In this blog, we break down the difference between health insurance and mediclaim, explaining their coverage, features, and benefits. You’ll learn how mediclaim offers basic hospitalization protection at a lower cost, while health insurance provides extensive and flexible coverage with add-ons. By the end, you’ll know which option suits your financial and medical needs better.
Opting for health insurance creates financial protection against unforeseen medical emergencies but paying premiums for health insurance can be costly to many. However, it becomes necessary to sign up for a health insurance plan that offers some sort of financial protection.In such cases mediclaim health insurance policy offers considerable protection against hospitalization expenses. Having said that, one common mistake that people often make is that they think mediclaim and health insurance are the same. However, there exists a major difference between mediclaim and health insurance.
Also read: Health insurance: a complete guide
Mediclaim health insurance policy offers specific financial protection against medical expenses to the policyholders.
Source: Max Bupa
This mediclaim health insurance plan takes care of the following.
Whatsoever, the coverage is limited to hospitalization expenses, the other expenses are borne by the policyholder itself.However, the mediclaim insurance policy tends to be a budget friendly health insurance policy.
A mediclaim policy works according to these features. Here are some of its main features:
A mediclaim health insurance policy covers hospitalization expenses and medical treatment expenses due to accidents, specific diseases and surgeries. The rest of the expenses are taken care of by the insured.
As per section D of the Income tax act of 1961, mediclaim offers certain tax benefits to the policyholder against the premium paid towards it.
A mediclaim premium is calculated based on the factors like sum insured, age of the insured, duration of the plan, gender and geographical location of the policyholder.
Mediclaim policy’s claim settlement happens in two ways. It is either a cashless claim settlement or a reimbursement of the claim settlement.
There are two types of mediclaim health insurance plans available. Individual and family floater mediclaim. The family floater mediclaim health insurance plan covers the dependent parents, spouse and children.
Health insurance is an insurance policy that covers all of the medical and surgical expenses of the insured. It provides complete protection against any medical emergencies.
Source: Western Slope Now
The insured either pays the medical bills out of his/her hands and the insurer reimburses the bills. Or, the insurer directly settles the bill to the hospital. A health insurance policy offers extensive coverage to a policyholder than a mediclaim policy, but it is costlier than a mediclaim health insurance plan.
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These are the features of a health insurance plan. One can also compare two health insurance plans using these features.
Health insurance coverage is pretty extensive. It offers you coverage against critical 30+ illnesses. Depending on the sum insured you opt for the coverage can be extended. This has additional advantages on room rent limits, alternative treatment coverage etc.
Some of the health insurance plans come with a co-pay option. While opting for copay in health insurance, the insurance company settles a major percentage of the bill and the policy insured pays the rest. For example, 80% of the medical bills will be settled by the insurance company and the rest 20% is paid by the policyholder. Opting for copay can help you decrease your insurance premium.
A health insurance plan not only protects you against medical expenses but also offers tax benefits. According to section 80D of the Income tax act of 1961, health insurance offers certain tax deductions.
One can add certain add on covers in health insurance. They can add-on maternity health insurance coverage, home hospitalization coverage, alternative treatment coverage etc.
For every claim free year, a percentage of sum insured increases upto a certain limit and this is known as no claim bonus. This is added every year during the time of policy renewal.
Most health insurance plans offer annual health check ups every year during the time of policy renewal. This can be applicable for the policyholder as well as the dependents depending upon the plan opted.
Also read: Difference between health insurance and term insurance
Source : Bajaj Allianz
In order to answer the question, ‘which is better: mediclaim or health insurance?’ we will have to consider several factors like
After considering the following factors, and the insured’s expectations, one can choose between a mediclaim and a health insurance policy. As both fulfil the basic needs of a health insurance plan, opt for that plan that fulfils your requirements and expectations.
Do you wish to provide an employee benefits package for your employees that include both group health insurance and mental wellness programs? Contact us for more information.
In most cases, yes. Employees can choose to enhance their sum insured, add dependents, or buy top-up covers at additional cost. HRs should offer these options during policy onboarding or renewal windows.
A Mediclaim policy is a type of health insurance that helps you pay for hospitalization and medical expenses, either through cashless treatment or reimbursement.
Yes, it is highly recommended. A Mediclaim policy protects your savings from unexpected hospital bills and ensures access to quality care.
Mediclaim is a type of health insurance, but there are more comprehensive policies available for health insurance. And these health insurance plans offer more health benefits.
Yes, with a family floater policy, your spouse, children, and parents can all be covered under one plan.
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