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How Mediclaim Differs from a Health Insurance Policy?

More than 5.8 million individuals in India die every year due to cancer, diabetes, stroke, cardiovascular, lung and liver diseases. More than 1.7 million lives are lost on account of heart diseases. These numbers majorly constitute premature deaths, i.e., prior to 70.

According to statistics, nearly 25% of all individuals in India run the risk of premature death due to a non-communicable disease. There are nearly 2.5 million cancer patients in India currently. Nearly 8 Lakh individuals join the lot each year, out of which, 5.5 Lakh patients die due to inadequate treatment or late diagnosis.

The growing numbers of non-communicable diseases in India have made a health insurance policy a fairly popular financial product. With growing awareness among individuals, health insurance policies in India are set to cover a lot of ground in the future, according to experts.

In any case, individuals find it difficult to differentiate between a mediclaim and a health insurance policy when they seek to apply for insurance coverage.

What is mediclaim?

A mediclaim is primarily used for financial coverage on hospitalisation expenses. It is specifically designed to meet the costs of hospitalisation pertinent to a specific illness or in case of accidents.

What is a health insurance policy?

A health insurance policy is more holistic compared to mediclaim. It financially covers any medical expenses and is not specifically bound to hospitalisation expenses.

What are the distinctive points of mediclaim and health insurance policies?

Apart from their defining feature, there are other elements as well, which vary significantly in these insurance coverage policies.

These are –

1. Coverage offered: In case of mediclaim, coverage is offered on a few specific ailments as is decided during the time of purchase.

For health insurance policies, more comprehensive coverage is offered, which allows financial support on a host of ailments and nearly 30 critical illnesses. The number of critical illness may vary depending on the financial institution.

2. Additional coverage: The insurance agreement cannot be altered to allow for additional coverage in case of mediclaim.

A health insurance policy can be altered to enhance the extension of coverage and allows for additions such as personal accident, maternity, accidental disability, etc.

3. Critical illness coverage: In most cases, mediclaim does not facilitate financial coverage for any critical illness.

On the other hand, Critical Illness Insurance policy provided by reputed financial institutions such as Bajaj Finserv offers comprehensive financial support concerning the treatment of more than 30 critical illnesses.

4. Flexibility: In the case of health insurance policies, you receive the flexibility of lower premium amount after a specified period and opt for longer policy duration.

For mediclaim, the policy is rigid and cannot be changed during the course of policy period.

5. Insured amount:  Mediclaim comes with a fixed limit of coverage beyond which it will not facilitate your hospitalisation expenses. The amount is decided upon at the time of policy purchase. In most cases, the maximum limit is Rs. 5 Lakh.

Health insurance policies, on the other hand, come with a much higher limit, i.e. up to Rs. 50 Lakh offered by the best health insurance plans in India.

6. Claim settlement: Claim settlements in mediclaim are done till such amount you have subscribed to is not exhausted.

On the other hand, claim settlements as per health insurance policies are usually done on a lump-sum basis in case of critical illnesses.

Health plan policies cover a lot of ground in terms of healthcare financial support, whereas mediclaim is for specific needs and purposes. Thereby, consider a health insurance policy if you want comprehensive financial coverage of your medical needs.

There are broadly two types of policies viz. individual and family floater. You can apply for health insurance online by visiting the respective insurance aggregator’s official website.

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