the insurer's premium individual health policy — going beyond the standard Mediclaim with three plan tiers (A/B/C) scaling from ₹2L up to ₹50L. Unique benefits not in NMP: Maternity & newborn cover, Air ambulance, Medical Emergency Reunion, Hospital cash, Doctor's home visits post-discharge, Medical Second Opinion for 160 illnesses, Vaccination for children. Optional Critical Illness benefit up to ₹25L and OPD cover. Health check-up every 2 years regardless of claims.
the insurer Health· Mediclaim Plus Policy· Individual Plan· + FAQ Page +
"This is a high sum insured policy which indemnifies for In-patient treatment expenses (minimum 24 hour hospitalization) and 140+ Day Care Procedures on Cashless/Reimbursement basis during the policy period with many additional benefits as per plan opted." the insurer's premium individual health insurance — positioned above the standard Mediclaim Policy (NMP) with higher SI options, three plan tiers, and a richer set of lifestyle and family benefits including maternity, air ambulance, and medical emergency reunion.
Plan A: ₹2L–₹10L (9 SI options). Plan B: ₹15L/₹20L/₹25L. Plan C: ₹30L/₹40L/₹50L. The highest SI available in the insurer's individual health portfolio — going beyond NMP's ₹10L cap. Plan C at ₹50L covers even major catastrophic medical events in premium hospitals.
₹50L Maximum SIMaternity and newborn cover from birth — a feature absent from the standard NMP. Plus vaccination for children. 2-year waiting period for maternity. This makes NMPP the right choice for young couples planning a family who need both hospitalisation and maternity coverage under one policy.
NMP Does Not Have This"Air ambulance" Available under Plans B and C. Covers air ambulance transportation to hospital for medical emergencies — critical for remote location emergencies or when ground transport is insufficient. Not available in NMP or ASP.
Plans B & C Only"Medical emergency re-union" Covers airfare for a family member to be reunited with the insured during a medical emergency hospitalisation away from home. Available in Plans B and C only. Unique to NMPP — not in NMP or ASP.
Plans B & C Only"the insurer Mediclaim Plus Policy pays out the cost of one Second Medical Opinion for each new diagnosis of a major disease" covering 160 major illnesses. One MSO per new diagnosis. Invaluable for confirming serious diagnoses before committing to treatment plans. Not in standard NMP.
160 Major Illnesses"Health Check Up facility: Expenses of health check-up once at the end of a block of two (2) policy periods irrespective of claim reported." NMP Plus: check-up every 2 years regardless of claims. Standard NMP: check-up only after 4 CLAIM-FREE years. NMPP's unconditional check-up is a significant advantage.
Every 2 Years· No Claims Condition/the insurer· Plans A / B / C Comparison
"Sum Insured range Rs.2,00,000 to Rs.50,00,000. Plan A: 9 slabs, 2L to 10L in multiple of 1L. Plan B: 3 slabs, 15L/20L/25L. Plan C: 3 slabs, 30L/40L/50L." The three plans are differentiated by sum insured range, room rent limits (Plan C: no room rent cap), and benefit availability (Air ambulance and Medical Emergency Reunion: Plans B and C only).
₹2L / ₹3L / ₹4L / ₹5L / ₹6L / ₹7L / ₹8L / ₹9L / ₹10L
₹15L / ₹20L / ₹25L
₹30L / ₹40L / ₹50L
Page· Entry Age· Family Members· Pre-Medical from Age 40· CI Check-Up Trigger
"The policy can be availed by any person above 18 years of age. Children between the age of 3 (three) months and 18 (eighteen) years can be covered, provided parent(s) is/are covered.The policy can be availed by any person up to 65 years of age."
"The policy can be availed by any person above 18 years of age.up to 65 years of age." Lifelong renewal after entry. No upper age limit on renewal once policy is issued.
18–65 Entry· Lifelong Renewal"Dependent child up to 18 (eighteen) years of age. Dependent male child above 18 and up to 25 years, if a bona-fide student and not employed. Dependent female child if not employed, till marriage." (Note: NMP allows children to 25 years broadly; NMPP has gender-specific conditions for 18-25 age group.)
Age and Status Based"Policy can be availed for self and: Spouse; Dependent legitimate or legally adopted children; Parents." Individual policy: each family member gets separate SI and separate cumulative bonus. Unlike NMP, siblings cannot be covered under NMPP.
Individual Basis"Pre policy checkup is required in cases where the proposer is: 40 (forty) years and above; OR opting for SI INR 6,00,000 and above (irrespective of age); OR opting for Critical Illness optional cover, between the age of 18 and 65 years." Stricter than NMP's 50-year threshold — NMPP requires check-up from age 40 OR at ₹6L+ SI.
