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Health Insurance vs Mediclaim – What's the Difference?
In regular conversations, mediclaim and health insurance are two popular terms, often used interchangeably. Although both policies cover medical expenses, they serve different purposes. While a mediclaim is typically limited to the hospitalisation expenses, a health insurance policy is a plan with broader coverage.
Anyone who is planning to purchase a medical insurance policy must understand the differences between these two plans. Health insurance and mediclaim policy differ in terms of premium charged, coverage, and the scope of the policy. In this guide, we will discuss mediclaim vs health insurance.
What is a Mediclaim?
A mediclaim is a type of medical insurance that typically only covers the hospitalisation expenses. In case the insured individual seeks hospitalisation for a specified illness or due to an accident, the insurance company covers the expenses up to the sum insured limit.
It is essential to note that a mediclaim revolves around hospitalisation expenses only. Other than these, generally, there is no other major coverage under a mediclaim policy. It is a suitable choice for people who only want hospitalisation coverage.
What is a Health Insurance Policy?
A health insurance policy is a broader plan that covers multiple medical expenses. Hospitalisation, pre- and post-hospitalisation expenses, daycare procedure, domiciliary treatments, etc., are usually covered in a health insurance plan. So, unlike mediclaim, health insurance has a wider scope.
There are different types of health insurance available, like individual plans, family floater, group health insurance, etc. So, depending on your preference, you may choose one.
Tip: You can further enhance the coverage of health insurance with various add-ons like critical illness cover, OPD care, etc.
Mediclaim Vs Health Insurance
Before you choose mediclaim or health insurance, understanding mediclaim vs health insurance is important. Here is a quick insight into the differences between the mediclaim and a health insurance policy.
| Mediclaim Policy | Health Insurance Policy |
| A medical insurance that covers only hospitalisation expenses | A medical insurance that covers hospitalisation along with various other medical expenses like pre- and post-hospitalisation, domiciliary expenses, etc. |
| The sum insured limit of the mediclaim policy is usually low | There are various sum insured options with health insurance plans. Some may go as high as ₹6 crore and more |
| Generally, mediclaim policies have limited to no option of add-ons (additional coverage along with the base policy) | Health insurance plans usually offer a range of add-on covers to enhance the coverage of the policy. Common ones are maternity benefits, critical illness coverage, etc. |
| Since the policy coverage is limited, the premium is also often lower compared to health insurance plans | In comparison to mediclaim, health insurance policies may have higher premiums due to wider coverage |
| Mediclaim is ideal for people who only want coverage for hospitalisation expenses | Someone looking for comprehensive medical insurance may go with a health insurance policy |
Which is Better: Mediclaim or Health Insurance?
Mediclaim and health insurance serve different needs of medical insurance. Since there is no one-size-fits-all medical insurance, the choice depends on personal preferences. Some of the factors that may help you make a decision are:
- The Coverage Scope: The first point to consider is the type of coverage you want. As discussed above, mediclaim is suitable for limited hospitalisation coverage, while health insurance covers several medical expenses.
Pro Tip: You may also purchase both mediclaim and health insurance to club the benefits of both policies. While mediclaim can take care of hospitalisation expenses, a health insurance policy will ensure sufficient coverage for various other medical expenses, along with hospitalisation.
- The Premium Charges: Another important factor to consider is the policy premium. The premium for mediclaim is usually low, as the coverage is also limited. However, the premium for health insurance is higher due to wider coverage. So, depending on your budget for premium, you may choose one of these.
Tip: You may split your premium budget into two parts to purchase both policies for comprehensive coverage!
Young and healthy? Find out which of these plans rewards you with lower premiums. Click here to check now!
Author Bio
Paybima Team
Paybima is an Indian insurance aggregator on a mission to make insurance simple for people. Paybima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 21 years of experience. Paybima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.
Over to You
Health emergencies don’t come with a calendar invite. Whether you're planning for your own future or looking out for your parents, choosing the right health insurance plan can make all the difference. That’s where a deeper look at the fine print helps. When you compare Star Health’s Red Carpet Plan vs Care Health Enhance Plan, what you’re really doing is choosing the kind of financial backup you want in your corner.
The Star Health Red Carpet Plan is made with senior citizens in mind. With benefits like annual preventive check-ups, it helps you or your ageing parents get covered without the usual hassles. On the other hand, the Care Health Enhance Plan acts as a top-up cover, ideal if you already have a base health policy and want to increase your shield without increasing your premium by too much.
While health insurance takes care of medical needs, don’t forget to plan for life’s bigger what-ifs. A term Insurance policy, especially a 1 crore term insurance plan, can be the long-term security net your family needs. Health and life coverage go hand in hand. And when chosen right, they help you face the future with confidence, not chaos.
Speak to an Advisor The Star Health Red Carpet Plan is made with senior citizens in mind. With benefits like annual preventive check-ups, it helps you or your ageing parents get covered without the usual hassles. On the other hand, the Care Health Enhance Plan acts as a top-up cover, ideal if you already have a base health policy and want to increase your shield without increasing your premium by too much.
While health insurance takes care of medical needs, don’t forget to plan for life’s bigger what-ifs. A term Insurance policy, especially a 1 crore term insurance plan, can be the long-term security net your family needs. Health and life coverage go hand in hand. And when chosen right, they help you face the future with confidence, not chaos.
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The main purpose of a good health insurance policy is to protect you from unexpected medical expenses. However, it is important to understand that not everything is covered under even the best health insurance policies.
Accidents can happen at any time, and in such cases, we always turn to hospitals for help. However, hospitals can turn out to be quite expensive when it comes to taking care of trauma from accidents. Even if you do have health insurance in place, you may still face surprising costs.
In regular conversations, mediclaim and health insurance are two popular terms, often used interchangeably. Although both policies cover medical expenses, they serve different purposes. While a mediclaim is typically limited to the hospitalisation expenses, a health insurance policy is a plan with broader coverage.
Last year, Ramesh Nagar, a 42-year-old software designer from Ambala, rushed to the hospital when his father had a cardiac arrest. Thankfully, the treatment went well and Ramesh’s father recovered quite soon. But soon after, Ramesh realised that the hospital bill wasn’t fully covered by their health insurance. It was the first time Ramesh was making a claim, and he was under the impression that every medical expense would be covered under their health insurance; however, when they realised that their health plan had certain exclusions and room rent limits, it was too late for them.
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