How Health Insurance is Different from Mediclaim?
Numerous blunders are made by consumers when purchasing health insurance. One of the most frequent errors is thinking of mediclaim as a euphemism for health insurance. Mediclaim and health insurance plans, however, are very dissimilar from one another. These words could appear similar at first glance, but if you delve a little further and take the time to comprehend the features provided by both policies, you will begin to notice the differences. We will give you details on both to help you evaluate them.
What is Meant by Health Insurance?
Health insurance is a type of insurance that provides complete coverage for unexpected medical and surgical costs. As long as the following conditions are satisfied, the insurer will take care of covering your expenses when you obtain medical treatment for a condition covered by your health insurance:
- The policy includes coverage for the sickness.
- The insurance permits the treatment procedures for which the claim has been made.
- Specific procedures are prohibited under some policies.
- The hospital and the treatment facility have the insurance company's approval.
- The claim is submitted correctly, and all necessary supporting information is included.
- The hospital or service provider may request payment from the insurance company directly, or you may receive a refund for any charges you have already paid.
- Health insurance coverage is offered annually and needs to be renewed yearly.
- Additionally, today you can purchase a health insurance plan online.
What is a Mediclaim Policy?
Mediclaim insurance is a form of insurance policy that provides specific financial protection against medical bills. It is a cost-effective method of reducing any medical emergency. However, the mediclaim insurance coverage is just for hospitalisation; the insured is responsible for covering all other medical costs.
Both sound alike, don't they? You'll be shocked to learn the differences between the two, though.
Understanding the Difference Between Mediclaim and Health Insurance
| Mediclaim | Health insurance |
| It only pays for hospitalisation costs. | As well as covering treatment costs, this insurance policy also covers costs incurred during pre and post-hospitalisation. |
| It does not provide add-on coverage. | Add-ons expand the scope of the policy's coverage. For example, critical illness insurance, personal accident insurance, accidental disability insurance, loss of income, daily [hospital cash] facility, etc., are some powerful add-ons. |
| A mediclaim policy's features cannot be changed; the insurance company predetermines them. | The policyholder has more freedom to select the necessary type of coverage. In addition, policyholders can tailor the coverage under the policy to their needs because the premiums are based on the chosen features. |
| A mediclaim policy's price remains constant over time. | A health insurance policy's cost can vary since policyholders may receive discounts for not filing any claims or for policies that last extended periods, such as two or three years. |
| The maximum coverage offered, five lakh rupees is another set feature. | There is no upper limit to health insurance coverage, which is based on the policyholder's age, evaluation of their health, and ability to pay the set rate. It may even reach two crores. |
| You can purchase medical insurance coverage on someone else's behalf, such as an employer on behalf of its employees. | In addition to individual personal health insurance coverage, health insurance for parents and dependent family members is an option. |
| According to the insurer, floater coverage under the mediclaim insurance may or may not be permitted. | All insurers permit [family floater health insurance] plans that cover oneself and one's family under a single policy, resulting in more inexpensive coverage. |
Which One, Mediclaim or Health Insurance, Should You Purchase?
Several elements will influence your choice:
- Your economic situation
- Health difficulties that you and your family members are struggling with
- Regardless of whether you favour long-term or short-term planning,
- Whether or, not your health plan needs to be flexible
- Whether you would require add-on covers and benefits
- Are you able to afford a high or low premium
- Considering your age, stage of life, and physiological condition, as well as that of your family
If you know which option will be better for you and your loved ones while keeping all the reasons mentioned above, picking one out of the two is not difficult.
Before Purchasing a Medical Claim or Health Insurance Policy, Bear the Following in Mind:
- Sum Insured – The plan typically has a predetermined sum that cannot be altered before renewal.
- The amount covered, the insured's age, gender, location, and chosen coverage duration are all considered when determining the plan's premium.
- The amount covered, the insured's age, gender, location, and chosen coverage duration are all considered when determining the plan's premium.
- Plan Basis - The plan is available for individual and family floater purchases. The primary beneficiaries of a family floater plan are the self, spouse, and dependents, including children and parents.
- Tax Benefits - Under Section 80D of the IT Act of 1961, the plan provides tax advantages on premium payments.
- Health insurance typically includes a No Claim Bonus at the time of policy renewal following the conclusion of each claim-free year. The renewal premiums may be lowered with the aid of this benefit.
- Co-payment - A co-payment might be required for some plans. Due to the insured paying a set percentage of the treatment costs while the insurance provider covers the remainder, the insurance premium might be reduced.
Conclusion
Mediclaim and health insurance are policies that help during medical emergencies. While the former is restricted to hospitalisation expenses, the latter is more comprehensive and beneficial for the entire family. It is better to have some insurance cover than to have none.
Your needs determine the response. Mediclaim vs. Health Insurance does not have a clear winner.
No, not always. Varying insurance firms may offer mediclaim policies with different inclusions and exclusions. To understand the extent of the coverage, read the policy's fine print.
Yes. In both situations, you are eligible to receive tax benefits under Section 80D of the Income Tax Act.
If you don't mind spending a significant amount annually to safeguard your finances, you should purchase a suitable health insurance policy. A mediclaim health insurance plan is an option if you have a limited budget and don't mind having a basic level of health coverage.
It is best to go with a critical illness rider/policy in such a situation as the same would offer you a high sum insured and better coverage benefits than both these policies.