Age 40+ OR SI ₹6L+ OR CI CoverPhysical exam (MD Medicine doctor)· HbA1c· Lipid profile· Serum creatinine· Urine routine and microscopic· ECG· Eye check-up including retinoscopy· Any other the insurer-required investigation. "The date of medical reports should not exceed 30 (thirty) days prior to the date of proposal."
30-Day Report Validity"The company shall reimburse 50% (fifty percent) of the expenses incurred for pre policy checkup, if the proposal is accepted and the premium has been realized." If proposal accepted: the insurer pays half the pre-medical check-up cost. Report validity: 30 days before proposal date.
50% Reimbursed if Accepted+ 22-Point Highlights List· Core Coverage Applicable to All Plans
Core coverage applies across Plans A, B, and C. Additional benefits (Air Ambulance, Medical Emergency Reunion) are Plan B/C only — see Plan comparison section. All 22 NMPP highlights confirmed from /the insurer.
Room/ICU charges, surgeon/anaesthetist/consultant fees, anaesthesia, blood, oxygen, OT charges, surgical appliances, medicines, diagnostics, prosthetics. "Lines of treatment covered: Allopathy, Ayurveda and Homeopathy (Up to 100% of SI)." All three systems covered up to full sum insured.
Allopathy + AYUSH· 100% SI"Pre and Post Hospitalisation up to 30 days and 60 days respectively for same disease/illness/injury for which Hospitalisation occurred." Note: NMP has 45 days pre; NMPP has 30 days pre. The standard is shorter here — confirm at purchase.
30 Days Pre· 60 Days Post"140+ Day Care Procedures on Cashless/Reimbursement basis during the policy period." All medical procedures under general/local anaesthesia requiring less than 24 hours hospitalisation due to technological advancement.
All Day Care"12 Modern treatments like Robotic surgery, oral chemotherapies, immunotherapies and etc., are now covered in the policy." Robotic surgery, oral chemotherapy, immunotherapy, HIFU, intravitreal injections, stem cell therapy, and others — subject to sub-limits as per plan.
12 Treatments· Sub-Limits Apply"Ambulance (including Air Ambulance) Charges and Organ Donor's expenses covered up to sub-limits mentioned." Road ambulance: all plans. Air ambulance: Plans B and C only. Organ donor's hospitalisation for harvesting: all plans, subject to sub-limits.
Air: Plans B & C Only"Mental illness, HIV/AIDS, Genetic disorders are now covered." All three are covered under NMPP — consistent with IRDAI's 2020 mandate for all health insurers to cover these conditions. Waiting periods may apply.
All Three Covered"Treatment for morbid obesity are now covered after specified waiting periods. Correction of eyesight, i.e., refractive errors above -7.5 D are now covered after specified waiting periods." Both conditions covered — the same as NMP.
After Waiting Period"Treatment related to participation as a non-professional in hazardous or adventure sports subject sublimit." Non-professional participation in adventure activities (trekking, bungee jumping, etc.) covered with a sub-limit. Professional sports participation: excluded.
Non-Professional· Sub-Limitthe insurer + GIBL +· Benefits Not Available in Standard NMP
These benefits are specific to Mediclaim Plus — they are not available in the standard Mediclaim Policy (NMP) or Arogya Sanjeevani (ASP). This is what justifies NMPP's higher premium over NMP.
"Maternity and New Born Cover (From birth), Vaccination for children as per limits under the policy." Normal and caesarean delivery covered. Newborn covered from birth. 2-year waiting period for maternity. Makes NMPP the right choice for young couples planning a family — no separate maternity policy needed.
From Birth· 2-Year WaitAir ambulance transportation to hospital during medical emergencies. Confirmed available in Plans B and C. Critical for individuals in remote locations, frequent travelers, or catastrophic emergencies requiring rapid air evacuation to a tertiary hospital. Not available in NMP, ASP, or NMPP Plan A.
Plans B & C· Air Evacuation"Medical emergency re-union" Covers airfare for a family member to travel and be reunited with the insured during a medical emergency away from home. "Benefits like medical emergency reunion (airfare for a family member) are included only in Plans B and C." Available Plans B and C only.
Plans B & C· Airfare for Family"Hospital cash benefit" Daily cash allowance for each day of hospitalisation — providing liquidity for incidental hospital expenses that insurance doesn't cover (transport, meals, loss of income). Amount varies by plan and sum insured — confirm limits with Probitas at 022 4302 0000.
