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Difference Between Health Insurance and Mediclaim

One of the most bandied about phrases that we hear in our lives is ‘health is wealth.’ We have heard it from our teachers, parents, and other well-wishers and it sticks with us because it is true!

We have Mediclaim and health insurances to help us during times when our health is in peril or requires some urgent maintenance.

Many people use both terms to refer to the same thing. In reality, however, they both mean different things. Let us take a look at their separate meanings before we get into Mediclaim V/s Health Insurance.

Health Insurance

Health insurance covers the medical and surgical expenses of the insurer. There are two ways - first, the insurer pays the bills, and the insurance company reimburses them in full. Second, the insurance company directly pays off the expenses by dealing with the hospital.

Mediclaim

Mediclaim insurance covers treatment expenses for previously specified illnesses and eventualities. There is a fixed limit to the costs that the Mediclaim will be able to reimburse. It covers expenses ranging from hospitalization to treatment. This type of insurance is helpful when one is hospitalized for 24 hours.

Different types of Mediclaim Policies 

  • Individual Policy- As the name suggests, this type of Mediclaim policy will only pay for the hospitalization expenses of an individual against the premium paid.
  • Senior Citizen Policy - This policy is usually reserved for senior citizens above the age of 60 for their medical and health expenses. Scores of senior citizens in our country have benefitted from this policy. It is especially beneficial if the policyholder is suffering from age-related ailments.
  • Family Floater Policy - Here, medical coverage is provided to one person in a family, which can be transferred or extended to other members of the family. This kind of policy is ideal for families where one member is the primary breadwinner.
  • Critical Illness Policy - Critical illnesses tend to be long-drawn, emotionally draining, and expensive affair. Not only for the person suffering from the disease but also this/her family members and loved ones. This policy will give much-needed respite to the policyholder and his/her family.

Different Types of Health Insurance Policies

  • Individual Health Insurance - This policy covers an individual against illnesses and medical expenses. It covers the expenses until the cover limit is reached.
  • Family Floater Plan - This policy gives you a single cover for your entire family! It covers the hospital and surgical expenses for more than one family member at a single time.
  • Unit Linked Health Insurance Plan - In this policy, some part of your premium will be invested while the rest will go towards providing you medical cover. You get returns of the investments that are made with your premium.

After looking at the above-mentioned statistics and definitions, you may wonder ‘but which should I choose and what is the difference between a Mediclaim and health insurance?

Here’s a breakdown of Mediclaim V/s Health Insurance

Mediclaim Health Insurance
Get coverage for accident-related treatments, hospitalization, and diseases. (The diseases are pre-determined, and the cover is only available for a specific period). Health insurance is more comprehensive and covers hospitalization charges (both pre and post). It also compensates if the policyholder is unable to hold onto their job due to an accident/ critical illness.
No add-on coverage. Further, it offers a range of add-on coverage like maternity coverage, critical illness coverage, personal accident coverage, etc.
Different Mediclaim providers provide different plan features. The plan features largely remain the same for virtually all health insurance providers.
No flexibility for coverage. Policyholders can change their premium amount and policy duration after a specific period.
No critical illness coverage. It provides critical illness coverage for more than 30 critical illnesses such as stroke, cancer, kidney failure, etc.
You can get coverage for only up to 5 lakh. Here, the sum assured can go up to 6 Crores per year!
You can file claims in a Mediclaim policy till the total amount insured is drained or exhausted. Claims that are made for critical illness and accidental disability receive a lump sum. But these claims can be made just once during the entire duration of the policy.Apart from this one can file claims until the insured sum is exhausted.
One needs to be hospitalized to avail Mediclaim benefits. He/she will not be able to file claims if not hospitalized. It is not necessary to get hospitalized to claim health benefits with health insurance. You can avail day-care benefits without getting hospitalized.

The Final Words

The above table highlights the features and differences between mediclaim and health insurance. Use it to figure out which of the two suits your situation and fulfills your needs the best.

In any case, always have insurance for your health as well as for your family members. Nowadays, people are not much particular about their health insurance or Mediclaim, however, they should be.

The world is full of surprises, and not all of them are good. If you have a Mediclaim or health insurance plan, you will not have to worry about the eventuality of an accident or illness.

Lastly, Mediclaim is best suited for people that belong to modest economic backgrounds. The premiums are manageable and the amount that can be claimed is also not that much. They can also opt for insurance policies if they feel that they require more substantial insurance.

All in all, both of these things ensure the holistic well-being of you and your family.

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