What is Difference Between Mediclaim and Health Insurance?

You take numerous actions to improve your health, including eating right, working out frequently, getting adequate sleep, and lowering your stress levels. You also likely already know that even with a healthy lifestyle, costs for medical care, medication, and recovery from severe or minor illnesses can be relatively high.

The necessity for sufficient insurance, including life and health insurance for family, has been amplified by the COVID-19 pandemic. Additionally, post-COVID problems can result in serious illnesses that demand prolonged hospitalisation and rehabilitation, adding to the cost.

What is Health Insurance?

A health insurance plan offers coverage for both medical and surgical sickness treatment. When you receive medical treatment for a condition covered by your health insurance best plan, the insurer will take care of paying your expenditures as long as the following criteria are met:

• The policy includes sickness coverage.
• The treatments for which the claim has been lodged are covered by insurance.
• The insurance company is associated with the hospital and the treatment centre.
• The claim is correctly filled out and includes all required documentation.

The availability of health insurance is offered annually, and it must be renewed annually. A health insurance plan can now be purchased online as well.

What is Mediclaim?

Specific financial protection against medical expenses is offered by a type of insurance policy called "mediclaim insurance." It is a practical way to lessen any medical emergency. However, only hospitalisation is covered by the Mediclaim insurance policy; all other medical expenses must be paid for by the insured. A mediclaim policy covers any planned operation during the policy period as well as hospitalisation costs incurred as a result of an accident, an emergency surgery, or both. Therefore, it only pays for hospitalisation expenses. Policies covering medical expenses also provide cashless or reimbursement ways to resolve claims.

Mediclaim Vs Health insurance

Basic differences between health insurance and mediclaim are listed below:

Coverage:

Only hospitalisation, accident-related medical care, and pre-existing conditions are covered by mediclaim plans, up to a certain cap. While a  health insurance plan provides all-inclusive medical protection against hospitalisation costs, ambulance costs, pre-hospitalization costs, post-hospitalization costs, etc. Additionally, it offers compensation if an accident results in a loss of income.

Flexibility:

Mediclaim provides no flexibility in terms of coverage. A family health insurance policy allows you to increase or decrease coverage. After a pre-determined amount of time, policyholders can lower their health insurance premium cost by extending the length of their policy. For instance, premium discounts are available with long-term plans.

Claims:

A policyholder may submit numerous claims under a Mediclaim insurance policy up until the total amount of insurance is used. In the case of health insurance, an insured may submit claims as long as the amount insured has not been used up. However, the promised value is paid in a lump sum when claims for accidental disability/Critical Illness Insurance coverage are made.  Throughout the policy, only one of these claims may be made.

Hospitalisation:

The insured must be admitted to the hospital to receive benefits under the mediclaim policy. It is not essential for the insured to be hospitalised to receive benefits from their health insurance. Benefits, including daycare procedure coverage, can be obtained without hospital admission.

Things to Keep in Mind Before Buying a Mediclaim or Health Insurance

Your choice will be influenced by several elements, including:

• Your economic situation
• Health difficulties you and your family members have
• Whether your health plan needs to be flexible
• Whether you require supplemental insurance and benefits
• Ability to afford a high or cheap premium
• Considering the age, stage of life and physiological condition of the policyholder

If you know which option will be better for you and your loved ones while keeping all the reasons mentioned above in mind, picking one out of the two is not difficult.

Even though both mediclaim insurance policy and family health insurance policy are eligible for tax benefits, insurance pros suggest picking a health insurance plan. This is so because health insurance plans provide extensive insurance protection. However, look for the best health insurance company in india with the most excellent services before selecting the best health insurance plan. A single plan cannot satisfy everyone's medical needs because everyone has different insurance demands. Similar to how one insurance company may meet the needs of one client while not meeting those of another. The numerous health insurance plans offered by platforms like Niva Bupa can be a better option regarding their coverage, services, benefits, and premium.

FAQs

1. Which one is better: Mediclaim or Health Insurance?

Health insurance is comparatively better since it provides wider coverage, such as hospitalisation, pre- and post-hospitalisation costs, ambulance fees, and even critical illness cover, while mediclaim covers only hospitalisation.

2. Can I have both Mediclaim and Health Insurance policies?

Yes, you can purchase both mediclaim and health insurance policies. This can provide you with layered protection, mediclaim for emergency hospitalisation, and health insurance for overall medical care and other advantages.

3. Is Mediclaim tax-deductible like Health Insurance?

Yes, the premiums for both mediclaim and health insurance can be claimed as a tax deduction under Section 80D of the Income Tax Act, provided they are within the limitations.

4. Does Mediclaim cover day care procedures or OPD expenses?

No, mediclaim policies don't cover day care procedures or OPD (Outpatient Department) expenses. Health insurance policies, however, tend to cover these based on the plan and insurer.

5. What should I check before deciding between Mediclaim and Health Insurance?

Consider aspects such as the scope of coverage, flexibility, claims process, affordability of premiums, and supplementary benefits such as critical illness cover or maternity benefits before making a choice.