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​ Know the Difference between Health Insurance Policy and Mediclaim

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Published on September 16, 2022. EST READ TIME: 3 minutes

Being fit and healthy now does not guarantee good health in the future as well. There can be a medical emergency that may require immediate hospitalisation and treatment. And if you don’t have health insurance or Mediclaim, you will be forced to pay for your treatment from your savings. This is what makes a healthcare plan so important for people of all ages. With insurers offering individual health insurance, family health insurance, Mediclaim and other healthcare plans online, you can easily buy a suitable type from the comfort of your home or office.

Before buying health insurance or a Mediclaim policy, it is important to know how these two policies differ from each other. Yes, health insurance and Mediclaim are not the same. A health insurance policy offers more comprehensive coverage and flexibility when compared to Mediclaim. Read on to know the difference between health insurance and Mediclaim and the benefits of both these healthcare plans.

What is a Mediclaim Policy?

Mediclaim is a type of insurance policy that covers the policyholders’ medical expenses and prevents financial setbacks. If a medical emergency requires immediate hospitalisation, the insurance provider will cover the bills. The policy can come in quite handy in case of an accident, sudden illness, or surgery.

What is Health Insurance?

Health insurance is a policy that covers the hospital bills and other associated expenses of the policyholders during medical emergencies and planned surgical procedures. The policy also covers other medical-related expenses, such as day-care treatments, ambulance charges, in-home hospitalisation, and organ donor expenses.

Difference between Mediclaim and Health Insurance

The following are the main differences between Mediclaim and health insurance:

	Health Insurance	Mediclaim Policy
Policy coverage	Health insurance offers wide coverage to policyholders and helps prevent financial setbacks during medical emergencies. In addition to covering hospital bills, health insurance policies also cover pre- and post-hospitalisation bills, daily hospital cash, AYUSH expenses, OPD expenses, mental healthcare, home healthcare, and more.	Medical policies cover only the hospital bills of the policyholders. So, you can file a claim only if you get hospitalised.
Hospitalisation	Hospitalisation is not necessary for health insurance. A healthcare plan also covers OPD treatment, home healthcare, pre- and post-hospitalisation expenses and other treatments that do not require hospitalisation.	Hospitalisation is necessary to avail of Mediclaim benefits.
Customisation	Health insurance providers allow policyholders to customise their plans with add-on covers and other benefits.	A Mediclaim policy cannot be customised.
Sum insured	Health insurance coverage can go up to crores of rupees. There is no limit to the maximum sum insured in health insurance.	The coverage of a Mediclaim policy is limited and will depend on the plan you choose to take. The sum insured is limited to a few lakhs.
Critical illness coverage	You can take critical illness rider coverage with health insurance by paying an additional premium.	Critical illness coverage is not available with Mediclaim.
Flexibility	Health insurance plans are flexible so that you can enhance or reduce your coverage at the time of policy renewal. For example, if your insurance provider is offering a discount on long-term health insurance policies, you can change the duration of your healthcare plan and save money.	Mediclaim does not offer any such flexibility to policyholders.

What are the Benefits of Mediclaim and Health Insurance?

Although there are several distinctions when it comes to Mediclaim vs health insurance, both health insurance and Mediclaim offer a plethora of benefits to policyholders. These benefits help policyholders save huge bucks and prevent financial woes.

Advantages of Mediclaim

The following are the benefits of a Mediclaim policy:

1. It covers hospital bills during medical emergencies.

2. It is cost-effective.

3. Mediclaim offers both cashless and reimbursement claim settlement.

4. It lowers financial burden and helps keep savings intact.

5. Mediclaim offers policies for individuals as well as families.

6. Policyholders can avail of tax benefits under Section 80D of the ITA on Mediclaim premiums.

Benefits of Health Insurance

A health insurance policy offers the following benefits to policyholders:

1. A healthcare plan offers comprehensive coverage with numerous add-ons.

2. It covers a chunk of your hospital bills as well as other associated expenses, such as pre- and post-hospitalisation expenses, ambulance charges and home healthcare.

3. Policyholders can opt for maternity and OPD benefits, a critical illness rider, and more.

4. Health insurance offers special plans for senior citizens.

5. Policyholders can cover their immediate family members under one family health insurance policy.

6. Policyholders can enjoy tax benefits on the premiums paid for health insurance under the ITA’s Section 80D.

Which One Should You Buy – Mediclaim or Health Insurance?

This will depend on several factors, such as your age, health, financial condition and more. Health insurance is better if you want more comprehensive coverage and flexibility. A healthcare plan will cover ambulance charges, pre- and post-hospitalisation expenses, mental healthcare, daycare treatment, home healthcare, AYUSH treatment, and more. You can also enhance your policy coverage with important add-ons and riders. If you are looking for a cheaper option, you can choose a Mediclaim policy. It will cover a significant chunk of your hospital bills and ensure peace of mind during medical emergencies.

Conclusion

Now that you know the difference between health insurance and a Mediclaim policy make sure you buy the right healthcare plan to cover your medical/hospital bills. Both types can come in handy during medical emergencies and save you from stress and financial setbacks. In addition to taking a healthcare plan for yourself, cover your loved ones under family health insurance or Mediclaim to ensure quality and timely treatment. Also, remember to renew your healthcare plans on time for continuous coverage.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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