5 min read
Updated on Sep 12, 2023
Mediclaim policy and Health Insurance policy are the two terms that are often confused with each other. In layman’s words, they are both related to medical insurance that provides financial coverage to the policyholders at the time of a medical emergency. Despite this resemblance, some major factors highlight the differences between them. Let us compare mediclaim vs health insurance.
A Mediclaim Policy is a kind of health insurance that covers the insured members, financially in case a medical emergency arises. The policyholders can either choose for reimbursement or direct bill settlement of the expenses incurred on the hospitalization due to accident, critical illnesses, or surgeries.
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Health insurance meaning is an insurance policy that provides wider coverage to its policyholders when he/she is stuck in a medical emergency. The comprehensive coverage offered under a health insurance policy can include much more than just hospitalization expenses, like coverage for critical illnesses, alternative treatments, daycare procedures, and others.
Let’s see this table to understand the difference between Mediclaim and Health insurance policy:
|Difference In||Mediclaim||Health Insurance|
|Coverage||Provides coverage on hospitalization charges of the insured. Can also cover critical illnesses up to a certain limit.||Provides comprehensive coverage to the insured and bears the expenses of in-patient hospitalization, outpatient charges, medical tests, etc.|
|Pre & Post hospitalization charges||Does not cover.||It covers the expenses, depending on the type of plan chosen.|
|Ambulance charges||Does not cover||It Covers ambulance expenses up to a certain limit.|
|Daycare procedure||Does not cover
(Mediclaim only covers for the hospitalization charges, thus will not bear the charges of daycare procedures)
|Covers for the patient’s daycare treatments like cataract surgeries, maternity-related treatments, diagnosis, etc.|
|Co-payment facility||Not permitted||Permitted|
|Cost and Benefits||With lesser benefits offered, Mediclaims are available at low costs. Mediclaims generally provide coverage up to INR 5 lakhs.||Health Insurances offer wider coverage under comprehensive plans and demand higher premiums with increased S.I options.|
|Number of Claims allowed||Under a Mediclaim policy, you can make numerous claims in one policy year until the limit of sum assured, exhausts.||Generally, a Health Insurance policy allows you to make only one claim per year.|
|Flexibility||Rigid plans with almost no variety or customization||Numerous health insurance plans are offered to suit the requirements of all with additional features and extra benefits.|
You have now seen that both Mediclaim Insurance and Health Insurance have their own pros and cons. Therefore, you should analyze your budget, requirements and the number of members to be insured, before investing in either of them.
If you are someone who cannot spend much on premiums but also does not want to overlook your family’s health, then opting for a Mediclaim can be a good choice. However, if you want wider coverage for your loved ones and afford the premium costs, then you should go for a suitable Health insurance policy. So, apart from your financial condition, there are certainly other factors that you can keep in mind before making a choice:
There are certain basic differences between mediclaim and health insurance, nevertheless, both of them will stand out for you financially when you are in a medical emergency. Whether you invest in a Mediclaim or a Health Insurance policy, it is important that you at least have some source to cover your expenses in an unfortunate situation. After all, an emergency can never be predicted, and in such a situation you would have to dig into your savings unless you have a strong backup plan.
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Should You Purchase Health Insurance or a Mediclaim Policy in India? Insurance professionals advise choosing a health insurance plan even though both mediclaim and health insurance plans qualify for tax benefits under Section 80D of the Income Tax Act. This is so because health insurance plans provide extensive insurance protection.
A medical insurance policy will only pay for inpatient care. Up to a certain extent, it might cover the treatment of particular illnesses. Contrarily, a health insurance policy has a wider scope.
Protection from medical debt is offered by Mediclaim insurance. At network hospitals, you can use the cashless payment option. Both individuals and families are eligible for Mediclaim. On the yearly premium, it offers tax advantages.
Additionally, the cost of healthcare has generally been increasing at a rate of 15% per year. Therefore, having mediclaim insurance to cover any unforeseen or anticipated medical needs is essential, as purchasing a health cover is always a lot less expensive than blowing through all of one's savings on treatment.
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