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Senior Citizen Mediclaim Individual
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Synopsis:
National Senior Citizen Mediclaim Policy is an indemnity health insurance policy for the aged.

Highlight:

  • Basic Sum Insured in INR 1LAC to 10LAC
  • Domiciliary Hospitalisation Up to 20% of the Sum Insured
  • Modern Treatment Up to 25% of SI for each treatment
  • Treatment due to participation in hazardous or adventure sports Up to 25% of SI
  • Morbid Obesity Covered after Waiting Period of 4 years
  • Refractive Error Covered after Waiting Period of 2 years
  • Funeral expenses (per individual) Up to INR 5,000 Under Plan B
  • Personal Accident:- Capital Sum Insured per individual – INR 1,00,000/ 2,00,000/ 3,00,000/ 4,00,000/ 5,00,000/ 6,00,000/ 7,00,000/ 8,00,000/ 9,00,000/ 10,00,000
  • Mental Illness Covered
Benefit:
Title Description
Room Rent Limit Plan A: 1% of SI per day subject to maximum of INR 5,000 per day | Plan B :2% of SI per day subject to maximum of INR 10,000 per day
ICU Daily Rent Limit Plan A: 2% of SI per day subject to maximum of INR 10,000 per day | Plan B: 4% of SI per day subject to maximum of INR 20,000 per day
Pre-Hospitalization Expenses 30 days
Post Hospitalization Expenses 60 days
Minimum Hospitalization Period 24 hours
Day Care Procedure Coverage 140 Day Care Procedures covered
Additional Cover for Critical Illness Benefit amount per individual- INR 1,00,000/ 2,00,000/ 3,00,000/ 4,00,000/ 5,00,000/ 6,00,000/ 7,00,000/8,00,000/ 9,00,000/ 10,00,000
Automatic Restoration of Sum Insured Plan A: Not Available | Plan B: Once during the Policy Period for road Traffic Accident
Pre-Existing Disease / Illness coverage Covered After 24 Months of continuous coverage
Waiting Period for New Policy Covered After 24 Months of continuous coverage
Co-Payment Insured opting for cover for pre-existing diabetes or hypertension 10% | Insured opting for cover for pre-existing diabetes And hypertension 25%
Free Health Checkup Plan A: Every 2 claim free years up to 2 % of the average SI subject to maximum INR 4000/Insured (individual basis) or per family (floater basis | Plan B: Every 6 claim free monthsup to INR 1000/Insured
Ambulance Expenses Up to INR 2,500 per Illness
Non-Allopathic Treatments Covers Allopathy, Ayurveda, Homeopathy treatments up to Sum Insured
Daily Hospitalization Allowance Plan A: Not Available| Plan B: INR 500/- per day for 5 days (in excess 3 days)
Donor Expenses Coveres Organ Donor’s Medical Expenses Medical expenses, Pre & Post-Hospitalisation expenses up to Sum Insured
Attendant Allowance Plan A: Not available |Plan B: Aya, Doctor's home visit charges and nursing care during Post-Hospitalisation (per individual) INR 500/- per day for 7 days
No Claim Bonus Increase by 5% of SI in respect of each claim free year of insurance. Decrease by 5% of SI for each year with claim reported

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