Hospitalization for illness, disease or accident, including the expenses of surgery at times imposes heavy financial burden on the person as well as his family, employer as well as welfare organization. To make things easier and hassle free the ‘National Insurance Mediclaim’ has been devised under the aegis of Government of India. The policy provides the following benefits.
1) Reimbursement of hospitalization expenses which incurred under the following head:
a) Room boarding expenses provided by the hospital or nursing home at 1% the sum insured or a maximum of Rs.5000 and ICU expenses at 2% the sum insured or a maximum of Rs.10,000. The overall limit can be extended to 25% of the sum insured.
b) Nursing expenses.
c) Fees of surgeon, anesthetist, medical practitioner, consultant and specialist. The maximum limit of this expense is 25% of sum insured.
d) Expenses on account of anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, diagnostic material, X-ray, dialysis, chemotherapy, radiotherapy, cost of pacemaker, artificial limbs, cost of organs and other expenses. The maximum limit per illness is 50% of the sum insured.
The company has also introduced some sub-limits.
Ambulance services charges would be 1% of the sum insured or a maximum of Rs.1000 provided registered ambulance is used for shifting the patient to the hospital from home. If admitted to ICU or emergency ward or from one hospital to another the maximum limit would be 50% of the sum insured. Hospitalization expenses of a person donating an organ during the course of organ transplant would also be covered at the rate of 50% of the sum insured.
Premium paid for self, spouse, dependent children and parents are exempt from income tax under section 80D of I.T.Act.
The cost of health check up and cumulative bonus is applicable only if the policy is renewed at the ‘National Insurance Company’.
The entry age for the policy is 18 to 59yrs. The policy can be renewed up till the age of 80.
Some additional features are that in a family the spouse, dependent children under the age of 3yrs,(if both parents have been insured), male child up to age of 25 if not employed and female children if not employed till she gets married. It also covers dependent parents.
The minimum sum insured is Rs.50000 and can be extended to Rs.5lac. Initial premium is 10% and 20% after 85yrs.