Star Health Medi Classic vs National Insurance National Senior Citizen Mediclaim policy
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Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Medi Classic is sold by Star Health and National Senior Citizen Mediclaim policy is sold by National Insurance. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.
Second, we know that both products have massive differences in their core structure. Medi Classic is quite basic. It offers little protection and it’s a generic policy that anybody could pick off the shelf. However, National Senior Citizen Mediclaim policy is specifically designed for senior citizens. So in many ways, you’re comparing apples and oranges here.
And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?
That’s something you’ll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.
Let’s start with Medi Classic. The product comes from Star Health’s stable:
Star Health Insurance is India's first standalone health insurance firm. And with an army of retail advisors pushing their products across the country, they’ve managed to capture a fair share of the Indian market.
The company also boasts a network of over 14,000+ hospitals and a decent claim settlement ratio of 83%.
National Senior Citizen Mediclaim policy meanwhile comes from National Insurance’s stable:
National Insurance is the country's oldest general insurance firm and is wholly owned by the Government of India. That means, despite a claim settlement ratio of 93% and over 3,200 network hospitals it can be a bit difficult to reach the insurer when you need them the most. Perhaps due to the fact that they are still a public sector enterprise.
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Compare Insurances Insurance Parameters Recommended Not Recommended | Medi Classic | National Senior Citizen Mediclaim policy |
|---|---|---|
| Network hospitals | 14,000+ | 3,200+ |
| Claim settlement ratio (avg. of last 3 years) | 83% | 93% |
| Co-payment | 10% (if purchased after turning 61) | No |
| Room rent | Any Room (max ₹5,000) | Any Room (up to 1% of sum insured) |
| Disease sub-limit | Yes | Yes |
| Pre existing diseases waiting | 3 years | 2 years |
| Pre/Post hospitalization | 30/60 days | 30/60 days |
| No claim bonus | 5% per year (up to 25%) | 5% per year (up to 50%) |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 200% restoration (once for different illness) | |
| Health check-up | Once every 4 years | Once every 2 years |
| Maternity | ||
| Out Patient Department | ||
| Day care |
Feature Comparison
Co payment
With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. In this case, however, Medi Classic requires you to co-pay a part of the bill 10% if you purchase after turning 61 whereas National Senior Citizen Mediclaim policy doesn’t impose a co-payment clause
Sub limits
Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, Medi Classic imposes disease-wise sub-limits on Cataracts, Modern Treatments whereas National Senior Citizen Mediclaim policy imposes sub-limits on Cataracts, Benign Prostatic Hyperplasia, Modern treatments
Waiting periods for pre-existing diseases
If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. In this case, Medi Classic imposes a waiting period of 3 years on pre-existing diseases while National Senior Citizen Mediclaim policy extends a waiting period of 2 years on existing conditions.
Pre and post Hospitalization expenses
Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, Medi Classic covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, National Senior Citizen Mediclaim policy covers expenses incurred 30 days before hospitalization and expenses incurred 60 after hospitalization, although there may be different sub-limits
No claim bonus
Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. And in this case, Medi Classic offers a no-claim bonus of 5% and National Senior Citizen Mediclaim policy similarly extends a 5% no-claim bonus.
Domiciliary
Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, Medi Classic doesn’t offer domiciliary protection whereas National Senior Citizen Mediclaim policy offers domiciliary cover.
Ayush treatments
Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case, Medi Classic covers Ayush procedures and National Senior Citizen Mediclaim policy also extends coverage for Ayush treatments.
Maternity benefits
If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, neither Medi Classic offers maternity cover nor does National Senior Citizen Mediclaim policy.
Out Patient Department (OPD)
Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, neither Medi Classic extends coverage for outpatient consultations, nor does National Senior Citizen Mediclaim policy.
Final Conclusion
If you’re specifically looking to buy a policy for senior citizens, National Senior Citizen Mediclaim policy makes a lot of sense. But considering Star Health has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that National Insurance has to offer, if the policy is made available to you.
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