Health Insurance vs Mediclaim: Which Is A Better Option?

1. Health Insurance vs Mediclaim:  Which Is A Better Option?

2. Overview Most people are now aware of the necessity of buying a medical insurance policy. But many of them use the two terms, i.e. health insurance & mediclaim, almost interchangeably. There are some basic differences between the two. The primary difference between the two lies in their scope of coverage. You can go through any health insurance app, and you will find the details. The health insurance policy covers all medical treatment and surgery-related expenses of the policyholder. There are different types of schemes under the broad health insurance umbrella.  But a mediclaim policy is a specific type of health insurance with restrictions related to diseases covered, hospital stay, insured amount, etc.

3. Comparison of Health Insurance & Mediclaim Policies • A brief comparison between the two types of policies can be made on the following aspects. • Scope of Insurance Cover • Hospital Stay • Flexibility • Critical Illness & Add-on Covers • Claims

4. Scope of Insurance Cover • A health insurance policy provides comprehensive coverage for all medical care expenses. Pre & post-hospitalization costs, medicine, doctor’s consultation charges, ambulance bills, etc. are covered. The sum insured can go up to Rs.5 crore. • But a mediclaim policy only covers the hospital treatment costs and specified diseases. The sum insured generally does not exceed Rs.5 lakh. Please check the mediclaim app for specific details.

5. Hospital Stay • Hospitalization is not necessary to claim the benefits under a health insurance policy. It also covers several daycare procedures that do not require a hospital stay for more than a day. • But hospitalization is mandatory to make a claim under a mediclaim policy.

6. Flexibility • Health insurance has inbuilt flexibility to customize according to your specific requirements. You can reduce or enhance the premium amount by changing the policy features. Check the health insurance appfor the terms & conditions. • A mediclaim policy does not offer any kind of flexibility to the policyholders.

7. Claims • A health insurance policy like a critical illness plan or a personal accident plan pays a lump sum amount to the policyholder against the insured event. Only one such claim can be made during the policy period. • In a mediclaim policy, you can make multiple claims till the insured limit is exhausted. Claims shall be settled only on the basis of actual medical bills, and no lump sum amount is payable.

8. Critical Illness & Add-on Covers • A health insurance policy covers over 25 serious diseases, such as cancer, stroke, heart surgery, etc. if you buy a critical illness policy. It also offers add-on covers for pregnancy care, personal accident, etc. • A mediclaim policy does not offer any critical illness coverage and add-on covers.

9. Conclusion • Once you understand the subtle differences between a health insurance plan and a mediclaim policy, you can make an informed decision and choose the one that is appropriate for you!