How is a Health Insurance Plan different from Mediclaim Policy?

Owing to a day-to-day hectic lifestyle and increasing work stress, physical inactivity, and a deteriorating environments,  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 led to increases in health care costs, Mediclaim policy makes things easy and reliable for you.

It thus requires you to get a medical cover that can help you pay all the medical bills. Choosing the right health cover will only help you in covering the medical expenses else the premium you pay will go in vain. Most people perceive Health Insurance and Mediclaim Insurance policies as two terms carrying the 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

Mediclaim policy protects you from different kinds of accidents and provides coverage for you 24*7 medical emergency for your illness and accident.

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 hospitalization expenses

Limit of Cover

A medical health insurance policy provides limited coverage and usually, you can get a cover of about Rs 5 to 6 Lacs. This policy also provides you the flexibility to get claims on every hospitalization expense 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 first need to pay for the medical bills, because the insurance company will reimburse you the amount, upon providing the hospital bills and other as asked by the company. Now, you can also avail of the option of cashless mediclaim, under which the insurance company will pay a part of 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 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, and ambulance charges and can avail of 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 a sum insured is available up to Rs 60 Lacs. Some health insurance policies covering critical illnesses, provide a lump sum amount, and afterward, 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 the expenses incurred arising due to the hospitalization of the insured. However, a health insurance policy provides 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.

Difference Between  Health Insurance Policy & Mediclaim Insurance Policy

FeaturesHealth InsuranceMediclaim Insurance
CoverageA health insurance plan covers expenses related to health, medical treatment, and surgery.Mediclaim only covers the expenses of medical treatment of accidents.
HospitalizationUnder Health insurance, you will get pre & post-hospitalization as per your need.But in Mediclaim insurance, you will get hospital as per accident injury and also getting medical treatment
Claim SettlementUnder Health insurance, you can claim any time of your expenses and also get your treatment in-network hospital, a cashless treatment.But in Mediclaim insurance, there is no need for raising claims because it’s a cashless treatment. You will get the medical treatment in-network hospital of your insurer company.
Tax ExemptionIf you are buying a Health insurance policy, then you are probably saving more tax with the plan.The amount of tax savings in Mediclaim policy is quite lower than in health insurance.

Conclusion

A medical health insurance policy covers you against hospitalization expenses incurred whereas, a health insurance policy provides comprehensive coverage in terms of illnesses or diseases covered

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.

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Sonia Nagpal

Sonia Nagpal is an Insurance Specialist. She has more than 25 Yrs of experience in sales, Marketing and Corporate Alliances.

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