How is a Health Insurance Plan Different from Mediclaim Policy?

Owing to day-to-day hectic lifestyle, increasing work stress, physical inactivity, and deteriorating environment lead to various serious illnesses that bring financial shock, when you go for its treatment. Even a minor illness may cost you a huge medical bill. Medical care advancements have also lead to increase in health care costs.

It, thus requires you to get a medical cover that can help you pay all the medical bills. Choosing a right health cover will only help you in covering the medical expenses, else the premium you pay will go in vain. Most of the people perceive Health Insurance and Mediclaim Policy as the two terms carrying same benefits. However, it’s not the truth.

Understanding the key features will help you differentiate a health insurance plan from a mediclaim policy.

Mediclaim Policy

Coverage Available: A Mediclaim Policy reimburses the cost of medical treatment arising from hospitalization and it also covers pre-specified illnesses up to the sum insured available under the policy. The premium amount is based on the sum insured chosen. This policy is helpful, as it covers expenses incurred due to hospitalization.

Limit of Cover: A mediclaim health insurance policy provides a limited cover and usually, you can get a cover of about Rs 5 to 6 Lacs. This policy also provides you a flexibility to get claims on every hospitalization expenses incurred, up to the sum assured amount.

Mode of Payment: As a mediclaim policy works on the principle of indemnity, you can go for reimbursement-based mediclaim, in which you firstly need to pay for the medical bills and the insurance company will reimburse you the amount, upon providing the hospital bills and other documents as asked by the company. Now, you can also avail the option for cashless mediclaim, under which the insurance company will pay a part or the entire claim amount to the hospital. The company will provide you the cashless mediclaim, when you are hospitalized in one of the network hospitals as listed by the insurer.


Health Insurance Plan

Coverage Available: A Health Insurance Plan offers a deeper coverage, as you are covered for both in-patient and out-patient expenses. In addition to the hospitalization expenses, you are covered for other expenses such as pre & post hospitalization, ambulance charges and can avail other benefits including no claim bonus, medical check-up, etc. It also provides coverage for several serious and critical illnesses.

Limit of Cover: A health insurance policy provides a huge cover and the cap on the sum insured is available up to Rs 60 Lacs. Some health insurance policies covering critical illnesses, provide a lump sum amount and afterwards, you can’t make any more claims.

Mode of Payment: Under a health insurance plan especially for a critical illness cover, the insurance company pays you the sum insured amount as a lump sum. You can file a claim on getting diagnosed with the illness.

A mediclaim policy covers only to the expenses incurred arising due to hospitalization of the insured. However, a health insurance policy provides a wider and more comprehensive coverage, such as in-patient hospitalization expenses, pre & post hospitalization, ambulance charges, free medical checks, and many more. Choosing the best health insurance plan helps you get a 3600 cover for all the medical care for you & your family.


Conclusion

A mediclaim health insurance policy covers you against the hospitalization expenses incurred, while a health insurance policy provides a comprehensive coverage in terms of illnesses or diseases covered and quantum of sum insured available.

A mediclaim policy may prove adequate to cover the hospitalization expenses arising from an illness, however a health insurance policy covers you against serious and critical illnesses that incur huge expenses. It is hereby, advised to choose the best health insurance plan that covers all the health care costs incurred on you and/or your family.

Harjot Singh Narula

Harjot Narula is founder and CEO of ComparePolicy.com, an IRDAI approved insurance web aggregator focussed on selling online insurance for companies. Harjot has more than a decade of experience in software development and has also spent 5 years in US working for the mortgage and risk management industry.

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