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National National Mediclaim Health Insurance

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National Health Insurance
National Mediclaim
Claim SettlementDedicated Team
Claim Settlement Ratio83.78%
Network Hospitals6,000+
RenewabilityLifelong
Starting Premium for 5 lac SIRs.586/month
Starting Premium for Rs. 5 lakhs SIRs. 586/month

About National National Mediclaim Health Insurance

National Mediclaim Policy is an individual health insurance policy that indemnifies in-patient treatment expenses that require at least 24 hours of hospitalisation along with other coverage benefits. It comes with sum insured options ranging between, Rs. 1 Lakh and Rs. 10 Lakh which you can select as per your requirements. This medical insurance policy is loaded with unique benefits some of which include cover for more than 140 daycare procedures, road ambulance expenses, 12 modern treatments including robotic surgery, oral chemotherapies, etc., treatment for morbid obesity covered after waiting period, organ donor expenses, pre-hospitalisation expenses and post-hospitalisation expenses, Ayurveda and homoeopathy expenses, and in-patient hospitalisation expenses.

One of the major benefits of being covered under this policy is that it offers coverage for mental illness, HIV/AIDS, and genetic disorders. Other benefits include reinstatement of sum insured, lifetime renewability benefit, free look period, migration and portability benefits, and tax benefits on the premium paid, under Section 80D of the Income Tax Act, 1961. You can seek cover under this policy if you are aged between 18 years and 65 years. To be covered under this policy, you will be required to undergo a pre-policy check-up only if you are aged 50 years and above including dependents and if you are buying a health insurance plan for the first time.

The policy comes with an optional co-payment clause of 15% of 20%, which you can opt to avail a discount in premium paid for this policy.

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Key Inclusions and Exclusions of the Plan

What's Included

  • Road ambulance expenses
  • 12 modern treatments including robotic surgery, oral chemotherapies, etc.
  • Treatment for morbid obesity covered after waiting period is covered
  • Mental illness, HIV/AIDS, and genetic disorders is covered
  • Organ donor expenses
  • 45 days pre-hospitalisation expenses and 60 days post-hospitalisation expenses

What's Not Included

  • Vitamins, tonics, etc.
  • Cosmetic or plastic surgery, change of gender treatments, and cosmetic or plastic surgery
  • Dental treatments unless necessitated due to accident or hospitalisation
  • Claims arising during the initial 30 days waiting period
  • OPD consultation
  • Drugs that are not prescribed by the attending doctor is not covered under the plan

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National Mediclaim User Reviews

4.6
Rating based on
282 User reviews
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What users are saying
  • All
  • Remarkable Experience

    My experience of purchasing the National Health-  National Mediclaim was wonderful. I bought this plan from an online platform that save me a lot of time and effort. The entire process was completed online and even after purchasing the policy, I didn’t have to chase the team to know about the status of my health policy. I am happy with my purchase. 

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    R
    By Reshma Ajmani
    On: Jun 20, 2023
  • Best experience

    It was the best experience I received during the issuance of my National insurance’s National Mediclaim plan. From quote generation to payment, it was a fast affair. The modern tools are convenient and contribute to the time-saving feature of the website.

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    S
    By Snehashis Bagchi
    On: Jan 20, 2021
  • Provides maximum assistance

    I was happy to get this assurance from InsuranceDekho to get maximum assistance whenever required. I am even happier to find that it is true. Be it on Whatsapp or call, the team is always on their toes to help. So satisfied that I bought National insurance’s National Mediclaim Plus plan from them.

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    R
    By Reema Basu
    On: Jan 15, 2021
  • I highly recommend national in...

    National Mediclaim is my first health insurance purchase with insurancedekho. I wanted a plan covering day care procedures as well as Ayurvedic & homeopathic treatment. Glad that i found this affordable plan without much hassle. Thanks insurancedekho!

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    V
    By Vishesh Chauhan
    On: Oct 29, 2020
  • Worth it insurance

    I am impressed with this national insurance policy. It has given me a very good cover for pre and post hospitalisation, daycare procedures or surgeries, Ayurvedic & homeopathic treatment, room, boarding and other charges. Also comes the benefit of cumulative bonus of 5% if no claims are reported. It is a policy worth recommending.  

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    M
    By Mugdha Patnaik
    On: Feb 07, 2020
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National Mediclaim Expert Review

  • Expert Review

    National Mediclaim Policy by National Insurance is among popular health insurance plans. National Insurance Company has designed this policy to provide financial support to the policyholder in case he or she is hospitalized due to an accident, disease or ailment.  Available on an individual and a family floater basis, the policy offers benefits of cashless treatment or reimbursement facility across the country. There is cover for 140 daycare procedures, pre and post-hospitlisation expenses, and many other benefits offered under this policy.

