Is that Health Insurance and Mediclaim are different?

Health insurance and medical plans are must-have options for everyone. The present market is flooded with numerous companies. Each one offers with similar or distinct coverage plan.

As a consumer or a buyer, it becomes essential for you to collect all relevant information in advance. This simple exercise will help you make the right selection. You can also ensure that the right plan will always offer the best coverage for you and your family.

Even if this is the case, still not many people make a wise decision about selecting the right plan type. One possible reason is that they are not aware of the kind of plan that will suit all their needs and requirements.

This factor is essential for individuals who want to be familiar with the benefits of both plans. It is also helpful for people who are not aware of the differences between the two types.

Note:- For individuals purchasing plans, if you are not aware of differences and offers, then both types may never be beneficial. You can never expect to get the best out of your coverage. Several mistakes are committed when purchasing health insurance or Mediclaim plans.

Common Mistakes made

  • In general, people are not aware that these policies are not the same. They can not offer similar benefits and coverage.
  • As per general people, Mediclaim and Health Insurance are similar terms that are synonyms to each other.
  • People feel that they can use both plans as per their benefit, in any case, to claim for coverage. That makes it essential for them to get familiar with the true definition of the two.

In this article, we shall try and cover the real differences between the two types. It will prove helpful in resolving the issue for most individuals. We will explain the areas where Health Insurance and mediclaim are different as compared to each other.

Mediclaim Policies – Definition

Mediclaim is also a policy that is categorized under the Health Insurance scheme. It differs from Health Insurance in numerous aspects. This is a type of coverage that will offer individuals with specialized benefits in terms of financial coverage.

It has been designed to offer you beneficiary with financial protection and, in general, will help cover any expenses that are health-related. This makes Mediclaim user-friendly and affordable.

So the moment you are looking around for financial assistance for health coverage in an emergency, then Mediclaim is the right option. It offers health insurance coverage that can be used by the beneficiary at the time of a medical emergency.

When purchasing Mediclaim, beneficiaries need to get familiar with its limitation factors. Most Mediclaim policies will offer certain types of restrictions and limitations.

These restrictions are imposed on the beneficiary at the time of covering hospitalization expenses. These are also types of costs that have to bet met by the insured person himself.

Features of Mediclaim plans

Mediclaim is assisted by a few essential elements that make it different as compared to other health insurance coverage. Some such salient features have been listed here below:-

  • Coverage Offered – It is evident that this policy offers insurers with health coverage benefits. The coverage benefits include hospitalization coverage and expenses. Apart from this, treatment cost on account of any sudden disease condition or accident is also covered under this policy plan.
  • Assured Sum – The main advantage of Mediclaim is that it is already assisted along with a sum that is pre-decided by the insurer and company. This feature saves a lot of hassle at the time of making claims.
  • Premium offered – The moment you opt for the Mediclaim policy, your premiums are already formulated in advance. The general sum of dividends depends on the insured amount. Besides, the age of the insured person, policy duration, gender, and his or her geographical location will also alter the premium amount.
  • Settlement claims – One significant advantage of opting for Mediclaim is that the entire procedure of processing is done as per reimbursement. The benefit can be requested by the individual in the form of cashless transactions instantly at the time of need.
  • Plan Basis – Mediclaim is one policy that offers buyers with the convenience where they can purchase any plan as a floater policy or for individual coverage. This provides complete coverage to each member of your family under the same idea. This is the best option for people who have dependents, parents, and kids to be covered under the same policy.
  • Tax Benefits<span style=”font-weight: 400;”> – As per the latest regulations imposed by the government, Mediclaim is completely exempted for any taxation. This has been stated under the bylaws of the IT Act under Section 80D formulated in 1961.

Health Insurance Policy – Definition

Health Insurance is slightly different as compared to Mediclaim as it will help in offering coverage against surgical procedures and Medical costs. So if you are undergoing a surgical procedure, or demanding Medical expense for treatments, then Health insurance is the right option.

It is also different as Health insurance demands the insured person to make the payments for all procedures in advance. The expenses offered by the company are paid by the insurer but reimbursed by the insurance company.

At the end of the medical procedure, the health insurance company will make all bill settlements on behalf of the insured person. The bills are directly paid to the hospital account.

When opting for health insurance, each one offers its own set of terms and conditions that are to be met by the beneficiary. It provides buyers with an extensive coverage plan in general.

Health insurance policies are also considered to be more expensive, as premiums are generally much more significant. Unlike Mediclaim, Health insurance policies are to be purchased as individual policies.

Features of Health Insurance

Even if it is more expensive as compared to Mediclaim, still it offers with its salient features.

