National Health Insurance FAQs

Anyone above the age limit of 18 can purchase the coverage. Children aged 3 months to 18 years can be insured if their parent(s) is/are eligible.

Anyone up to the age limit of 65 can purchase the coverage of the National mediclaim plus policy.

These family members can benefit from the policy:

• Self
• Spouse
• Legitimate or adopted dependent children
• Parent(s)

Yes. National Critical Illness Policy offers coverage for 37 major illnesses and treatments.

If the insurance proposal is approved and the insurance premium is paid, the firm will repay 50% of the expenditures used for the pre-policy examination.

The following reports are necessary for a National health insurance pre-policy check-up:

1. Physical examination signed by a physician
2. The lipid profile
3. HbA1c
4. Creatinine in the blood
5. Microscopic inspection and urine routine
6. Eye test (including retinoscopy)
7. ECG
8. Any other inquiry that the firm requires

In order to track your claim, you need to first visit the National General website. Click ‘Track Claim Status’ on the page menu. Input basic details - customer ID, claim number, policy number, loss date and a captcha. Click on ‘search’. You will be provided with an updated claim tracker.

In order to contact National health insurance online, you need to mail them at customer.portal@nic.co.in.

Visit their website to locate your local National General office.

Visit their website to locate a National network hospital in your locality.

There are other offline payment options available. However, online healthcare insurance renewal is one way to pay for National health insurance renewal online. Additionally, a demand draught or check may be used to make payments in the presence of the insurer's office. Be aware that certain insurers will only accept cash payments up to a certain amount when renewing medical insurance coverage.

One-year agreements for medical insurance are frequently made available for purchase. Some insurance providers could remind you to renew. One-year agreements for medical insurance are frequently made available for purchase. When the policy is set to expire, certain insurers may send the insured a renewal notification.

You only have 60 days from the final settlement date when your existing National health insurance plan expires to renew your protection, according to IRDAI.

The insurance companies have a predetermined grace period for consumers who don't extend their insurance before their policies expire. It is often desirable to renew well before the date of expiration, but since the insurance companies don't provide any coverage even during the grace period, this is not always the case. Therefore, for no reason at all, avoid or ignore the expiration date.

It is advisable to pay a premium before the fiscal policy expiration date in order to benefit from the plan's advantages. Due to unanticipated circumstances, National health insurance offers a 30-day time limit to settle the payment; insurance benefits are suspended during this time.

Seven working days after obtaining the last "required" document, the company normally responds to claims. However, there are times when the deadlines are extended. These can last for a maximum of 30 days.

A claim's amount might be decreased as a result of any of the following components:

• The cost of meals, calls and other non-medical costs is not covered by reimbursement.
• Without the required paperwork or prescriptions or if original bills and receipts are not submitted.
• Reports of diagnostic tests are not submitted.
• There is a price cap for each unique service or benefit, but there are no real records or bills.
• Depending on your insurance coverage, this information may differ and is just being offered as an example.
• Any therapy or research that is carried out that is unrelated to the patient's condition by the patient has a price.

Over and above the Sub-limits.

You may receive care for free at more than 3,201 National health insurance network hospitals.

The indemnity bond for loss of policy document, which must be created on INR 200 stamp paper and properly notarized, must be submitted if the claimant has lost the original policy bond.

When a hospital stay is anticipated, the insurance company must be notified three days in advance. However, if a covered individual requires emergency hospitalisation, the healthcare provider for the coverage must be contacted very once.

The National health insurance policy download is available for download on the insurer's website. If you'd want more help, you can also phone the National health insurance team's customer support at 18003450330.

The National health insurance claim process is described in the policy papers, yes. There are two ways to register a claim: cashless claims and reimbursement claims. For records and to resolve claims, every policyholder should have a copy of their National health policy download on hand. The insurance provider must be notified within 48 to 72 hours of a scheduled hospitalisation by policyholders.

The policy schedule, the first premium receipt, any attached endorsements or supplements, along with all addenda provided by the company from time to time, the medical examiner's report, and any other document(s) requested by the company and submitted by the policyholder to enable the company to process the proposal are all considered to be part of the policy document. You can get yours through the portal of the National health policy download online.

The five main elements of the National health insurance policy are:

• Exclusions
• Insurance declarations
• Insurance contracts
• Definitions
• Conditions

When real policy information is unavailable or takes some time to arrive, the insurance provider will occasionally give a cover note known as a National Insurance policy note. On their official page, you may get the National health insurance copy download.

Air ambulance, maternity insurance, hospital cash benefit, medical emergency reunion, and kid immunizations. alternative cover Critical Illness Benefit up to INR 25 lakhs under insurance coverage. Every year there is a growth in the policy amount covered, up to a maximum of 50% of the SI.

