National Senior Citizen Mediclaim is definitely a decent policy if you’re 60+, with pre-existing diseases. After all, they'll start covering these pre existing complications after just 2 years (as opposed to 4 years). But if you have other choices this policy could be a letdown considering they do have a few unsavoury conditions.
What's good here?
You’ll never have to split the bill
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
You always have full cover irrespective of the disease
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Short waiting period for Pre Existing Diseases
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after just 2 years. It’s probably the best deal you can get to be honest.
Pre & post hospitalization expenses covered
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Day Care treatments covered
If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.
Covers Alternative Medicine
Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.
What's bad here?
Restrictions on the rooms you can pick and much more
Your insurer won’t let you stay in a room whose rent exceeds 1% of the sum insured. If it’s an ICU they’ll bump it to 2% of the sum insured. And in the event you breach these limits, then you’ll have to pay a lot more - Read more here
Free Health Checkups every year
If you’re planning on getting a full body checkup every year just to make sure you’re in fine working condition, the insurer will cover the costs.
Some coverage if you are forced to hospitalize at home
The insurer will pay up to 20% of the sum insured if you are forced to hospitalize at home due to a medical condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.
What's lacking here?
No Restoration Benefit
Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.
Special Bonus for being healthy and not claiming insurance
Your sum insured increases by null% each year, so long as you make no claims during this period. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 50%. Also, the bonus amount will reduce at same rate each time you make a claim. But hey, it's still a bonus.
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