    National Mediclaim Policy is available for people between the age of 18 and 65 years. However, it also covers financially dependent children (from 3 months to 18 years) provided that at least one parent is covered. The policy also provides coverage to dependent parents. Moreover, the line of treatment covered under the policy include Allopath (up to 100% of the sum insured), Ayurveda and Homeopathy (up to 20% of the sum insured chosen). The sum insured ranges between Rs. 50,000 and Rs. 5 Lakh in multiples of Rs. 25,000.

  • Major Attractions

    Apart from providing basic health cover, National Mediclaim policy provides additional benefits such as health incentives like a cumulative bonus of 5% in case no claims are reported, family discounts, health check-ups and so on.  The cover is also available for surgical appliances, medicines, drugs, diagnostic tests, pacemaker, artificial limbs, stent and implants, dialysis, chemotherapy, radiotherapy and many others. Here are some more elements you get when choosing this policy:

    • Free health checkup once at the end of a block of four continuous claim-free policy period
    • Ambulance expenses (per insured person in a policy year) 1% of the sum insured, subject to the maximum of Rs. 2,000
    • Expenses incurred for oxygen, blood, OT charges, x-ray, etc.
    • Cashless treatment at network hospitals through TPA
    • Pre-determined limit cover for specific surgeries or procedures in network hospitals
    • 10% discount on premiums if the policy is purchased for the family
    • An annual increase in the sum insured by 5% for each claim-free year up to a maximum of 50% of SI opted
    • No medical screening required for persons up to 50 years

  • What’s More?

    National Mediclaim Policy by National Insurance gives a comprehensive approach to secure you and your family’s health. It reduces the financial burden during unforeseen health emergencies. No sub limit is applied in case of hospitalisation in a preferred provider network (PPN). Some other benefits under the plan are:

    • The policy can be renewed lifelong
    • Portability (migration) allowed for similar products
    • Free look period to cancel or continue the policy is 15 days
    • Third party claim settlement service to settle the claim
    • Premium paid for the policy towards self, spouse, dependent children and dependent parents are eligible for tax rebate under Section 80D of Income Tax Act 1961 

  • Conclusion

    There are many health insurance policies, but not all of them can be suitable. You can’t compromise with the safety of your and your family's health. The National Mediclaim policy has been designed keeping in mind customers and their needs. It makes sure you get the best possible treatment without spending your hard-earned money. It does not just offer financial support, but also makes sure you and your family remain stress-free in emergencies.

    To buy this policy or get more information about it, give a call to InsuranceDekho. InsuranceDekho is committed to helping customers by giving them the opportunity to compare different policies, get free quotes, and choose a policy which is most suited to them.

National National Mediclaim Brochure

  • 657.93 KB
  • PDF Document
  • Jul 08, 2019
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Claim Process at National Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 72 hours prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 72 hours and for planned hospitalisation intimate within 72 hours prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

FAQs on National Mediclaim Health Insurance Plan

  • Can I increase my sum insured under this policy?

    Yes. You can increase the basic sum insured under your policy at the time of renewal. For the enhanced sum insured, the waiting periods will be applied. You will be able to avail of coverage benefits with enhanced sum insured after the completion of waiting periods. 

  • What is the minimum entry age for this policy?

    Anyone who is aged above 18 years can be covered under this policy. Children aged between 3 months to 18 years can also be included if at least one of the parents is covered under the same policy. 

  • What is the maximum entry age for this policy?

    The maximum entry age of this policy is 65 years. 

  • Who all can be covered under this policy?

    Self, spouse, dependent children and dependent parents can be covered under this policy. 

  • What is the age limit for policy renewal?

    This policy can be renewed lifelong. 

  • Do I get any tax benefit on purchase of this policy?

    Yes. The premium paid for this policy is exempted from income tax under Section 80D of the lncome Tax Act, 1961. 

  • Is treatment for obesity covered under this policy?

    No. This policy does not provide cover for obesity. The policy also excludes coverage for pregnancy and related complications, hormone replacement, cosmetic treatment, or genetic disorders. 

  • Is there any sub-limit on room rent expenses covered under this policy?

    Yes. Room rent expenses are covered up to 25% of the sum insured for any one illness, with the following sub-limits: 

    • Room Rent- up to 1% of SI, subject to a maximum of Rs. 10,000 per day 
    • ICU charges- up to 2% of SI subject to a maximum of Rs. 20,000 per day

  • Does this policy provide cover for daycare procedures?

    Yes. This policy provides cover for over 140 daycare procedures to the policyholders.

  • Is there any waiting period for pre-existing diseases under this policy?

    Yes. There is a waiting period of continuous coverage for pre-existing diseases under this policy. 

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