The National Insurance Varistha Mediclaim Policy is a health insurance provided by the National Insurance Company. The policy acts as a security for senior citizens who are more prone to frequently falling sick. Senior citizens within the age of 60 to 80 years can benefit from the policy. The tenure of the policy is one year, after which it can be renewed on a yearly basis. It covers hospitalisation and domiciliary hospitalization for a fixed sum insured per person.
Sub-limits are applied to certain treatments under the Varistha Mediclaim Policy the details of which are given below:
A sub-limit of Rs. 10,000 for cataract related treatments
A sub-limit of Rs. 20,000 for benign prostatic hyperplasia related treatments
Under domiciliary hospitalisation cover, a sub-limit of maximum 20% of the sum insured is applicable
Details of the copayments applied to the medical treatment bills under the policy are as follows:
10% copayment is applied to all treatments except cataract and benign prostatic hyperplasia
20% copayment is applied to the treatment for cataract and benign prostatic hyperplasia
10% co-payment is applicable for pre-existing disease treatments for which additional premiums have been paid
Pre-Policy Medical Screening is not required for those insured under the health insurance policies offered by the National Insurance Company.
Those not insured under the health insurance policies of the National Insurance Company have to get their health check-ups done at their own cost
If the proposal is accepted by the insurance company, 50% of the medical expenses incurred on pre-insurance medical checkups are reimbursed
The date on the medical reports should not be within 30 days of the date on policy proposal
The policy can be renewed annually on timely payment of the renewal premium. The renewal premium must be paid within 30 days of the date of policy expiry.
Those insured under the policy have to serve a waiting period of one year for specific diseases, the details of which can be found in the policy document.
An initial waiting period of 30 days has to be served to avail the benefits of the Varistha Mediclaim Policy
A 10% loading on premiums up to 85 years of age and a 20% loading on premiums above 85 years is applied
A free look period of 15 days is provided to those insured under the policy to offer them a window for cancellation on grounds of dissatisfaction from coverage/terms/conditions of the policy.
The policy can be withdrawn from the insurance company’s side. The policy holders are informed by the National Insurance Company before the withdrawal of any health insurance plans and they are also given an opportunity to switch to any other similar health insurance plan under the company.
A 30-day long critical illness survival period is provided under the plan which means that the policy holder has to survive a minimum of 30 days after being diagnosed with a critical illness to be able to claim the policy.
Coverage is provided only once a policy year in case of critical illness.
Although coverage is provided for open-chest CABG treatment, the amount payable is limited to 20% of the sum insured
If the insured person is not in a condition to relocate to a hospital or in case of unavailability of hospital beds, they can get treatment at home. Domiciliary treatment is done under special recommendations of the doctor, however, it doesn't cover the following things:
Any treatment for less than 3 days
Pre-hospitalisation and post-hospitalisation medical expenses
Medical expenses for certain diseases like Asthma, Bronchitis, Chronic Nephritis, etc.
Inpatient hospitalisation facilities are provided on hospitalisation for 24 continuous hours or more.
Pre-hospitalisation cover is provided for expenses incurred 30 days before the date of hospitalisation and post-hospitalisation cover is offered for 60 days after date of discharge .
A waiting period of 4 years applies to coverage of the treatment expenses for pre-existing diseases.
Domiciliary hospitalisation expenses
Room rent expenses up to a fixed limit
Cost of Anesthesia, Blood, Oxygen, Surgical Appliances, Drugs, etc.
Intensive Care Unit expenses covered up to a fixed limit
Health check-up on every three claim-free years
Expenses arising owing to HIV or AIDS
First 30 days waiting period for any disease
Intentional self-injury, drug or alcohol abuse
Congenital external disease or defects or anomalies
Vaccinations of any kind
Health care expenses can spoil the financial math for households very quickly. A safety net in the form of insurance has always been an integral part of healthcare. The current circumstances have made the requirement of insurance more prominent. The ongoing pandemic has seen senior citizens falling in a high-risk category. Since the National Insurance Varistha Mediclaim caters to senior citizens within the age of 60 to 80 years, it is undoubtedly the most important financial instrument during these times. To avail one of the most ideal health insurance policies, visit Finserv MARKETS, where you get swift claim settlements and an insurance cover of up to Rs 50 Lakhs.
The policyholder can claim benefits under 80D of the income tax act.
If you are covered by medical insurance for the last three years you do not need a test before the start of the policy. But in case you are not covered by health insurance, a medical test is mandatory.