Daily Cash· All Plans"Doctor's home visit and nursing care during post hospitalization payable as per limits in each plan." Post-discharge home care by a doctor or nurse: covered up to plan-specific limits. This bridges the gap between discharge and full recovery — extending care beyond the 60-day post-hospitalisation reimbursement.
Post-Discharge· Plan Limits"Vaccinations for children" Vaccination and inoculation coverage for children covered under the policy. Standard waiting period applies. Makes NMPP particularly valuable for young families adding newborns — vaccination costs are covered alongside the delivery and newborn hospitalisation.
Children· With Waiting Period"the insurer Mediclaim Plus Policy pays out the cost of one Second Medical Opinion for each new diagnosis of a major disease" covering 160 major illnesses. "There is a special benefit of Medical Second Opinion (MSO) coverage (for 160 major illnesses) for up to two MSO per family member for each new diagnosis." Critical for cancer, cardiac, and neurological diagnoses.
160 Illnesses· 1 MSO per Diagnosis"Expenses of health check-up once at the end of a block of two (2) policy periods irrespective of claim reported." Unlike NMP's check-up (4 claim-free years required), NMPP's check-up is every 2 years regardless of whether you made claims. No need to maintain a claim-free record to receive this benefit.
Every 2 Years· No Claims ConditionTwo Optional Covers· Available Across All Plans
"Add on covers such as Critical Illness and Out-patient Treatment.Critical Illness Benefit amount per individual — INR 2,00,000/3,00,000/5,00,000/10,00,000/15,00,000/20,00,000/25,00,000 & Outpatient Treatment Limit of cover per individual — INR 2,000/3,000/4,000/5,000/10,000." Both add-ons available for all individuals between 18–65 years on NMPP.
A lump-sum benefit paid on diagnosis of specified critical illnesses — separate from the hospitalisation indemnity benefit. Uses lump sum for any purpose: treatment, income replacement, loan repayment, lifestyle adjustment after diagnosis.
Benefit Amounts Available (per individual):
Covers OPD consultations, diagnostic tests, and medicines — expenses that occur without hospitalisation and are excluded from standard indemnity policies. Makes NMPP one of the few the insurer products offering OPD coverage.
OPD Cover Amounts Available (per individual):
5%/Year Max 50%· Check-Up Every 2 Years Irrespective of Claims
"Annual Increase in SI by 5% for each claim free year up to a maximum of 50% of SI opted.Health Check Up facility: Expenses of health check-up once at the end of a block of two (2) policy periods irrespective of claim reported."
| Claim-Free Years | CB | Effective SI |
|---|---|---|
| Year 0 | 0% | ₹25,00,000 |
| Year 3 | 15% | ₹28,75,000 |
| Year 5 | 25% | ₹31,25,000 |
| Year 10 | 50% | ₹37,50,000 |
| Year 10+ | 50% cap | ₹37,50,000 |
At Plan B ₹25L SI: after 10 claim-free years, effective cover = ₹37.5L — at no additional premium. At Plan C ₹50L: grows to ₹75L.
/NMPP· Better PED Wait Than NMP
"All pre-existing diseases included after first thirty six (36) months of Policy." NMPP's 36-month PED wait is better than NMP's 48-month wait — a significant advantage for buyers with pre-existing conditions.
Multiple Discount Types Available· Not Just Online Discount
"Discounts for Purchasing policy online, Family, Youth discount 10%." NMPP offers multiple discount types — significantly more than NMP's two discounts.confirmed additional zone-based discounts. Multi-year policy discount confirmed.
Purchasing policy online or direct (no intermediary) — same as NMP's 10% direct discount. Applies to new purchase and renewals without intermediary.
"Family discount 10%" Discount when multiple family members are covered under the same NMPP policy. Confirm exact qualifying criteria with Probitas.
"Youth discount 10%" Discount for younger proposers entering the policy. Exact age band for qualifying as "youth" — confirm with Probitas at 022 4302 0000.
"Discount in Lieu of No Maternity/Infertility cover for individuals above forty five years — 3% on individual premium for self and spouse." For those aged 45+ who don't need maternity cover.
"Discount for multi year policies — 4% discount for opting 2-year policy tenure and for 3-years tenure 7%." NMPP can be issued for 1, 2, or 3 years. Multi-year lock provides additional premium saving.
"4.4% for Zone II, 11.11% for Zone III, 20% for Zone IV." Treatment zone selection affects premium. Lower-zone areas (smaller cities) qualify for higher premium discounts. Confirm applicable zone with Probitas.
7-Point NMPP Exclusion List
Exclusions confirmed directly from the insurer's NMPP page. The lists 7 specific exclusion categories for NMPP.