  • Coverage – In terms of coverage, Health insurance is believed to be a bit comprehensive. It is designed to help offer coverage against critical illness conditions. The coverage offered is still restricted to the age of 30 years or above for the beneficiaries.
  • Health insurance does not cover any critical illness that falls under a primary health plan. It is always considered to offer buyers with additional coverage.
  • Renewable Offers – Buyers purchasing health insurance are offered with a renewable discount benefit at the time of maturity. The buyers can opt for this renewal benefit at the time of claim free year completion period. This is offered to the buyers as no claim Bonus offer.
  • Co-payment factor – There are several health insurance policies that are assisted, along with co-payment benefits. This factor proves helpful as it lowers the premium amounts. Under this benefit, the insurance company is responsible for paying a certain percentage of coverage on behalf of the insurer.
  • Tax Benefit<span style=”font-weight: 400;”> – Just like Mediclaim, Health insurance also offers a buyer with the benefit of Taxation under the 1961 Act Section 80 D.

Comparison Table – Mediclaim and Health Insurance

S.NoFeaturesMediclaim PolicyHealth Insurance Policy
1Coverage OfferedMediclaim will offer coverage to buyers only for covering Hospitalization, pre-mentioned disease condition, and Treatments related to accidents for each of the limits that have been specified earlier.It is efficient in offering coverage that is comprehensive. Will be the best option for covering hospital fee & charges both at pre and post-hospitalization stages including other additional expenses like ambulance etc. The policy will also offer complete coverage at the time of income loss on account of hospitalization or during accident cases.
2Add on factorsIt is not efficient and does not support any Add on policies under its coverage plans.Health insurance can be customized as per requirements, and Add on features are available. It provides full benefit against additional illness (Critical or non-critical), disability case coverage, coverage at the time of maternity treatments, etc.
3Customization and flexibilityMediclaim is not considered to be flexible and thus may not offer customization features.Most policies can easily be customized as per requirements. Plans are more flexible. Premium amounts can be increased or decreased at any time during the policy tenure. The duration of each policy or program can also be managed. Long terms benefits can be added as per personal requirements and conditions.
4Plan detailsIn each case, the nature of the plan can be distinct, varying from one buyer to another. Each company again will offer its own set of insurance plans and benefits for coverage.In most cases, the overall benefit offered by the company will remain the same and may not vary from one service provider to another for the equal sum assured plan.
5Coverage against critical illnessMediclaim is believed not to offer the buyers with any benefit for covering essential conditions of illness.The company offers a coverage for over 30 different types of critical illness to the buyers. It is designed to offer complete insurance coverage in case of cancer, kidney failure, stroke, etc.
6Assured SumAs the policy is determined to provide benefit in the form of the additional plan so the overall coverage in each case may only be below 5 Lakh rupees in value.In general, most companies offer a limitation of 6 crores as the assured sum that is usually given away at the time of maturity. The sum is offered as a yearly amount under the coverage. So it is evident that the coverage provided is extensive for buyers.
7Claims madeA policyholder can make a claim for any settlement against his mediclaim. This can be done till the maximum limitation of the claims to be filed has reached.The company always ensures that the lump sum amount of money will be paid in case the insurer makes a claim at the time of accident, disability or any type of critical illness. The buyer is also allowed to make any such big claims only once during his time of tenure of his policy or lifetime.  In general, an insurer is also allowed to make any claims at any time till he or she is having a fixed sum of money with the policy or till his entire amount has not been withdrawn.
8Hospitalization expensesTo make any type of claims for mediclaim the insurer will only be able to make if he or she has been admitted in the hospital.To get full benefit of the premium sum or coverage it is not important for the insurer to be admitted in hospital. A general claim can also be made by the insurer for his day care services at home.

Note:-  The above mentioned table gives a complete comparison between the health insurance and mediclaim. It will also make the process of selection more simplified for the buyer in the current market.

Expert’s advice

As there are so many different options and plans to select from between the two categories, it leaves people more confusing. Making the right choice some times can be a daunting task.

You just need to keep in mind that no matter what you select, each type offers with tax exemption benefit. It has been regulated and stated by the IT taxation ACT. If you ask experts, they always suggest opting for health insurance in general.

One of the major advantages with health insurance is that the policy and plans are very much comprehensive. It also offers with better coverage for entire family. It is thus more important to make the right selection of reputable company. Select one that offers coverage you and your family needs.

The selection of best mediclaim or health insurance company can never be understood in few words. You have to get to the bottom of the type of plan you need the best.

Insurance coverage or mediclaim benefits are factors that are individuals choice. It should cater all your personal needs. It is also important that policy should suit your requirements.

In the long term, it should offer with benefits that you might have expected for your family or loved ones. This is also one of the reasons why companies are always coming up with new and better plans every time.

Final verdicts

It is important for you to try and get familiar with what exactly your needs are. Look into all possible expectations with the policy that you have. It is important that the plan or policy you selected should in fact cater your needs and be flexible.

In the online world, you can compare different policies and plans and then make your wise decision. In general, both Mediclaim and health insurance are the two most important tools for each and every individual to enjoy a healthy lifestyle, even after retirement.

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