In today’s world, no one can deny the importance of having adequate financial protection against medical expenses. Mediclaim and health insurance are two popular methods to insure your health-related costs. Many people think they are the same but that’s not so. While they both offer coverage for medical expenses, they differ in the scope of their coverage. Which covers what and which should you go for? Let’s find out.
What Is Health Insurance Policy?
Health insurance is a financial protection plan that helps individuals and families cover medical expenses. It involves paying a premium to an insurance company, which then provides coverage for a wide range of healthcare services, including hospitalisation, daycare procedures, post-hospitalisation expenses, ambulance charges, medication, preventive care, etc.
Health insurance operates in two ways: either the policyholder pays for medical expenses upfront and is later reimbursed by the insurer or the insurance company directly settles the bill with the networking hospital. The latter is called the cashless mode.
Health insurance plays a crucial role in reducing the financial burden of healthcare and ensuring access to necessary medical treatments and services.
What Is Mediclaim Policy?
Mediclaim is a specialised insurance policy designed to provide financial protection specifically for hospitalisation-related expenses in a cost-effective manner. Do note that in a mediclaim policy, the coverage is limited to hospitalisation costs. Other medical expenses have to be borne by the insured.
Difference Between Mediclaim Insurance and Health Insurance?
In India, the terms ‘mediclaim policy’ and ‘health insurance’ are often used interchangeably. But these two are not the same. Let’s look at some of the major differences between health insurance and mediclaim plans.
| Health insurance | Mediclaim |
| Offers comprehensive coverage beyond hospitalization, including pre-and post-hospitalization expenses, daycare procedures, OPD expenses, daily hospital cash, etc. | Provides coverage only for hospitalization expenses |
| Provides a variety of add-on covers such as the critical-illness, maternity benefits, and infertility covers. | Does not offer additional covers or add-ons. |
| Coverage is extensive and varies based on factors like age, location, and the number of members covered. | The maximum hospitalization coverage is usually around Rs 5 lakh but could vary depending on the insurance provider. |
| Health insurance plans are flexible and can be customized to suit individual needs. | Less flexible compared to health insurance options. |
Should You Buy a Mediclaim Policy or Health Insurance in India?
When deciding between a mediclaim policy and health insurance in India, opting for a comprehensive health insurance plan is generally recommended. While both options offer tax benefits, health insurance plans provide more extensive coverage.
It’s important to conduct thorough research and compare various health insurance plans offered by different companies based on their coverage, services, benefits, and premiums.
Keep in mind that individual insurance needs can vary, so finding the best health insurance plan depends on your specific requirements and preferences.
Bottom Line
Health insurance and mediclaim are two popular ways to insure your health-related costs. They are not the same. While health insurance has wide coverage, mediclaim caters to only hospitalisation-related expenses. So, assess your insurance requirements and compare the different plans to choose the right option. Generally, health insurance is preferable to mediclaim.