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National Health Insurance Super-Top-Up Plans
National Super Top-up Mediclaim is a special kind of health insurance. It helps pay your hospital bills only after you spend a certain amount or use up your regular health insurance limit. This policy is for both individuals and families. For families, it works on a “floater” basis, which means the coverage is shared by all family members. You can buy this policy even if you don’t have any other health insurance. For individual plans, the insured amount and the waiting amount (called deductible) apply to each person separately. For family floater plans, the insured amount and deductible are shared by the whole family. Some key Features of the Super Top Up Plan are as follows:
- 01
Sum Insured
Rs. 3 lakh to Rs. 20 lakh
- 02
Minimum Entry Age
Individual policy: 18 years
Family Floater policy: 3 months - 03
Maximum Entry Age
Adults: 65 years
Dependent children: 18 years - 04
Deductible Amount
Rs. 2 lakh to Rs. 10 lakhs
- 05
Pre-existing disease waiting period
48 months
- 06
Day care treatments
140
Main Benefits of the National Super Top-up Mediclaim Policy
Here are some simple things that can affect how much you pay when you renew your National Health Insurance policy:Helps with high medical costs
This policy supports you when hospital bills become too expensive.
No limits on room rent or doctor fees
You can get back the full amount you spend on room rent and doctor fees. There are no small limits on these.
Cashless treatment in many hospitals
You can get treatment without paying money first at over 6000 hospitals in more than 12 cities.
Fixed rates for some surgeries
Some surgeries have set prices in network hospitals, so you know what to expect.
Bonus for no claims
If you don’t make a claim in a year, your insurance amount goes up by 5% every year, up to 50% extra.
Good claim approval record
National Insurance has a claim settlement rate of 84.61%, which means they pay most of the claims.
Health Insurance Plans By National
What is Covered and Not Covered in the National Super Top-Up Mediclaim Policy?
This policy covers the following and does not cover the following
Covered
- Mental illness, HIV/AIDS, and genetic diseases are covered under this plan.
- Bariatric (weight loss) surgery and maternity care are covered up to the full insured amount.
- Ayurveda, Homeopathy, and Allopathy treatments are all included.
- Costs for the organ donor and medical expenses before and after hospital stay are covered up to the insured amount.
- Hospital stay costs like room rent, ICU charges, and fees for doctors, surgeons, anaesthetists, and specialists are all included.
- Adventure and risky sports injuries (for non-professional activities like trekking) are covered, but with some limits.
- Eye surgery (vision correction) and treatment for morbid obesity are covered, but only after a waiting period.
Not Covered
- Medicines without a doctor’s prescription (non-prescription drugs).
- Vitamins and tonics, unless a doctor says they are needed for treatment.
- Health problems caused by alcohol or drug abuse are not covered.
- Injuries you cause to yourself on purpose (self-harm) are not included.
- Doctor’s home visit charges are not paid by the policy.
- OPD treatments (like regular checkups or small treatments without a hospital stay) are not covered.
FAQs
Yes, the plan covers 12 new types of treatments. These include things like oral chemotherapy, robotic surgery, immunotherapy, and more.
If you have an accident during the cooling period, the plan will pay for the treatment. Other health problems are not covered during this time.
If you are over 50 years old and buying this for the first time, a health check-up is needed (including for dependants). If you already have a regular health policy for 3 years in a row, then you don’t need a check-up.
No, dental care is not covered, unless it is caused by an accident and needs hospital treatment. Normal dental checkups or cleanings are not paid for.