National Parivar Mediclaim Plus Policy

What is the Plan all About?

National Parivar Mediclaim Plus is a floater health insurance policy providing health cover for your family as a single sum insured. This health policy covers in-patient hospitalization expenses for you and your family.

3 plan variants can be opted under this plan:

Plan A
Plan B
Plan C

Key Features

Health cover for family
Avail daily hospital cash
Anti rabies vaccination
Option to choose add-on covers
Lifetime renewability
Enjoy tax benefits

Policy Benefits

In-patient hospitalization expenses such as Operation Theater charges, Anaesthesia, blood , oxygen, etc. requirements are covered.
Pre hospitalization expenses are covered for 30 days prior hospitalization
Post hospitalization expenses are covered for 60 days post hospitalization.
Listed day care procedures/surgeries which need the insured to be hospitalized for less than 24 hours are covered.
Domiciliary treatment expenses are covered.
Organ donor expenses incurred during the course of organ transplant are covered. Hospitalization, Pre & Post hospitalization are also covered.
Daily hospital cash is payable for a maximum of 5 days, provided hospitalization exceeds 3 continuous days.
Doctor’s Home Visit and Nursing Care allowance (during post hospitalization) is applicable for Plan B & C up to the limits specified.
Anti Rabies vaccination is reimbursed as limits specified in the policy.
Maternity expenses are covered as limits specified in the policy. Vaccination for new born baby is a part of maternity cover.
Medical expenses incurred for treatment of infertility are covered as limits specified in the policy.
Vaccination for children (male-12 years, female-14 years) is covered as limits specified in the policy.
Medical Second Opinion is provided two times per family for each new diagnosis in a policy year. It is applicable for 160 major illnesses.
Out-patient treatment (per family) is covered as an add-on cover. This benefit can be availed up to the limits specified.
Critical illness is covered as an add-on cover. This benefit can be availed up to the limits specified.
Pre-existing Diabetes/Hypertension is covered an add-on cover. This benefit can be availed up to the limits specified.

Value Added Benefits

Get no claim discount. Get 5% discount on base premium, on completion of each claim free policy year.
Enhancement of sum insured at the time of policy renewal.
Reinstatement of sum insured in case of road traffic accident.
Emergency ambulance charges are covered.
Air ambulance charges are covered up to limits specified. This benefit is not applicable for Plan A.
Ayurveda and Homeopathy treatment expenses are covered.
Medical emergency reunion is covered for Plan B & C with no sub-limits applicable.
Health check-up is covered after every 2 continuous claim free policy years and it is covered up to up to Rs 5,000, Rs 7500 & Rs 10000 for Plan A, B & C respectively. This benefit can be availed irrespective of claims.
No pre-policy medical check-up is required up to 39 years, except opting for critical illness.
50% cost of pre-policy medical check-up is reimbursed.
Avail tax benefits u/s 80D as per IT Act, 1961 for premium paid for this plan.

Sub Limits

For Plan A- Room rent is capped up to 1% of SI or actual expenses, whichever is less. For Plan B & C- Room rent is payable for actual expenses.
For Plan A- ICU charges are capped up to 2% of SI or actual expenses, whichever is less. For Plan B & C- ICU charges are payable for actual expenses.
5% to 22.5% co-pay applies, when you are undergoing treatment in a zone other than the one you have paid the premium. 10% co-pay applies, in case of treatment taken in a non-network hospital. This co-pay shall not apply on Critical illness & Outpatient treatment optional covers. This co-pay is applicable only for Plan A. 75%, 50% & 25% co-pay applies for year 1, 2 & 3 respectively in case of Pre-existing diabetes / hypertension.
For Plan A- Cataract surgery is capped up to 15% of SI or Rs 60,000, whichever is less. For Plan B & C- actual charges are payable.
For Plan A- Domiciliary hospitalization is capped up to Rs 1 Lac. For Plan B & C- is capped up to Rs 2 Lacs.
Daily hospital cash (per insured person) of Rs 500, Rs 1000 & Rs 2000 for Plan A, B & C respectively.
For Plan A- Maternity expenses are capped up to Rs 30,000 for normal delivery and Rs 50,000 for caesarean section. For Plan B & C- covered up to actual expenses.
Ambulance charges of Rs 2500, Rs 4000 & Rs 5000 for Plan A, B & C respectively.

Waiting Period Clause

Initial Waiting Period: A waiting period of 30 days from the inception date for all hospitalization claims except in case of accidents.
Specific Waiting Period: Specific illnesses such as Benign ENT disorders, Tonsillectomy, Mastoidectomy, etc are covered after 12 months of policy coverage. Illnesses such as Cataract, Hernia, Hydrocele, Piles, etc are covered after 24 months of policy coverage. Treatment for joint replacement, Osteoarthritis and osteoporosis are covered after 48 months of policy coverage.
Pre existing Disease Waiting Period: Any pre-existing ailment/injury that was diagnosed /acquired within 36 months from the issuance of the first policy.
Maternity Waiting Period: Maternity expenses are covered after a waiting period of 24 months.
Infertility Waiting Period: Medical expenses incurred in the treatment of infertility are covered after a waiting period of 24 months.

Who can Buy the Plan?

Factor	Minimum	Maximum
Age (as on last birthday)	Adult: 18 Years, Children: 3 Months	Adult: 65 Years, Children: 25 Years
Sum Assured	6 Lacs	50 Lacs
Cover Type	Individual/Family Floater	-
Policy Tenure	1 Year	3 Years
Grace Period	30 Days	-
Free Look Period	15 Days	-
Riders	Out-patient Treatment, Critical Illness, Pre-existing Diabetes/Hypertension	-