The National Mediclaim Policy from National Insurance safeguards your health and the health of your family. It lessens the cost associated with unplanned medical crises. In the case of hospitalisation through a preferred provider network, there is no sub-limit.

By acquiring National health insurance with AYUSH cover, you can get covered for treatments such as. Homoeopathy, yoga, Ayurveda, Siddha, Unani, and other effective alternative healthcare practices. As a component of well-being and precautionary healthcare, you can enrol in AYUSH treatment coverage.

If the proposer is 40 years of age or older, purchases SI for INR 6 lakh or more (regardless of age), or chooses the critical illness optional cover from the National Health Insurance benefits while between the ages of 18 and 65, a pre-policy checkup is necessary.

Always bear in mind that healthcare insurance has several exclusions. A policy's exclusions list, which differs between policies, might help you decide which one best meets your needs.

• Psychological counselling, palliative therapy or other psychotherapy types that don’t require hospitalisation.
• Cost of the organ to be transplanted won’t be covered under National health insurance.
• It does not cover delivery or termination within a waiting period of nine months. However, the waiting period clause won’t apply if delivery, abortion or miscarriage is due to an accident or any other medical emergency.
• One of the major exemptions in health insurance is the expense of cosmetic treatment.
• If you already have the ailment when you seek coverage, it will be regarded as a pre-existing condition.
• Health insurance may not always provide coverage for alternative treatment modalities for conditions such as electromagnetic therapy, acupuncture, naturopathy, homoeopathy, and disorders caused by lifestyle choices.
• For damages that the covered deliberately causes, health insurance falls short. This includes any injuries caused by self-inflicted injury or failed suicide attempts.
• Rent, ambulance costs, and doctor visits are just a few of the expenses that National health insurance policies put a cap on.

COVID-19 is covered under theNational health insurance network hospitals scope. The insurance programme covers hospital stays and COVID-19-related diagnostic procedures. Find out if there are any nearby National health insurance hospital lists by visiting the website.

If you decide to receive treatment at a clinic outside the insurance network, you will be compelled to pay the medical fees on your own after being released. Later, you can contact the insurance company and request a reimbursement.

The network of theNational health insurance network hospitals plan includes more than 3,201 hospitals. They are widely dispersed across the nation and have easy access to medical care.

An insurance provider has a contract with a network hospital that enables covered individuals to receive care without paying cash. Your insurance company will cover your out-of-pocket medical costs if you obtain hospital treatment in the network.

insurance is meant to protect you from the costs of necessary medical bills. Thus, certain non-medical expenses that your claim for cashless health coverage would not cover may be charged to you, such as:

• Healthcare facility registration fees
• Purchasing toiletries
• Services fees
• Entrance fees

A premium is the price of the coverage you've purchased, as determined by your insurance company. Prior to your insurance carrier starting to offer coverage, you must incur a deductible.

Following are some tips for reducing your premium:

• Select long-term health insurance
• Select top-ups
• Opt for family floater plans
• Buy at younger age
• Maintain a healthy way of life
• Increase your deductible to a higher amount

A good calculator not only saves you time and effort but is also simple to use. Genuine documents are not essential to getting top prices. One may get premium rates for a range of possibilities in moments by filling in a few facts like identity,date of birth, your annual income,  and so on. You can access your health insurance online without the supervision of an agent.

The basic structure is Final Additional Bonus (if specified), Bonuses, and Sum Assured. The insurance company is required by corporate policy to incorporate the maturity value in all inducements and most recent bonuses.

A health insurance premium calculator is an online application that allows a potential customer to calculate the cost of the premium for a specific health insurance plan. Given the rise in medical expenditures, determining the premium is more crucial than ever.

The plan offers the sum insured from INR 3 lakhs to INR 20 lakhs.

The plan has deductible amounts from INR 2 lakhs to INR 10 lakhs.

Yes. Allopathy, Ayurveda and homoeopathy treatments are covered by the policy.

Yes. The top up policy from National General covers pre-existing diseases after a waiting term of 12 months.

Anyone within the entry age limit of 18 to 65 years is eligible to purchase National health insurance top up plans.

Policyholders who are between the age of 18 years to 65 years are eligible to buy National Critical Illness Policy.

Yes. National health insurance critical illness plans do cover specified severity cancer.

If your insurance proposal is accepted, half of your pre-acceptance policy check-up fees will be paid.

The following pre-acceptance medical tests are necessary:

• Physical examination
• Lipid profile
• HbA1c
• Serum creatinine
• ECG
• Urine routine & microscopic examination
• Eye check-up (plus retinoscopy)
• Any other medical test required by the firm and is considered important for qualification.

Here are the specified exclusions for National health insurance critical illness plans:

• Diseases during the 3-month waiting period 
• Pre-existing diseases
• Assisted conception, infertility, sterility, genetic disorders, congenital conditions
• Pregnancy
• Drug addiction & non-prescribed drug
• Self-infliction injury