National Health Insurance Parivar Mediclaim Plus Policy: Full Guide 2025

The healthcare expenditure in India has been on an upward trend up to 2025. Increasing numbers of families are seeking health insurance plans in order to be ready to face any medical emergency. One such health insurance scheme that is drawing the attention of the urban and semi urban families is the National Health Insurance National Parivar Mediclaim Plus Policy. This article dissects all the significant details concerning this policy to enable you to make a decision on whether it is suitable to your family.

What is National Health Insurance National Parivar Mediclaim Plus Policy?

National Parivar Mediclaim Plus Policy is a special health insurance scheme by a government owned insurance company called National Insurance Company. This policy was introduced to safeguard the Indian families against the escalating healthcare expenses and it insures the whole family (Self, Spouse, Dependent Children, and Parents or Parents in Law) under one policy. This offering includes medical expenses, hospitalisation, critical diseases, day care treatments and a number of value added benefits.

In 2025, families are increasingly becoming conscious of risk protection of health. The Parivar Mediclaim Plus Policy is applicable to both nuclear and joint families with a broad coverage on a single sum insured. This plan is unique in that it can cover 6 family members, has high sum assured options, maternity cover and critical illness benefits.

Another question that people would want to know is:
Q: Who is entitled to National Parivar Mediclaim Plus Policy?
A: Indian citizens between the age of 18 and 65, spouse, children (91 days to 25 years) and dependent parents or parents-in-law may be insured under one policy.

What are the Highlights / Key Features in 2025?

The following are the highlights and key features of the National Parivar Mediclaim Plus Policy in the current year:

• Family Floater Basis: Covers 6 members of the family under one sum insured.
• Sum Insured choices: Rs 6 lakhs to Rs 50 lakhs. The middle class and wealthy families are served by the higher sum insured options.
• Wide Age Entry: Entry of adults at the age of 18 to 65 years. Children covered since 91 days.
• Parents/Parents in Law Coverage: You can add either set of parents to take care of joint family requirements.
• Pre and Post Hospitalisation Cover: 60 days prior to and 90 days after hospitalisation.
• No Claim Bonus: 5-50 percent of the sum insured as bonus in every year of claim free.
• Day Care Procedures: More than 140 procedures listed which are done without 24 hour hospitalisation.
• Critical Illness Rider: It provides an optional coverage of 11 critical illnesses such as cancer, stroke, kidney failure, heart attack.
• Maternity and Newborn Cover: Covers normal and C-section delivery as well as newborn care after 3 years of waiting.
• Organ Donor Expenses: This is in recognition of real life needs in that it covers organ donor hospitalisation.
• AYUSH Treatments: Cost of Ayurveda, Unani, Siddha and Homeopathy is covered when taken in government approved centres.
• Cashless Network: More than 7000 network hospitals in India to receive cashless treatment.
• Recharge or Restoration: After you exhaust your sum insured it is replenished to cover future unrelated hospitalisation in the same year.

Surprisingly enough, you know? The IRDAI 2024 healthcare report shows that family floater plans such as Parivar Mediclaim Plus have increased by 18 percent with more Indians realizing the importance of collective health risk cover.

What are the Comparisons of National Parivar Mediclaim Plus with other Family Floater Plans?

In the selection of a health policy, it is useful to compare some of the important aspects. The following table compares Parivar Mediclaim Plus with other family floater policies that are popular in 2025:

Insurance expert opinion: Insurance consultants usually note that the National Parivar Mediclaim Plus Policy has an average cashless network in terms of the number of hospitals available compared to the private insurance companies; however, the fact that it is a government-backed insurance policy ensures stability and comparatively low premiums.

Which diseases and services are covered?

The National Parivar Mediclaim Plus Policy is comprehensive in terms of the healthcare requirements in 2025. The following are some of the typical costs paid:

• Accidental, illness or surgical hospitalisation
• Physicians charges, drugs, diagnostic procedures
• Pre and post admission medical expenses
• More than 140 day care surgeries listed
• AYUSH Treatment (Ayurveda, Yoga, Unani, Siddha, Homeopathy, Naturopathy)
• Maternity costs such as caesarean section and new born baby cover
• Outpatient care of some illnesses
• The cost of domiciliary hospitalisation
• Hospitalisation of organ donor under sum insured
• Defined critical illness optional cover

Another question people have is:
Q: What is excluded in National Parivar Mediclaim Plus Policy?
A: Non-medical costs, cosmetic surgery, dental treatment except due to accidental injury, OPD (except certain out-patient benefits), self-harm and pre-existing conditions until the wait period is over.

Pros and Cons of Parivar Mediclaim Plus Policy in 2025?

Advantages:

• One policy covering the entire family simplifies administration, billing and renewals
• It is affordable premium with broad coverage which makes it appropriate to middle income Indian families
• Covers dependent parents or parents in law as opposed to many other policies
• Regulated insurer of the government sector which is IRDAI regulated
• New age and AYUSH therapies were involved
• Newborn baby and maternity cover to expanding families
• Several sum insured up to 50 lakh rupees
• Add-ons are critical illness and personal accident cover

Limitations:

• There are sub limits or co payment requirements of some of the modern treatments and high value procedures
• Cashless hospitals network is lower than some of the major private insurers
• 3 year waiting period on pre-existing illnesses and maternity benefits
• Sublimits on some treatments such as cataract or knee replacement disease-wise
• The higher the age group, the higher the premiums may be as opposed to some of the private insurers

Who is This Policy Worth Considering?

