What is mediclaim? This is one of the common questions that linger in the minds of most individuals who are planning to buy a health insurance policy. Common people often get confused between mediclaim and health insurance. They do share a few features but vary in terms of coverage and other factors. Let’s clear up this confusion for you.
What is Mediclaim?
Mediclaim is a financial tool that covers your medical expenses, like health insurance. It is a safety net that protects your savings from being drained due to medical emergencies. You own a mediclaim policy, pay the premiums on time, and get the medical expenses reimbursed after verification by the service provider. It is the same with health insurance. The only difference is that mediclaim policies do not have add-ons to increase the coverage features.
Types of Mediclaim Policy
There are various mediclaim policies, just like different health insurance plans, and these different mediclaim plans are designed to provide financial protection against medical expenses. Some of their popular plans include:
Medi Classic Insurance Policy
With this insurance, you can be reimbursed for hospitalisation expenses due to illness, disease, or accidental injuries. It also offers sum insured options, pre- & post-hospitalisation, daycare procedures, and health check-ups.
Comprehensive Insurance Policy
It is a high-coverage policy that offers extensive benefits such as hospitalisation coverage, pre & post-hospitalisation, maternity benefits, and outpatient costs.
Family Health Optima Insurance Plan
It is one of the best mediclaim policies for family that covers not just the policyholder but the policyholder’s spouse, children, and parents. The top benefit of family health optima insurance is that it provides very affordable premiums.
Senior Citizens' Health Insurance Policy
This is a plan specialised for individuals aged 60 to 75 years, and it specifically covers expenses for age-related diseases and illnesses. No pre-medical screenings are required to purchase a senior citizens' health insurance policy.
Women's Care Insurance Policy
This is a specialised plan for women, covering maternity expenses, delivery costs, and wellness benefits. This policy ensures financial security and peace of mind for women at every stage of life.
How Does Mediclaim Insurance Work?
As mentioned, mediclaim offers a financial backup for medical expenses. It also has a coverage limit set annually. Once you cross the coverage cap, you will have to pay the rest of your medical bills with cash. This coverage limit resets every year.
A Mediclaim policy has premiums like otherhealth insurance plans. Learn how to find my health insurance premium online. Top health insurance companies provide an online calculator to get a glimpse of a premium before you buy a plan. After getting an idea, you can afford a mediclaim plan.
Coverage: Mediclaim insurance helps cover hospital and medical expenses when you need treatment. Instead of paying the full amount yourself, your insurance company pays a part of it.
Purchase a mediclaim policy: You can buy a mediclaim policy by paying a yearly premium to the insurance company, and if at all you wish to renew the coverage, you can pay the premium on time and renew it.
Make a Claim: You can claim your insurance in two ways:
Cashless Claim – If treated at a network hospital, the insurance pays directly to the hospital.
Reimbursement Claim – If treated at a non-network hospital, you pay first and get the money back later.
Benefits of Mediclaim
Inpatient hospitalisation costs: A mediclaim policy will cover the medical expenses of an insured individual admitted to a hospital. The only factor is that the patient should be hospitalised for more than 24 hours.
Daycare: Some policies cover treatments that don’t require hospitalisation. All these terms are mentioned in the Clauses section of a mediclaim policy document.
Pre and post-hospitalisation expenses: Many policies also cover the pre- and post-hospitalisation costs.
Domiciliary treatment costs and annual health checkups: Some plans cover the treatment a patient is receiving at home. Annual health checkups are also covered.
No-claim bonus: Policyholders are often rewarded with a no-claim bonus when they don't seek medical coverage for a specified period. This bonus increases the coverage amount without increasing the premium amount.
Difference between Mediclaim and Health Insurance
Let's discuss the difference between health insurance and mediclaim plan. Here is the table showing the difference between health insurance and mediclaim policy.
Aspect
Mediclaim
Health Insurance
Coverage
Covers hospitalization expenses only
Covers hospitalization + additional benefits
Scope
Limited coverage for medical expenses
Broader coverage including OPD, critical illness, maternity, etc.
Claim Process
Requires hospitalization for claims
Claims can be made for various treatments beyond hospitalization
Sum Insured
Fixed sum insured
Offers flexibility with higher sum insured options
Additional Benefits
No additional benefits beyond basic coverage
Includes preventive healthcare, wellness benefits, and more
Premium Cost
Lower premiums
Higher premiums due to extensive coverage
Customization
Not customizable
Allows customization with add-ons and riders
Pre/Post-Hospitalization
May not cover pre & post hospitalization expenses
Covers pre and post hospitalization expenses
Ideal For
Individuals seeking basic coverage for emergencies
Individuals looking for comprehensive medical protection
Why Do I Need Mediclaim Insurance?
There are many reasons for why you need a mediclaim insurance.
Financial Security : Mediclaim insurance policy protects from sudden and high medical expenses.
Provide access to Quality Care : Mediclaim's insurance policy ensures that you have access to top healthcare without having to worry about quick payments.
Emergency Readiness : Mediclaim insurance policy offers quick treatment at the time of many unexpected health crises.
Family Coverage : Mediclaim insurance helps safeguard the whole family below one policy.
Preventive Care : Mediclaim insurance policy enhances health check-ups and early disease detection.
Tax Advantages : Mediclaim insurance is eligible for tax deductions below Section 80D.
Rising Healthcare Costs : Mediclaim insurance policy reduces the impact of increasing medical or healthcare expenses.
Customizable Policies : Mediclaim insurance policy provides tailored choices for particular requirements and budgets.
Peace of Mind : Mediclaim insurance provides reassurance and safety for health-associated uncertainties.
Why to Opt for a Mediclaim Policy?
In the case of a medical emergency, it offers a financial safety net.
In the event of an emergency, receiving medical care is made more convenient by the availability of a cashless hospitalisation service.
The insurance company handles hospitalisation expenses, and it lessens the financial strain and is an inexpensive way to obtain medical care.
It provides you with the assurance that you can afford the expenses and obtain high-quality medical care.
There are options for both individual and family floater mediclaim insurance, so you may select the one that best suits your needs in terms of both money and health.
Tax benefits are available for premiums paid for health insurance.
Know how to reduce health insurance premiums by affording mediclaim at an early age. Opt for a family floater plan to do the same.
Mediclaim offers tax benefits like health insurance policies. Under Section 80d, you can claim a sum of up to Rs. 25,000 from taxes every year. Senior citizens can claim up to Rs. 50,000 while filing income tax returns by using the details of their mediclaim. Get your mediclaim plan today!
Disclaimer: Health Insurance Coverage for pre-existing medical conditions is subject to underwriting review and may involve additional requirements, loadings, or exclusions. Please disclose your medical history in the proposal form for a personalised assessment. This FAQ page contains information for general purpose only and has no medical or legal advice. For any personalized advice, do refer company's policy documents or consult a licensed health insurance agent. T & C apply. For further detailed information or inquiries, feel free to reach out via email at marketing.d2c@starhealth.in
