Mediclaim Insurance – Frequently Asked Questions

Posted on: Aug 26, 2022 | | Written by:

Mediclaim Insurance – Frequently Asked Questions

Practically everyone, these days, knows how important it is to have health insurance. Medical emergencies can otherwise ruin all your savings in the wink of an eye. The problem takes a bigger magnitude if you get hospitalised. Which is why, having a Mediclaim policy can act as a saviour and minimise your financial trouble. However, before taking such a policy, you are likely to have many questions in your mind. So, this blog covers the common questions that are asked about Mediclaim policies, so you can make an informed decision.

What is Mediclaim Insurance?

Mediclaim insurance is a health insurance policy that provides financial protection against only hospitalisation expenses. This means, you can claim for the expenses only if you are hospitalised which could be due to a sudden illness, surgery or an accident. Mediclaim insurance does not cover annual health check-ups, OPD expenses, daily hospital cash, and AYUSH treatments among others. You can opt for cashless or reimbursement Mediclaim policy. In cashless facility, the insurer directly settles the bills with the hospital. In reimbursement, you need to pay the bills and get them reimbursed from the insurer after submitting the required documents.

FAQs about Mediclaim

1. Are Mediclaim insurance and health insurance same?

No, although both provide financial security in case of a medical emergency. The main difference lies in the scope of coverage. While a Mediclaim policycovers only hospitalisation expenses, health insurance offers a comprehensive coverage that goes beyond hospitalisation costs such as hospital daily cash, OPD expenses, annual check-ups, alternative treatments, etc.

2. Is there a limit to the sum insured in Mediclaim insurance?

Yes, the sum insured cannot exceed INR 5 lakhs.

3. Can I opt for add-on covers to enhance my Mediclaim policy?

No, there are no add-on covers with Mediclaim insurance.

4. When can I file a claim after purchasing Mediclaim policy?

If you need to get hospitalised due to an emergency such as an accident or illness or injury, you can file the claim. If it is a network hospital, you can avail cashless facility. If the hospitalisation is in a non-network hospital, then you need to pay the bills and file for reimbursement. For reimbursement, you should keep all the bills and documents handy.

5. Does Mediclaim insurance cover dental treatments?

Most insurance providers do not cover dental treatments. However, you can check with your insurer about the inclusions and exclusions.

6. I have a corporate policy? Can I still buy Mediclaim insurance?

Yes, you can if you want more coverage.

7. How can I buy Mediclaim policy?

There are two ways to buy it - online and offline. Buying it online is more convenient as it can be done from anywhere with just a few clicks. Visit the website, fill the required details, make the payment and your policy will be issued. You can also customise the coverage. If you opt for the offline route, you need to visit the office of the insurance provider, submit the documents and it will take a few days to get the policy.

8. What are the things to keep in mind when buying a Mediclaim policy?

There are certain things that you must keep in mind such as, wide network of hospitals, claim settlement ratio of the insurer, premium, duration of waiting period, capping and limits, co-payment, among others.

9. Can I get a refund if I need to cancel the policy?

Every policy comes with a free look period. This period is provided to the policyholder to understand the terms and conditions of the policy. If you are not convinced with the policy, you can cancel it within the free look period and get a complete refund. The free look period can be 10-15 days from the date of purchase, depending on the insurance company and the plan.

10. How will the insurer pay me if I get admitted in a non-network hospital?

If you get admitted at a non-network hospital, you need to pay the bills first and then claim for reimbursement. You need to submit the bills and other required documents while filing for reimbursement.

11. Will Mediclaim insurance cover COVID-19 related expenses?

Yes, Mediclaim insurance will cover the expenses related to COVID-19 provided the insured has been hospitalised for a minimum of 24 hours. However, it is better to check with the insurance provider about the terms and conditions related to COVID-19.

Conclusion

Life tends to throw curveballs when you are least expecting them. So, you need to stay prepared for any eventuality, which is why having a Mediclaim policy is highly recommended. If you are confused whether to buy Mediclaim or health insurance, then it depends on your and your family’s health needs, financial condition, whether you need comprehensive coverage, whether you need flexibility in your plan, and if you want to go for long-term or short-term planning. But make sure you are secured with an active health plan.

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

Mediclaim policy is a lifesaver! Buy one thoughtfully by avoiding these common mistakes

Mediclaim & health insurance terms decoded with the right differences you should know about

Know the Difference between Health Insurance Policy and Mediclaim