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Benefits of National Health Insurance?

Benefits of National Health Insurance

Benefits of National Health Insurance. National Insurance Company Limited (NICL) is a wholly-owned general insurance firm that India controls. It was established in 1906 and is considered among the oldest insurance companies in India. The company is located in Kolkata and has offices across India and an international branch situated in Nepal.

Rashtriya Swasthya Bimayana gives many possibilities to customize the program to meet the demands of various families and senior citizens. Citizens, etc. They can provide for requirements like hospitalization in-patients and daycare and hospitalization services. It also provides the most comprehensive medical insurance for those who are insured. A financial facility that is on time.

Achievements of National Insurance Company Limited

Here is a list of the best achievements throughout the decades. Let’s look.

  • The company was awarded the Economic Times Best Brands Award.
  • Awarded for All-round Excellence in General Insurance Category by Economic Times – BFSI Best Brands 2016
  • Received ‘Samudra Manthan Best Insurer of the Year Award’ in 2016.
  • Received SKOCH Financial Inclusion Awards in 2016.
  • Awarded ‘ICONIC BRAND Award’ (Insurance Sector) in 2016.

Features of National Health Insurance

The price of healthcare is rising rapidly, making it more crucial to have an insurance policy that covers any medical bills in emergencies. One of the most challenging aspects of buying medical insurance is selecting a company. According to the IRDAI Annual Report for 2019-20, 29 health insurance providers in India. With such a wide range of available insurance companies in the market, it’s becoming increasingly challenging to choose the most reliable insurance provider.

To make the process of making a decision simple for you, We’ve listed the top aspects of this company. Let’s take a look.

A brief overview of these features is given below. Let’s take a look more in-depth.

Benefits of National Health Insurance

1 Network Hospitals

National Insurance Company has a vast number of hospitals that are members of the network policyholders can access for cashless treatment. The company has agreements with over 2,600 health establishments across the nation. Patients can receive treatment at any of the hospitals in the network without worrying about the cost since the company will cover all medical expenses for the patient.

Below is a table that lists the hospitals that are part of the network of hospitals that are part of the network offered through National Health Insurance as compared to other hospitals in the top network operated by insurers.

2 Annual Premium

If you’re interested in knowing more about an insurance company’s reliability, Make it the top priority to analyze their market standing. The graph below shows the rise in National Health Insurance premiums in the past four years. In this graph, it is apparent that the insurance company saw an improvement in its insurance cost starting in 2016-17 through 2018-19.

3 Claim Support

The proportion of support for claims is a crucial aspect to be considered when purchasing the health insurance policy. It aids in assessing the potential settlement of claims for the company. It is typical to buy health insurance to ensure we can cover medical expenses should there be a tragic incident that occurs shortly. It is recommended to choose an insurance company with an outstanding support rate for claims. If we’re discussing National Insurance Company, then according to IRDAI data, the ratio of shares support offered by this company is 45.37 percent.

4 Solvency Ratio

Before you put the money you have saved into health insurance plans provided by the business, it is essential to know how stable the company’s finances are. It is suggested to look at how solvency is rated of the company before choosing the best plan. Under IRDAI, Medical insurance companies in India must maintain a solvency ratio of a minimum of 1.5. The solvency ratio for National Insurance Company is 0.37.

5 Operating Network

National Insurance Company has an extensive operating network, including branches across India. The company has 1730 offices, with over 13000 highly skilled employees and more than 50.000 agents. In addition, National Insurance also operates an overseas office in Nepal. With the oversight of this large operations and distribution, it aims to provide its services to a large number of customers across India and Nepal.

Benefits of National Health Insurance

Types of National Health Insurance Plans

To meet the various demands of its customers, the National Insurance Company has created a variety of options for medical insurance. The table below provides information on the general view of the various plans. Let’s take a look at this.

1. National Mediclaim Policy

National Mediclaim policy includes hospitalization costs in medical treatments for injuries or illnesses caused by the insured within the policy’s period starting at the three-month mark up to the time of self-separate spouse dependent children or dependent parents’ family relatives, parent, father-in-law, law or brother ( from 25 to 25 years old) young) or sister (if not married on the day of the marriage) and a child born.


