National Mediclaim Plus Policy

Entry Age

18 years to 65 years. Children between the ages of 3 months and 18 years can also be covered provided the parents are also covered by this policy

Basis

Individual / Family floater

Policy Period

1 year with a grace period of 30 days

Renewability

Lifelong

Sum Insured

Rs. 2 lakhs to Rs. 10 lakhs in increments of Rs. 1 lakh

Rs. 15 lakhs, Rs. 20 lakhs and Rs. 25 lakhs

Rs. 30 lakhs, Rs. 40 lakhs and Rs. 50 lakhs

Medicals

Discount

1. 10% discount on premiums of family members are covered under this policy
2. 10% discount if the insured and the spouse are between 18 years and 25 years old
3. 5% discount on the premiums if the policy is bought online

Co-payment

20% of the claim if treatment is done in non-network hospital

Common Features

1. Pre-existing conditions will be covered after 3 years
2. The policy provides for one medical second opinion for each major illness diagnosed in one policy period
3. Vaccination of children up to the age of 12 years will be covered up to Rs. 1,000
4. Organ donor's medical expenses will be covered
5. Allopathic, Ayurvedic and homeopathic treatments will also be covered
6. Day care procedures will be covered
7. Pre-hospitalisation expenses up to 30 days will be covered
8. Post-hospitalisation expenses up to 60 days will be covered

Unique Features

1. Room charges up to 1% of the sum insured will be covered
2. ICU charges up to 2% of the sum insured, subject to a maximum of Rs. 15,000 will be covered
3. For pregnancies up to Rs. 30,000 for normal deliveries and Rs. 50,000 for caesarean sections will be provided
4. Daily hospital cash of Rs. 500 will be provided for a maximum of 5 days
5. Ambulance charges will be covered up to Rs. 2,500
6. The policy will cover up to Rs. 1,000 for health check-ups every 2 years
7. For surgery for cataract the limit will be the lesser of 15% of the sum insured and Rs. 60,000

1. Room and ICU charges up to Rs. 15,000 will be covered
2. For pregnancies up to Rs. 60,000 for normal deliveries and Rs. 75,000 for caesarean sections will be provided
3. Daily hospital cash of Rs. 800 will be provided for a maximum of 5 days
4. Ambulance charges will be covered up to Rs. 4,000
5. Air ambulance charges of up to 5% of sum insured will be covered
6. Medical emergency reunion will be covered up to Rs. 20,000
7. Post-hospitalisation, doctor/nurse visits to the house will be covered for 10 days at Rs. 750 per day
8. The policy will cover up to Rs. 2,000 for health check-ups every 2 years
9. For cataract surgery the limit will be Rs. 80,000

1. Room and ICU charges up to Rs. 20,000 will be covered
2. For pregnancies up to Rs. 80,000 for normal deliveries and Rs. 100,000 for caesarean sections will be provided
3. Daily hospital cash of Rs. 1000 will be provided for a maximum of 5 days
4. Ambulance charges will be covered up to Rs. 5,000
5. Air ambulance charges of up to 5% of sum insured will be covered
6. Medical emergency reunion will be covered up to Rs. 20,000
7. Post-hospitalisation, doctor/nurse visits to the house will be covered for 10 days at Rs. 1000 per day
8. The policy will cover up to Rs. 3,000 for health check-ups every 2 years
9. For cataract surgery the limit will be Rs. 100,000

Benefits

1. The sum insured can be increased at the time of renewing the policy
2. The sum insured can also be changed to that of Plan B or C at the time of renewing the policy
3. The sum insured will increase by 5% every year subject to a limit of 50%