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Difference Between Mediclaim And Health Insurance Policy

Saykat by Saykat
February 3, 2023
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Difference Between Mediclaim And Health Insurance Policy
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How certain are you regarding your future health? Well, none of us are! In fact, we are not even aware of what awaits us in the future!

So, it is immensely crucial for you to have a comprehensive plan for yourself and your loved ones. Only then will you be able to have a stress-free future. But if you are unsure where to start, don’t worry; we are here to help you.

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There are two significant ways through which you can acquire the best benefits in case of unexpected medical emergencies. While one is medical insurance or mediclaim, the other is a health insurance policy.

Today, this article will briefly discuss the differences between the two insurance instruments. But before that, we will quickly look into the two instruments separately. Please stay tuned until the article’s end so you can make an informed decision.

Come, let’s get started.

Health Insurance – What is it?

Health insurance is a typical coverage that provides you with complete coverage for surgical and medical expenses during emergencies.

This insurance instrument can function in two different ways. Either you must pay the expenses out of your pocket, which your insurance company later reimburses. Or, your insurance company directly settles all your hospital bills.

Mediclaim – What is it?

A mediclaim policy is also a health insurance policy that offers you specific financial protection during medical emergencies. It takes care of all your hospitalisation expenses whenever you:

  • Have met an accident
  • Have to undergo any surgery during the tenure of your mediclaim policy
  • Have experienced sudden illness or surgery

In the case of mediclaims, you can either consider choosing cashless or reimbursement.

We know both medical insurance and health insurance plan sounds pretty similar. But there are considerable differences between the two, and you’ll be surprised to learn about them.

Health Insurance vs Mediclaim – What are the Differences?

The primary difference between mediclaim and health insurance is probably the scope of coverage. And this typically pertains to the offered compensations, diseases covered, and the plan’s flexibility. Nevertheless, we have drawn out the potential differences between the two instruments in the table below:

Health Insurance Mediclaim 
A health insurance plan is flexible and can be customised according to your requirements. But a medical insurance policy doesn’t come with any probable flexibilities.
Health insurance plans provide comprehensive coverage that typically extends further than hospitalisation expenses. Some of the additional expenses include daily hospital cash, annual health checkups, alternative treatments, OPD expenses, AYUSH, etc. Mediclaim only provides coverage against any expenses related to hospitalisation. This means you can make a claim only when you are hospitalised.
A health insurance plan’s coverage is extensive and typically determined by various factors. Some of them include age, number of members in a single plan, city, etc. The hospitalisation coverage in mediclaim is limited and does not exceed Rs. 5 lakhs.
A health insurance policy offers a plethora of add-on covers, including maternity benefits, critical illness coverage, infertility cover, etc. When it comes to mediclaim, there are no such add-on covers associated with it.

Things You Should Know Before Purchasing a Health Insurance or Mediclaim in India

Whether you purchase a health insurance plan or a mediclaim, there are certain things that you must keep in mind:

  • Sum Insured

The health insurance plan and mediclaim policies usually come with a pre-decided insured sum. Thus, it cannot be altered during renewal.

  • Plan Basis

A mediclaim policy can be purchased either as an individual or as a family floater. Please note that a family floater plan usually provides coverage for self, spouse, dependent parents, dependent children, etc.

  • Claim Settlement

The claim request for both health insurance and mediclaim is processed in two significant forms – cashless and reimbursement.

  • Discounts on Renewal

Most health insurance policies benefit from a Claim Bonus during policy renewal. And this happens after the end of every year when zero claims have been made. This typical benefit can significantly help in acquiring discounts on premium renewals.

  • Tax Rebates

According to Section 80D or the Income Tax Act 1961, a health insurance plan offers remarkable tax benefits.

  • Co-Payment

There are some health insurance plans which come with a co-payment. This basically helps in decreasing the insurance premium as a percentage of treatment expenses is paid by the insured. Meanwhile, the remaining amount is paid by the insurance company.

To Conclude

Both health insurance policy and mediclaim policy are two different instruments for mitigating all health-related risks. Nevertheless, both of them primarily fulfil the insurance needs of the buyers.

Now that you are familiar with the potential differences between the two, you can choose the one that suits you better. Future Generali is right at your disposal, where you can find both insurance instruments. But before you can jump to conclusions, make sure you compare the plans and analyse your expectations.

Thus, you will be able to fulfil all your insurance requirements!

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