National Senior Citizen Mediclaim Health Insurance

What is National Senior Citizen Mediclaim Health Insurance?

This health insurance plan is offered by the National Insurance Company for senior citizens and helps cover various medical expenses. It includes costs for hospital stays (Allopathy and AYUSH), treatment at home if needed, and expenses before and after hospitalization. It also covers daycare procedures, organ donor costs, ambulance services, hospital cash, and doctor visits at home.

Details of National Insurance Senior Citizen Health

Here are some key details of the National Health Insurance for Senior Citizens:

Types of Plans Under the National Senior Citizen Mediclaim Policy

There are two types of plans available:

• Plan A:

• Covers hospital stay (inpatient treatment)
• Includes pre-hospitalisation and post-hospitalisation expenses
• Covers home treatment (domiciliary hospitalisation)
• Covers daycare procedures (treatments not requiring a full hospital stay)

• Plan B:

• Includes everything covered in Plan A
• Also covers hospital cash (daily allowance during hospital stay)
• Ambulance charges
• Doctor’s home visits
• Charges for a nurse or attendant after hospital discharge
• Funeral expenses
• Regular medical consultation charges

Main Benefits of National Health Insurance for Senior Citizens

Some key benefits of National Senior Citizen Mediclaim Health Insurance are:

• Coverage Options: Offers health insurance coverage up to ?10 lakhs on an individual or family floater basis.
• Hospital Network: Provides cashless treatment at over 6,000 network hospitals across India.
• Treatment Coverage: Includes AYUSH therapies, modern medical treatments, organ donor expenses, and correction of refractive errors.
• Additional Medical Benefits: Covers ambulance charges, domiciliary (at-home) hospitalization, and daily hospital cash benefit.
• Post-Hospitalization Support: Covers doctor’s home visits, nurse/attendant/aya charges, and funeral expenses.
• Sum Insured Reinstatement: Automatically restores the sum insured if it gets exhausted due to a road traffic accident.
• No Claim Bonus: Adds 5% of the sum insured for every claim-free year, up to 50%.
• Flexible Premium Payment: Premiums can be paid quarterly or half-yearly as per convenience.
• Discounts: Offers a 10% discount for direct or online purchases without intermediaries and an additional discount for opting for co-payment.
• Optional Covers: Available at extra cost for Day 1 coverage of diabetes/hypertension, outpatient treatment, critical illness, and personal accident.
• Health Check-up Reimbursement: Reimburses the cost of health check-ups based on the selected plan.
• Tax Benefits: Premiums paid are eligible for tax deductions under Section 80D of the Income Tax Act, 1961.

Inclusions of Senior Citizen Health Plan by National Insurance

Here are some expenses that are generally included in this plan:

1. Coverage for advanced medical treatments
2. Treatment for severe obesity
3. Surgery to correct vision problems
4. Daily hospital cash benefit (only under Plan B)
5. Funeral cost coverage (only under Plan B)
6. Charges for doctor visits, nursing care, attendant, or aya services (only under Plan B)
7. Restoration of the insured amount if fully used due to a road accident (only under Plan B)
8. Hospitalization for inpatient treatment
9. Medical care at home if hospital admission is not possible
10. Expenses before getting admitted to the hospital
11. Expenses after being discharged from the hospital
12. Coverage for daycare treatments that do not need an overnight stay
13. Treatment under the Ayurveda and Homeopathy systems
14. Costs of ambulance services
15. Medical expenses for organ donors
16. Coverage for the treatment of HIV/AIDS
17. Coverage for mental health conditions

Exclusions of Senior Citizen Health Plan by National Insurance

Here are some expenses that are generally excluded from this plan:

1. Treatments received outside India
2. Weight loss treatments (unless medically necessary)
3. Treatment related to alcohol or drug addiction
4. Dental care (unless caused by an accident)
5. Supplements or vitamins taken without a doctor’s prescription
6. Cosmetic or plastic surgeries that are not medically required
7. Treatments that are not scientifically proven

Conclusion

National Senior Citizen Mediclaim Health Insurance is a helpful plan designed to take care of the medical needs of people aged 60 and above. It offers flexible coverage options, a wide hospital network, and benefits like cashless treatment, health check-ups, and tax savings. With two plan options, it covers everything from hospital stays to home care and even funeral costs. This plan provides peace of mind during old age by reducing the burden of rising healthcare costs. It is a smart choice for senior citizens and their families.