policy offers extensive financial coverage for a wide range of critical illnesses, ensuring that policyholders receive the necessary support and financial assistance during challenging times. With a sum insured ranging from Rs.1 lakh to Rs.75 lakh, this policy provides substantial coverage to address the financial burden associated with critical illnesses. 

Features and Benefits: 

• Lump Sum Payment – One-time payout upon first diagnosis of a covered critical illness.

• 5% Early Entry Discount – Available for policyholders under 42 years of age at purchase.

• No Pre-Policy Medical Check-Up – No medical check-up required for individuals up to 45 years of age.

• Survival Period – Insured must survive 30–90 days post-diagnosis to qualify for the lump sum payout.

How to Buy National Health Insurance Online?

To purchase a National Health Insurance policy online, follow these steps: 

• Visit the official National Health Insurance website and click on 'Health Insurance'.

• Select individuals to insure, enter their ages, city of residence, and contact details.

• Indicate any medical history or pre-existing diseases.

• Browse and select the plan that best suits your needs.

• Review policy details, coverage, and premium amount.

• Complete the payment to receive your policy document.

How to Renew National Health Insurance Online?

To renew your National Health Insurance policy online, follow these steps: 

• Step 1: Visit the official website of National Health Insurance. 

• Step 2: From the dropdown menu, select 'Health Renewal.' 
• Step 3: Enter your registered mobile number and the One-Time Password (OTP) received on your mobile. 
• Step 4: For new customers, click on the health insurance icon on the homepage and provide the requested details such as age, city, phone number, etc. 
• Step 5: Select the specific National Health Insurance policy you want to renew. 
• Step 6: Pay the renewal premium amount using the available online payment options. 

• Step 7: After successful payment, your policy will be renewed, and you will receive confirmation of the renewal. 

Documents Required for National Health Insurance

When you are raising a reimbursement claim under National Health Insurance, it is essential to ensure that you have all the necessary documents ready to facilitate a smooth and successful claim process: 

• Claim Form – Fully completed form with insured's details and treatment information.

• Cash Memos & Prescriptions – From hospital or chemist for medicines and medical supplies.

• Hospital Bills & Receipts – Itemized evidence of all medical expenses incurred.

• Discharge Certificate – Details of hospitalization duration, treatment, and patient condition.

• Investigation Reports – Test reports with payment receipts and prescriptions.

• Doctor's Certificate – Confirming diagnosis date and medical history.

• Surgeon's Certificate – Details of surgical procedure with payment receipts (if applicable).

• Additional Documents – Any other documents requested by the insurance company.

How to File a Health Insurance Claim?

Policyholders can file 2 types of claims with National Insurance Company Limited:

• Cashless Claim: In the case of planned hospitalisation, intimate the insurer at least 72 hours prior to admission and in the case of emergency hospitalisation, intimate the insurer within 24 hours of admission at a network hospital of National Insurance. A pre-authorisation request has to be approved by the TPA in order to avail cashless facility at a network hospital. The TPA reserves the right to approve or deny the request.
• Reimbursement Claim: In the case of planned hospitalisation, intimate the insurer at least 72 hours prior to admission and in the case of emergency hospitalisation, intimate the insurer within 72 hours of admission. Within 15 days from of discharge from the hospital, the insured member has to submit a duly-filled claim form along with the original medical documents to the TPA or the insurer in order to make a reimbursement claim. The claim will be approved or rejected as per the policy terms and conditions.

Online Payment Options for National Health Insurance Policy

National health insurance policies are available on the company website for purchase. The insurance cover can be between Rs.1 lakh to Rs.5 lakhs. Individual and Parivar Mediclaim policies are available online. The individual mediclaim policy is available for people up to 50 years of age and a sum insured of up to Rs.5 lakh. Online premium payment can be made via the NICL portal using net banking, credit card or debit card.

GST rate of 18% applicable for all financial services effective July 1, 2017.

Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST