Mediclaim Policy vs Health Insurance in india

Health insurance and a mediclaim policy are both insurance instruments related to health and medical issues. However, there are differences between the two that can help you choose the right one according to your needs. First, let us understand what health insurance and mediclaim policy are.

Health insurance covers all your medical expenses related to diseases and covers hospitalisation charges in case of an accident or injury. The insurance can provide cashless treatment with the partner hospital. Or else, you can pay for your medical expenses and get them reimbursed from the insurance company.

Benefits of health insurance policy

● There are multiple add-ons available in the health insurance policy according to your needs.
● All the charges are covered in the health insurance policy, including pre and post medical treatment expenses and checkups.
● You can opt for a cashless claim where the insurance company will directly pay all the hospitalisation charges.
● You can also choose a family floater plan that covers your entire family under the insurance. If any member of your family is ill or injured, the insurance will cover all the treatment expenses. There is also a senior citizen floater plan you can opt for if you have old parents.


Benefits of mediclaim policy

● The sum assured is pre-determined and cannot be altered, unlike in a health insurance policy.
● The sum assured is decided based on your age, background, geographical locations, habits, and pre-medical conditions and treatments.
● You get immediate assistance in terms of medical expenses in case of hospitalisation.

A mediclaim policy covers only specific illnesses and hospitalisation charges up to a specific limit and the sum assured. It also does not cover your pre and post-hospitalisation medical expenses.

Differences Between health insurance and mediclaim policy

The significant differences in terms of health insurance and mediclaim policy are as follows:

1. The major difference between both financial instruments is the sum assured in both scenarios. Mediclaim is against specific illnesses and treatments and thus covers only up to Rs 50 Lakhs. In contrast, a health insurance policy covers all types of illness and accidents and thus can offer coverage up to Rs 5 Crore.
2. Health insurance covers the pre and post-treatment expenses as well. In contrast, a mediclaim policy only covers hospitalisation charges and the other charges during the treatment. It does not cover the medicine and checkup expenses, which are considered in a health insurance cover.
3. You can make claims in a mediclaim policy till you exhaust your sum assured. However, in health insurance, a claim can only be made once during the insurance tenure.
4. A mediclaim policy only covers specific illnesses, which are mentioned in the policy terms. In contrast, health insurance covers almost all illnesses except eye, nose, ear, cosmetology, pregnancy, or any pregnancy-related condition. These conditions can only be covered in health insurance if hospitalisation is required with a waiting period of two to three years.
A mediclaim policy covers pre-existing diseases, while it is not covered in health insurance policies.
5. Both mediclaim and health insurance are valid for one year, after which you have to keep renewing it every year as per the government guidelines.
6. Both a mediclaim policy and a Health insurance policy gives you tax benefit under section 80D. You can claim Rs 15,000 annually in your income tax returns as an insurance premium paid.
7. Health insurance provides numerous add-ons for policy covers, whereas, in the mediclaim policy, there are no add-ons against the terms and conditions mentioned in your policy.
8. While a health insurance policy is flexible and can be altered according to your needs, a mediclaim policy is not flexible.
9. The plan and features of a mediclaim policy may differ from one insurance company to another. However, the plan and features are the same across insurance companies when it comes to health insurance policies.
10. Both mediclaim policy and the health insurance policy provide bonuses. While a mediclaim policy will offer you discounts, a health insurance policy provides a no claim bonus every year you file no claims.

Thus, both mediclaim policy and health insurance policy may look identical but have many differences in structure and benefits. Keep in mind the following points if you have to choose between the two:

● If the insurance is for a specific cover or in general
● If your family history suggests a medical condition, which can be diagnosed at a later stage.
● If you need add-on covers or extensive benefits
● The financial condition and the ability to pay the premium
● If you are planning for long-term or short-term insurance cover

Consider these points before you decide on buying health insurance or a mediclaim policy. You can choose to buy from online platforms that can cater to your needs.

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