5 things that make Health Insurance different from Mediclaim

Health Insurance and mediclaim, these two are often confused. But they are not the same. Investing in an insurance policy is not the same as investing in a mediclaim. Knowing the difference between these two policies can help you make the right decision. But what is the difference between this insurance and mediclaim? This guide will help you out. 

  • Pre and post hospitalisation expenses:

    A mediclaim policy strictly covers the cost of hospitalisation. It may cover the treatment of specified illnesses to a particular limit. A Health Insurance policy, on the other hand, is more broad-based. It includes expenses incurred a number of days before and after hospitalisation, such as on diagnosis, doctor’s consultation charges, etc. These costs are not included in a traditional mediclaim policy.
  • Ambulance charges:

    A mediclaim does not allow for reimbursement of ambulance charges. In contrast, in most Health Insurance policies, ambulance charges up to a particular limit are allowed in the insurance claim. These expenses are reimbursed by the insurance company.
  • Maternity benefits and Daycare procedures:

    A mediclaim typically covers the cost of hospitalisation for specified illnesses. They do not include any spends on maternity costs, be it caesarean or any medical treatment for the child. Mediclaim requires the person to be hospitalised, so they naturally exclude daycare procedures where the person does not require to be hospitalised, such as cataract surgery. These items are possible in a Health Insurance policy claim.
  • Cost and benefits:

    Since the coverage of a mediclaim is restricted, the cost of the insurance policy is also lower than a Health Insurance policy. The coverage under this is usually restricted to Rs. 5 lakhs. However, a Health Insurance policy is a comprehensive policy with many more inclusions. This increases the premium cost, and also gives a higher sum assured.
  • Number of claims:

    A mediclaim policy allows multiple claims to be made during a year until the time the sum assured limit is not exhausted. In a Health Insurance policy, typically, the insured can make one claim during the year.

The differences between mediclaim & Health Insurance on the face of it are not major, but when it comes to getting claims reimbursed, an insurance policy covers more and allows greater protection. However, a mediclaim is also very affordable, making it an option that many people opt for.  So, if it’s mediclaim or Health Insurance, then pick the one you can afford and the one that will give the best protection to your family. If a Health Insurance policy is out of reach, at least pick a mediclaim to cover your family.

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Read more on the reasons why you need Health Insurance here.

*Terms and Conditions apply. The information provided in this article is generic in nature and for informational purposes only. It is not a substitute for specific advice in your own circumstances. You are recommended to obtain specific professional advice from before you take any/refrain from any action.