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National Insurance

National Insurance

National Mediclaim policy

National Mediclaim policy is an okay policy for the most part. But if you are looking for comprehensive coverage this policy perhaps simply doesn't cut it, because it does have a few unsavoury conditions

What's good here?

coPay

You most likely don't have to split the bill

The insurer will bear the entire cost of treatment (up to the sum insured) unless you explicitly opted to pay a portion of the bill. And if you’ve opted to co-pay a part of the bill, have you thought through it completely?

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diseaseSublimit

You always have full cover irrespective of the disease

No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.

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dayCare

Day Care treatments covered

If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.

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prePost

Pre & Post hospitalization expenses covered

No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 45 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.

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ayush

Covers Alternative Medicine

Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.

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What's bad here?

special mention
warning
Be aware of

Restrictions on the rooms you can pick and much more

Your insurer won’t let you stay in a room whose rent exceeds 1% of the sum insured. If it’s an ICU they’ll bump it to 2% of the sum insured. And in the event you breach these limits, then you’ll have to pay a lot more - Read more here

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ped

Long waiting period for pre-existing diseases

If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems only after 4 long years. It could be much shorter you know? Like 2 years perhaps!

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domiciliary

No coverage if you are forced to hospitalize at home

The insurer will not cover the costs if you are forced to hospitalize at home due to a medical condition. In insurance lingo, they call this a policy with no domiciliary cover.

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What's okay here?

restoration

Some Restoration Benefit

Even after you claim part of the cover on one occasion, you will have 100% of the cover restored, if you are hospitalized one more time in a bid to treat a different complication. In the same year, by the way.

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What's lacking here?

ncb

Underwhelming bonus feature

Your sum insured increases by 5% each year, so long as you make no claims during this period. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 50%. And while this is a decent deal, most insurance companies offer a much higher bonus. But hey, it's still a bonus.

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healthCheckup

No free Health Checkups unless you wait 4 years

If you’re planning on getting a full body checkup just to make sure you’re in fine working condition, the insurer will cover the cost once in 4 years. However, just so you know, most insurance policies offer free yearly health checkups.

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Frequently Asked Questions

Yes. National Mediclaim policy imposes 3 kinds of waiting periods -
  • 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
  • Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
  • Pre-Existing Disease Waiting Period: There's a 4-year waiting period for any pre-existing disease you may have while buying the policy.
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