  • Treatment for AYUSH will be covered (up to 100% of the amount insured).
  • Provides coverage for more than 140 daycare services.
  • The policyholder also has the right to the benefit of a cumulative amount of 5 percent of the Sum Assured the year that is not a year that is claim-free when the policy is renewed after an ongoing basis.
  • Twelve new treatments, such as oral chemotherapy, immunotherapy, etc., belong to the program.

2. National Mediclaim Plus Policy

National Mediclaim Plus policy is an individual policy that provides medical expense protection by providing comprehensive coverage that is far more extensive than traditional health insurance plans.


The plan is offered in three plans of payment that range from. 2,00,000 to 50,00,000 Rs. These plans comprise:

plans A 9 Slabs from 2L to 10L in multiples up to 1L. Plans B 3 Slabs 15L/20L/25L

Plan C – 3 Slabs, 30L/40L/50L

It will cover medical expenses (including Air ambulances) and organ donation expenses (up to a specified limit, as per these guidelines). Benefits of National Health Insurance

It pays (payable according to the plan’s limitations) for the expenses incurred due to hospitalization, doctor’s residency visits, and nursing services. Benefits of National Health Insurance

Cash assistance for hospitalization (up to five days max) is available to the insured by the policy’s provisions.

The vaccination of children up to 12 years is covered under the program.

3. National Family Mediclaim Policy

National Family Mediclaim Policy is the name of a health insurance policy that provides responsibility for health expenses of the entire family (at the minimum, two members in the household, i.e., parents, spouse, self, or dependent kids) as a lump-sum covered.


  • It covers allopathic as well as ayurvedic or homeopathic remedies only.
  • The policy covers prehospitalization costs (up 30 days or more)) as well as post-hospitalization expenses (up 30-to-60 day calendar).
  • Get tax-free benefits by claiming Section 80D of the Income Tax Act, 1961 for the amount of tax you have to pay.
  • This plan covers medical costs related to admission to the hospital at home.

4. National Parivar Mediclaim Plus

National Parivar Mediclaim Plus is a comprehensive health insurance policy that provides coverage to self, dependent children, spouse, and parents/mother-in-law under one Sum Insured.


The plan provides three ways of how to pay the Sum Assured

Plan A Five slabs that have a multiplication of the 6L as well as 10L

Plan B: 3 Slabs, 15L/20L/25L

Plan C: 3 Slabs, 30L/40L/50L

The policy gives AYUSH benefits. Under this policy, allopathic, ayurvedic, and homeopathic therapies are covered up to the amount of the insurance policy.

It covers prehospitalization for up to 30 days and post-hospitalization coverage for up to 60 days.

Benefits of National Health Insurance

In exchange for a price, you’ll be able to cover diabetes that is already present as well as hypertension.

5 .Overseas Mediclaim Business and Holiday

The Overseas Mediclaim Business and Holiday Policy are designed to cover emergency medical situations in foreign countries when traveling to work or on vacation. This policy is available to three types of travelers:

  • Business and holidays
  • Education and employment
  • Frequent Corporate Traveler


  • According to the plan, the client must pay the first US 100 of the claim.
  • It will also cover delays and losses when checking-in baggage.
  • If a person is over 70 and taking longer than 60 days, they must submit the following medical document (from the MD Cardiologist) along with the proposal form:
  • ECG
  • Blood sugars or urine are not in the course of a strip test

5. Overseas Mediclaim Employment and Studies Plan

Overseas Mediclaim Employment & Studies is a program that provides for travel-related expenses emergencies when traveling abroad. It is accessible to three categories of travelers:

  • Business and holidays
  • Employment and study
  • Frequent Corporate Traveler


  • The policy guards against damage or delays with baggage checked-in.
  • The policy also covers accidents involving medical or disability.

6. National Critical Illness Policy

The National Critical Illness Policy looks at the cost of treatments and the costly healing process associated with these illnesses. The policy covers you for the insured’s entire life victimized by one of these severe diseases.

The policy gives two options to protect against the most severe illness.

  • Plan A11 serious illnesses are covered under this.
  • The Plan B37 Critical illness (including plans A covered ailments) are covered under this.


  • Policyholders can enjoy discounts of 10 percent on premiums for members of the family who are eligible when the insurance plan is bought for the whole family.
  • Suppose you’re an employee of National Insurance Company. In that case, this policy will give you an additional 15 percent on your premium, which will cover you as well as the members of your household.