"Only claims arising out of accidents are payable for the first 30 days of Inception of the Policy." All non-accident illness claims in the first 30 days of a new NMPP policy: excluded.
"All pre-existing diseases included after first thirty six (36) months of Policy." PEDs excluded during 36-month waiting period. Must disclose all PEDs at proposal or risk claim rejection.
"90 days, One, Two and Four Years waiting period for specific diseases." Conditions including hernia, cataract, sinusitis, calculi, maternity, infertility, refractive error, and morbid obesity: excluded during their respective waiting periods.
"Change-of-Gender Treatments, Cosmetic or Plastic Surgery, Excluded Providers." Gender reassignment, cosmetic procedures, and aesthetic plastic surgery: excluded. Reconstructive plastic surgery necessitated by accident or disease: covered.
"Vitamins, Tonics Drug/alcohol abuse, Self-Inflicted Injury." Health supplements, vitamins, tonics, and alcohol/drug abuse-related conditions. Intentional self-harm: excluded.
"Non Prescription Drug, Home visit charges." Over-the-counter medications without doctor prescription: excluded. Note: The "home visit charges" exclusion is distinct from the post-discharge doctor home visit benefit (which IS covered under plan limits).
"Dental treatment (unless arising out of accident and requiring hospitalization) and Out Patient Department treatment (OPD treatment)." OPD is excluded from the base NMPP — but can be added via the OPD Optional Cover (₹2,000–₹10,000 per person per year).
"Vaccination and Inoculation of any kind unless it is post-animal bite." General vaccinations excluded during waiting period (2 years for children). Post-animal bite vaccination (anti-rabies): covered. After 2-year waiting period, vaccination for children: included.
Cashless + Reimbursement + Critical Illness + OPD — Four Claim Types
NMPP has four distinct claim processes — more complex than standard NMP due to the Critical Illness and OPD optional covers. All confirmed from the insurer's NMPP page. the insurer Toll-Free: 022 4302 0000.
"For planned hospitalisation, intimation is to be sent to the TPA/Company in advance (72 hours prior) with details of Name and address of the hospital and condition requiring hospitalisation." Emergency: "within 24 hours of admission." Network hospitals: cashless pre-authorisation. Plan C policyholders: no room rent limit applies — select any room type without sub-limit penalty.
"Written intimation/mail/fax about hospitalisation is to be sent to TPA/Company within 72 hours of hospitalisation in the case of emergency hospitalisation and 72 hours prior in case of planned admission." At discharge: collect Discharge Summary, investigation reports, Claim Form Part A & Part B. Submit all originals within 15 days. Pre and post-hospitalisation claims: separate submission after treatment completion, within 15 days.
"Notice of claim in writing to office within 15 days of diagnosis/procedure. Documents shall be submitted, along with the completed claim form, at the Policy issuing office within 30 days from the survival period." Required documents: completed claim form, medical practitioner's certificate confirming CI diagnosis with date, original discharge summary, pathological/radiological/diagnostic reports confirming CI diagnosis.
"Claim documents supporting all such outpatient treatments shall be submitted to the TPA/company twice during the policy period, within 30 (thirty) days of completion of 6 month period." Documents: all original bills and prescriptions from medical practitioner; diagnostic test bills and copy of reports; any other documents required by the insurer. Submit at months 6 and 12 of the policy year.
"Duly filled Claim form (Part A & Part B). Original bills, payment receipts, medical history, discharge certificate/summary. Original cash-memo from hospital/chemist supported by prescription. Original payment receipt, investigation test reports. Attending medical practitioner's certificate regarding diagnosis. Surgeon's original certificate stating diagnosis and nature of operation."
Mediclaim Plus Policy (Individual Plan) — Frequently Asked Questions
Get Your the insurer Mediclaim Plus Policy Quote
Tell us your details and our the insurer health specialist will provide exact NMPP premium for your selected plan, explain CI and OPD add-on options, and compare NMPP with standard NMP to help you make the right choice.
By submitting you agree to our Privacy Policy and Terms & Conditions. Mediclaim Plus Policy (Individual Plan)· the insurer· IRDAI SI ₹2L–₹50L across Plans A/B/C. 36-month PED wait. Maternity: 2-year wait. Room rent: cap for Plans A/B; no cap for Plan C. Optional CI: ₹2L–₹25L. Optional OPD: ₹2K–₹10K. CI survival periods apply. Health check-up every 2 years. All terms per NMPP policy wording. Probitas Insurance Brokers Pvt. Ltd.· IRDAI Lic. No. 528.