MediClaim vs. Health Insurance: Learn the Important Differences
Introduction:
Medical insurance is an armor that covers your expenses in case of medical emergencies. It offers coverage to policyholders based on certain conditions and timely paid premiums.
The blog posits two kinds of medical insurance – MediClaim and health insurance. Health insurance offers comprehensive coverage along with add-on coverages, whereas MediClaim requires raising a claim or reimbursement of hospitalization only.
Exploring the differences is crucial to making informed decisions while opting for a particular medical insurance policy.
Hence, the blog elaborates on the differences between MediClaim and health insurance to help you choose medical insurance that meets your total financial budget and needs.
The Basic Understanding of MediClaim and Health Insurance
MediClaim Policy
MediClaim policy is a medical insurance policy that alleviates the financial burden on individuals in cases of unexpected illnesses and accidents. It is pocket-friendly and the most common choice among people as it assists them with inflated healthcare costs.
MediClaim policy ensures you get robust financial security during medical emergencies. You have to raise a claim to avail its benefits effectively.
Health Insurance
Healthcare insurance, unlike MediClaim, is useful not merely during medical emergencies. It covers a broad range of medical expenses and has fixed benefits. These charges include pre- and post-hospitalization, consultation fees, and ambulance expenses, among others.
Additionally, the expenses cover surgeon fees, operation theater charges, nursing fees, room rent, doctor consultation fees, daycare treatment, and tax benefits. Overall, this form of medical insurance is more expensive than MediClaim.
Highlighting the Distinctions: MediClaim vs. Health Insurance
- Coverage Areas
MediClaim is indemnity-oriented. It covers the in-hospital charges for accidents and a minimum number of other pre-existing diseases. Meanwhile, health insurance provides comprehensive coverage of pre and post-hospitalization charges. The latter also allows you to avail compensation in case of an accident-based disability resulting in income loss.
- Policy Customization
You cannot change the coverage amount (or insured sum) in a MediClaim policy. It has no room for flexibility and offers financial coverage up to the pre-set amount. However, you can customize the coverage amount in health insurance. You can access benefits such as a cumulative bonus to increase the insured sum and customize the policy per your medical needs.
- Add-Ons
MediClaim does not allow any add-ons to the plan, but health insurance does. It offers add-on coverages for personal accidents, maternity, and critical illnesses (such as kidney failure, cancer, etc.).
- Total Number of Claims Allowed
You may file multiple claims according to MediClaim until the total insured sum depletes. While you can opt for the same in a health insurance policy, you are eligible to receive an additional lump sum in cases of accidental disabilities. However, the final number of claims depends on the overall terms and conditions.
- Is Hospitalisation Necessary?
You receive hospitalization coverage and claim as per the insured sum under MediClaim policy. On the other hand, health insurance covers beyond hospitalization charges and offers additional benefits.
- Premium Charges
MediClaim is relatively cheaper compared to a health insurance policy due to limited coverage whereas the latter offers extensive coverage of numerous medical charges.
Opting For the Ideal Medical Insurance: Can Different Be Better?
Life is unpredictable. Choose the right medical insurance policy to secure your health and financial stability. As a result, you will enhance your and your family’s futures. A necessary step towards making the right decision is to explore the key advantages of a MediClaim policy and health insurance. Focus on the comprehensive coverage offered, out-of-pocket additional expenses, and customization policies. Understanding the benefits of the two will enable you to make an informed decision that aligns with your particular needs.
Core Benefits of A Cost-Effective MediClaim
Using the MediClaim policy, you can make cashless payments at network hospitals or get a total reimbursement for your hospitalization fees. This helps you avail medical treatment at any insurer network hospital without paying upfront. Your insurance company settles the overall hospital bills directly during your discharge.
Core Benefits of A Comprehensive Health Insurance
Health insurance allows comprehensive coverage of medical expenses during pre-hospitalization, and post-hospitalization. Additional coverage includes room rent, doctor consultation fees, ICU fees, diagnostic test charges, etc. This policy offers add-ons such as critical illness and maternity coverage with cashless and reimbursement claim options.
Deciding Factors: Choose the Right Medical Insurance Plan
After outlining the key benefits of both, you have to factor in specific components before purchasing a medical insurance plan:
- Type of Plan: There are diverse medical insurances available in the market. Check the coverage details, i.e., premiums and policy terms, before finalizing any purchase.
- Pre-set Insured Sum (Coverage Fees): Determine the coverage fees that fit your needs and budget. Often, there are unalterable coverage policies that cause financial liabilities in case of emergencies.
- Term of Policy: Consider the longevity of the policy chosen. Your choice of policy might depend on the policy term and offered premiums. Long-term insurance plans help you avoid any frequent renewal plans.
- Claim Settlement: There are generally two types of claim settlement processes – cashless and reimbursement. A smooth settlement process ensures a hassle-free experience. Awareness of the claim settlement ratio offered by the insurer will ensure easy access to the policy benefits.
- Additional Discounts: Several insurance companies offer a No Claim Bonus to policyholders on renewal premiums. You can avail of up to 50% NCB in case you have a certain number of consecutive claim-free years available.
- Copayment Option: The copayment clause highlights that the policyholder has to pay a certain portion of the insured sum during claim settlement.
For example, if the clause states that you need to “co-pay” 15% of the Rs. 3 lakhs insured, you pay Rs. 45,000 meanwhile the remaining amount is paid by the insurance. This inevitably affects the premium – the higher the copayment amount, the lower the premium. Health insurance policies don’t entail any copayment, unlike MediClaim.
The Right Choice: Weigh the Differences!
MediClaim and health insurance, both, have their advantages and disadvantages. The final decision rests on the policyholder’s coverage needs and total medical budget. The former is cost-effective whereas the latter provides comprehensive coverage.
Purchasing a medical insurance policy has become convenient owing to the advancing digital age.Healthcare insurance may serve the same purpose, but it’s not the same as MediClaim in terms of premiums and coverages.
Today, you can choose the ideal insurance by visiting and meticulously browsing your preferred insurer’s website. You can also access the details through life insurance and general insurance companies in India.
Read the terms and conditions policies carefully. And, finalize a medical plan that suits your needs and budget. Protect your health, finances, and future by investing in the most suitable insurance policy!
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Also, check out our recent post on: “What is the 50/30/20 rule for Budgeting?”
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Disclaimer – This article is for educational purposes only and by no means intends to substitute expert guidance. Mutual fund investments are subject to market risks. Please read the scheme-related document carefully before investing.