7. National Senior Citizen Mediclaim Policy

This plan has been specifically developed, especially for seniors (60-80 age), covering the hospitalization (Allopathy, Ayurveda, and Homeopathy) and the cost of home hospitalization or treatment for illness or injury within the time frame of the policy.


  • This plan comes with two choices:
  • Plan A 10-slab plan, Rs.1,00,000 from Rs.10,00,000.
  • The plan B consists of 10-slabs Rs.1,00,000 until. 10,00,000. There are a few other possibilities
  • The plan provides coverage for allopathic treatments. It also covers ayurvedic as well as homeopathic remedies.
  • The scheme also covers (up to 20% in the case of SI) medical expenses in hospitalization at home.

8. National Super Top Up Mediclaim Policy

National Super Top Up Mediclaim is the most high-risk health insurance policy covering one premium for the entire family. It offers comprehensive insurance coverage at a fair price.


  • The expenses of treating obesity will be covered in the timeframe specified.
  • The insurance plan covers (up to the amount of insurance) for pre and post-hospitalization expenses (up to 60 or 30 days) and medical expenses for the organ donor and hospitalization treatments.
  • Twelve contemporary treatments are covered in the report.

9. Arogya Sanjeevani Policy

Arogya Sanjeevani, an insurance plan for individuals with health issues that will cover hospitalization expenses in the event of an injury or illness within the period of this policy.


  • If you have to treat cataracts in one eye, it will provide sufficient protection (Rs 40000 or 25% SI, depending on the lesser).
  • AYUSH insures a policyholder for treatment.
  • The plan provides coverage for hospitalizations before and afterward (up to 30 (or 60) days, depending on the project).

Benefits of National Health Insurance

Exclusion of National Health Insurance Plans

These are the exceptions in which there is no insurance to the insured.

Let’s take a look.

  • Any psychiatric and psychosomatic disorder, illness/disease/accidental injury arising from drug/alcohol abuse by the policyholder.
  • There isn’t any coverage for travel that is in contravention of health advice or services like routine checks.
  • This claim rests on military, naval, or air force missions.
  • Any illness or injury directly or indirectly caused by war, aggression, or terrorist acts or violence.
  • Treatment of any kind for spinal injuries.
  • The cost of any expense related to the treatment of sexually transmitted diseases such as HIV or AIDS.

How to Buy National Health Insurance Plans?

There are two ways to buy an insurance policy for health through the National Insurance Company. You can first buy health insurance from the official website owned by the firm. Note that the business only sells specific health insurance products over the web. You can also purchase policies from third-party agents or brokers.

We’ve given a detailed step-by-step procedure to buy health insurance through the National Insurance Company website in the next section. Learn more.

  • Visit the official website of the company.
  • Click on the ‘Products’ tab and select”Health” from the menu.
  • Click on the “Get Quote’ or ‘Buy’ Policy menu.
  • Select the plan you’d like to purchase, then click it.
  • Fill in all the required information as well as other information.
  • Pay the cost online.

When you’ve completed your purchase, you’ll receive the soft copy of the policy to your email address that is registered by the business. You can also visit your nearest National Insurance Company branch to buy a health insurance policy. Benefits of National Health Insurance

Benefits of National Health Insurance

Documents required to make the National Health Insurance claim

Below is the document list that the clients need to submit to file a claim for their Rashtriya Bima Yojana

  • Complete the claim form accurately.
  • The patient’s photo ID
  • Prescription of the Medical Practitioner Advising Admission
  • Original bill with detailed break-ups.
  • Receipts from payments
  • Summary of discharge contains the patient’s complete medical history and other details.
  • Tests/Diagnostic tests have been confirmed by a prescription issued by the medical professional treating the patient. Medical Practitioner, etc.
  • OT Notes or surgical certifications (for surgeries) giving details of the procedure carried out.
  • Invoices/stickers to implant patients If suitable.
  • MLR (Medico-Legal Report) copy when FIR (First Information Report) is filed, if filed and if applicable.
  • Information about NEFT (to permit direct debit of claim to an account at the bank) as well as a cancelled check
  • KYC (Proof ID ) with the address) from the individual who made a claim, in instances when the amount of liability is more significant than Rs.1 lakh according to
  • AML guidelines
  • Legal Succession/Succession Certificate, wherever applicable

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