• Joint families, nuclear families, newly married couples and old people who wish to cover parents or parents in law under a single umbrella
• Individuals who want a stable, customer-trusting and government sector insurer support
• Individuals interested in maternity cover, AYUSH, and critical illness cover without having to purchase several policies separately
• Families that do not seek massive cashless hospital systems or fancy room coverage
• Individuals who are willing to wait the first years of waiting period to receive full benefits

Did you know? More than 60 percent of Parivar Mediclaim Plus Policyholders in 2024 were the first time buyers and they wanted to cover both parents and children in an affordable manner.

What is the Claim Process and How Fluent is it?

The claim procedure of the Parivar Mediclaim Plus by National Insurance Company is a combination of old and new.

• Inform the insurer or TPA of planned/emergency hospitalisation within time.
• In a network hospital, present your policy and ID to have cashless claim processed; pre authorisation normally takes 3 to 4 hours.
• To claim back, you should provide all the hospital bills, discharge envelope, test reports and claim form within 15 days of discharge.
• Insurer pays legitimate claims in most cases within 2 weeks of all the paper work.

Other questions people ask are:
Q: Can I make more than one claim within a year in the National Parivar Mediclaim Plus?
A: Yes, claims are permitted to your insured limit within a year; the restoration/recharge benefit restores the sum insured to new, unrelated hospitalisations within the same policy year.

What is the 2025 Premium Cost?

The National Parivar Mediclaim Plus Policy premiums vary according to the age of the members, amount of sum insured opted, and the number of family members. An example of an average indicative premium table of a family of four (2 adults 35 and 32, 2 kids 7 and 2 years, year 2025):

Note: There will be higher premiums on senior parents and previous claim history. GST as may be applicable.

Most cities in India also have a zone based premium hence it is advisable to check with your local National Insurance branch or site to get the actual breakdown.

Do I Have to Know of Any Exclusions or Waiting Periods?

Yes, Parivar Mediclaim Plus Policy has certain significant waiting periods and exclusions in accordance with the major health insurance policies:

Waiting Periods:

• Pre-existing diseases: 36 months
• Maternity cover: 36 months
• Specified Illnesses (hernia, piles, joint replacement etc.): 24 months
• OPD Consultations: Nil in case of listed illnesses (in case OPD benefit selected)
• New born baby cover: This is available after 91 days

Main Exclusions:

• Hearing aids, spectacles, contact lenses, nonmedical items
• Cosmetic surgery other than burns/plastic surgery due to accidents
• Treatments outside India
• Infertility, birth control, HIV AIDS
• Drug, alcohol, self-injury treatment

There are other questions that people ask:
Q: Is Covid 19 covered in National Parivar Mediclaim Plus Policy?
A: Yes, Covid 19 related hospitalisation and post hospitalisation expenses are now covered as per latest IRDAI guidelines.

What Is the Way to Purchase or Renew the Policy?

In 2025, the purchase and renewal of the policy is easier than ever:

• Online application at the site of National Insurance
• Go to local branch office or dial their customer helpline
• Offer proposal form, age, ID, KYC, prior policy information in case of any
• Pay premium (Net banking, UPI, card)
• At renewal, claims or health status may be required to be declared

SMS or email reminders are sent out to remind of renewal. The policy is renewable throughout life.

Did you know? As of 2024, National Insurance also provides wellness points, and discounts on renewal preventive checkups, depending on your healthy lifestyle history.

TL;DR or Short Summary

National Parivar Mediclaim Plus Policy is the family floater health insurance of National Insurance Company.
It is appropriate in families of up to 6 people, and it covers adults, children, and either of the parents.
Sum insured offered is between Rs 6 lakh and 50 lakh.
Includes hospitalisation, day care, maternity, new born, AYUSH, critical illness and organ donation.
There is a 3 year waiting period on pre-existing illnesses and maternity.
Most Indian families will be able to afford it in 2025 with government backed trust.
It is easily purchasable or renewable online or offline.

People also ask

Q1: Is it possible to have both my parents and parents in law in the same policy?
A1: No, the parents or the parents in law cannot be added in one Parivar Mediclaim Plus Policy, but only one of them.

Q2: What would occur in the event of lapse of my policy or failure to renew?
A2: Renewal has a 30 day grace period. Failure to do this may mean that you will have to purchase a new policy with new waiting periods.

Q3: Can a new member of the family be added in the middle of the policy year?
A3: Yes, newborns and newly married spouses may be added midterm by notifying the insurer and paying pro rata premium.

Q4: Does outpatient dental, optical or maternity check-up cover?
A4: Outpatient dental and optical are not covered, with exception of injury related. Maternity package after waiting period includes maternity check-ups.

Q5: Is it safe and valid to buy policy online?
A5: Yes, digital policies purchased on the official site of the insurer or on the portals recognized by the insurer are legally valid and safe to claim.

Sources:

• National Insurance Company Ltd. Official Web site