Mediclaim vs Health Insurance : What Is The Difference Between Mediclaim Policy And Health Insurance Policy?

What is a Mediclaim Policy? 

A Mediclaim Policy is a kind of health insurance that covers the insured members, financially in case a medical emergency arises. The policyholders can either choose for reimbursement or direct bill settlement of the expenses incurred on the hospitalization due to accident, critical illnesses, or surgeries. 

Benefits of a Mediclaim Policy

1. In the case of hospitalization, the expenses incurred can be claimed immediately. 
2. Direct bill Settlement facility is available on cashless policies by the mediclaim insurance company. 
3. A reimbursement facility is available according to the type of plan you choose. 
4. Affordable premiums are applicable in comparison to health insurance policies.

What is a Health Insurance Policy?

Health insurance meaning is an insurance policy that provides wider coverage to its policyholders when he/she is stuck in a medical emergency. The comprehensive coverage offered under a health insurance policy can include much more than just hospitalization expenses, like coverage for critical illnesses, alternative treatments, daycare procedures, and others. 

Benefits of a Health Insurance Policy

1. The policy offers comprehensive coverage with several add-ons. 
2. Covers the pre-and-post hospitalization charges of the insured, apart from the hospitalization costs.
3. Numerous policies are available to suit the requirements of all, be it senior citizens or your entire family. 
4. The policy allows you to choose for extra coverage regarding maternity benefits, outpatient benefits, and critical illness coverage.

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Mediclaim vs Health insurance : Mediclaim And Health Insurance Policy Difference

Let’s see this table to understand the difference between Mediclaim and Health insurance policy:

Difference In	Mediclaim	Health Insurance
Coverage	Provides coverage on hospitalization charges of the insured. Can also cover critical illnesses up to a certain limit.	Provides comprehensive coverage to the insured and bears the expenses of in-patient hospitalization, outpatient charges, medical tests, etc.
Pre & Post hospitalization charges	Does not cover.	It covers the expenses, depending on the type of plan chosen.
Ambulance charges	Does not cover	It Covers ambulance expenses up to a certain limit.
Daycare procedure	Does not cover   (Mediclaim only covers for the hospitalization charges, thus will not bear the charges of daycare procedures)	Covers for the patient’s daycare treatments like cataract surgeries, maternity-related treatments, diagnosis, etc.
Co-payment facility	Not permitted	Permitted
Cost and Benefits	With lesser benefits offered, Mediclaims are available at low costs. Mediclaims generally provide coverage up to INR 5 lakhs.	Health Insurances offer wider coverage under comprehensive plans and demand higher premiums with increased S.I options.
Number of Claims allowed	Under a Mediclaim policy, you can make numerous claims in one policy year until the limit of sum assured, exhausts.	Generally, a Health Insurance policy allows you to make only one claim per year.
Flexibility	Rigid plans with almost no variety or customization	Numerous health insurance plans are offered to suit the requirements of all with additional features and extra benefits.

 

What should I invest in Mediclaim Insurance or Health Insurance?

You have now seen that both Mediclaim Insurance and Health Insurance have their own pros and cons. Therefore, you should analyze your budget, requirements and the number of members to be insured, before investing in either of them. 

If you are someone who cannot spend much on premiums but also does not want to overlook your family’s health, then opting for a Mediclaim can be a good choice. However, if you want wider coverage for your loved ones and afford the premium costs, then you should go for a suitable Health insurance policy. So, apart from your financial condition, there are certainly other factors that you can keep in mind before making a choice:

1. If your and your family’s medical history  has been healthy, you may consider a Mediclaim 
2. Also, keep in mind their age and stage. Elderly people, women planning a family, individuals working in a risky environment would need better coverage
3. Whether you wish to make a short term or long term investment
4. Flexibility and freedom to customize is available only in a health insurance policy
5. Mediclaim policies have a lower premium