National Varistha Mediclaim Policy Health Insurance

• Pre and post-hospitalisation expenses
• No claim bonus 
• Critical illness cover
• Pre-existing illness cover
• No prior medical screening or check-up
• COVID cover included
• Day care, domiciliary, ICU, room expenses
• Ambulance expenses

• Hospitalisation expenses: The National Senior Citizen Mediclaim policy covers pre hospitalisation and post hospitalisation expenses provided that the period before hospitalisation does not exceed 30 days and post-discharge does not cross 60 days.
• No-claim bonus: Insurers are eligible for a 5% no-claim bonus on every claim-free year. The maximum limit for this bonus is 50%. This bonus can be added cumulatively to the sum insured when renewing the policy. 
• Critical illness coverage: National Insurance Varistha Mediclaim Policy provides cover for critical illnesses such as 
  • Cancer
  • Renal Failure
  • Multiple Sclerosis
  • Stroke
  • Major Organ Transplant
  • Coronary Artery Surgery
  • Permanent paralysis of limbs
  • Permanent blindness 
  • Open heart CABG
  • Kidney failure
• Pre-existing disease coverage: The National Senior Citizen Varistha Mediclaim Policy covers pre-existing conditions like diabetes and hypertension from the onset of the policy. However, additional premium payment is applicable. The policy also includes joint replacement surgery, hernia, fissure, sinusitis, piles, congenital internal diseases, and cataract after a waiting period of one year. 
• No prior medical check-up: Policyholders are not required to undergo a medical check-up to avail coverage if they were insured under an insurance plan for the previous three years. If not, they are required to go for a medical check-up. 
• Co-payment: Insurers must pay 10% co-payment on all claims. They also have the option of 2% copayment which will make them eligible for a 10% discount on the premium. An additional 10% co-pay is applicable in case of pre-existing diseases.
• Additional coverage: Policy holders benefit from cashless hospitalisation at network hospitals. In addition to this, inpatient care, domiciliary hospitalisation, ambulance charges, room rent, intensive care unit expenses are also included. 

Here's a table highlighting the eligibility criteria to avail the benefits of the National Senior Citizen Mediclaim policy: 

• The Varistha Mediclaim policy covers 8 critical illnesses: Cancer, Renal Failure, Multiple Sclerosis, Stroke, Major Organ Transplant, Coronary Artery Surgery.
• It also provides coverage for injuries and accidents.
• Domiciliary hospitalisation expenses up to 20% of original sum insured is included under the policy.
• Policyholders can avail room rent and Intensive Care Unit expenses to a certain limit.
• Expenses incurred in anesthesia, medical drugs, surgical equipment, blood, oxygen are covered.
• For every three years that a claim is not made, policyholders can avail a health check-up.
• Medical fees of surgeons, physicians, anaesthetists, consultants, disease specialists up to 25% of the sum insured is included.

• Costs incurred in case of HIV or AIDS or related immune-deficiency syndromes are excluded.
• Any expense or critical illness during the first 30 days of the waiting period is not covered. Convalescence expenses or rest cure are excluded. 
• Costs arising due to sterility and venereal disease are excluded.
• Maternity costs, pregnancy-related expenses including caesarean are excluded. 
• Expenses arising due to intentional self-harm attempts, abuse of alcohol and drugs shall not be compensated for. 
• Diseases from birth or congenital diseases or birth defects/anomalies are excluded. 
• The policy does not include cosmetic or plastic surgery, change of life.
• If the insured is hospitalized for diagnosis and evaluation, it will not be covered. 
• Other exclusions include naturopathy treatment, dental treatment, war-related treatment, cost of spectacles, hearing aids, etc.