National Super Top Up Mediclaim Policy

Policy Details:
National Super Top Up Mediclaim Policy is a high threshold health insurance product, covering the members of a family under a single sum insured on floater basis or each member on individual sum insured basis. The policy provides the customer an option to choose a high sum insured at reasonable cost. This policy can be taken with/without a base policy. This policy provides unique features which address all health related concerns of our valued customers. The expenses incurred should be reasonable, customary and medically necessary.

Highlights

Highlights of National Super Top Up Medicalim Policy
Sum Insured (SI) and Threshold

The Policy is available with following combinations of Threshold and sum insured.



For Policy issued on individual basis, both Threshold and sum insured shall apply on individual basis on each insured person.
For Policy issued on floater basis, both Threshold and sum insured shall apply on floater basis to all the insured persons.

Entry Age of proposer 18 to 65 years
Maximum entry age of any family member - 65 years.
Who can be covered Self, Spouse, Dependent legitimate or legally adopted children, Parents/Parents-in law, new born 3 months 18 years.
Lines of treatment covered Allopathy, Ayurveda and Homeopathy
In-patient Treatment including Room Rent/ICU charges, Medical practitioners, surgeon, anesthetists, consultants, specialist fees and other charges are covered.
Ambulance Charges on actuals but will be paid once for any one illness for each insured person.
Organ Donor Medical expenses, Pre & Post Hospitalization expenses covered up to Sum Insured.
Pre and Post Hospitalization up to 30 days and 60 days respectively for same disease/illness/injury for which Hospitalization occurred.
12 Modern treatments like Robotic surgery, oral chemotherapies, immunotherapies and etc., are now covered in the policy.
Treatment for morbid obesity are now covered after specified waiting periods. (refer policy for complete details)
Correction of eyesight, i.e., refractive errors above -7.5 D are now covered after specified waiting periods
. Treatment related to participation as a non-professional in hazardous or adventure sports subject sublimit.
Mental illness, HIV/AIDS, Genetic disorders are now covered.
Cashless Facility available at Network Hospitals Only through TPA. Pre Negotiated Package rates for specific surgeries/procedure in network hospitals.
Life Long Renewability.
Portability (migration) allowed from/to similar products only as per IRDAI guidelines.

Covered

Why buy National Super Top Up Policy:
Policy covers commonly excluded diseases/conditions likeHIV/AIDS, Obesity- bariatric surgery and Maternity up to the Sum Insured, subject to waiting periods.
Waiting period of only one year in all Pre-Existing Diseases. Waiting periods for specific diseases are limited to 90 days, one and two years instead of the usual one, two and four years.
Medical expenses are reimbursed without any sub limits. (For e.g. Room rent per day, Doctor fees & etc.).
This policy can be taken with/without a base policy.
Attractive discounts for Early Entry, Family (in individual policies only) and Online/Direct/Walk in customers.
Annual Increase in SI by 5% for each claim free year up to maximum 50% of SI opted.
Tax Rebate under Section 80D of Income Tax Act 1961 for premium paid

Pre Policy Check Up National Super Top Up Policy
For Whom -
Proposers aged 50 years and above (including dependents) and availing the policy for the first time.

No pre policy health check-up shall be required for existing policyholders of the Company,covered under any retail indemnity health insurance policy for a continuous period 3 years or more as on date of opting for this policy.

The Pre Policy check-up reports required are
a) Physical examination (report to be signed by the Doctor with minimum MD (Medicine) qualification)
b) Blood sugar (fasting/ post prandial)
c) Lipid profile
d) Serum creatinine
e) Urine routine and microscopic examination
f) ECG
g) Any other investigation required by the Company

Note: The date of medical reports should not exceed 30 days prior to the date of proposal. 50% of the expenses incurred for pre policy check-up shall be reimbursed, if the proposal is accepted. Terms and conditions apply.

Exclusions

Exclusions National Super Top Up Mediclaim Policy
Only claims arising out of accidents are payable for the first 30 days of Inception of the Policy
All pre-existing diseases included after first twelve months (12) of Policy and thereafter as follows:



90 days, One, Two and Three Years waiting period for specific diseases
Change-of-Gender Treatments, Cosmetic or Plastic Surgery, Excluded Providers
Vitamins, Tonics Drug/alcohol abuse, Self-Inflicted Injury
Non Prescription Drug, Home visit charges
Dental treatment (unless arising out of accident and requiring hospitalization) and Out Patient Department treatment (OPD treatment)