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How is a Health Insurance Plan Different from a Mediclaim Policy?

​Health Insurance Policy and Mediclaim Policy sound like synonyms; however, they differ greatly from each other. This article will provide you differences as well as insights about them both.

Health Insurance: It is a comprehensive policy plan that covers pre and posts hospitalisation expenses including cost of medicines.

Expenditure at hospitals: Under this most remarkable feature the insurer provides coverage for both pre- and post-hospitalisations charges at the time of medical emergency over a specific period of time.

Cashless Transactions: All known insurance companies have a few hospitals under their networks. Such hospitals allow the cashless transaction to the insured at the time of hospitalisation. The policyholder just needs to tell the policy number and the insurance agency, as well as the hospital, handle the remaining things.

Transportation charges: This is the add-on feature where the cost of an ambulance is covered by the insurer.  

No claim bonus: Another add-on feature the insurance holder can have for every claimless year. The form of no claim bonus varies with the plans, either they are discount in premium or increment in the assured sum.

Medical check-ups: A few insurance companies also offer medical check-ups benefit along with health insurance.

Tax benefit: Under the 80 D Income Tax Act by the Indian Government, the person paying a premium amount of health insurance is liable for a tax exception.

 

Mediclaim Insurance    

It is limited to expenditure at the hospital, more like the cost of operation and doctor fees along with a few other things. Mediclaim is meant to settle the expenses at the time of medical emergency. The basis of mediclaim premiums is a fixed sum for a specific duration.

Cashless Transaction: Under this provision, the insurer pays a specific sum or sometimes an entire cost of hospitalisation. This benefits only works when the insured get treated in the network of hospitals under insurance company. This feature saves the mediclaim holder from managing a huge amount of cash at the time of medical emergency. The policyholder needs to claim the cost by following certain procedures.

Reimbursement: For this facility, the insured need to intimate by email or telephone to the insurer about hospitalization before or after it happens. To get the reimbursement, the mediclaim holder must provide all the necessary documents like payment and medicine receipts.

 

Things one should consider:

  1. The individual mediclaim provide protection to the individual. The parameters for a family floater plan are different from individual mediclaim. In a case when the individual Mediclaim holder dies or reaches a particular age, the policy expires for his other kin.
  2. Buying a mediclaim at an early age provides the maximum benefits of the policy which mainly includes low premium with better coverage.
  3. The mediclaim provides a coverage to pre-existing disorder and related complications if mentioned at the time of its purchase.  

Understanding the difference between a mediclaim policy and health insurance is important in order to choose the right fit for the future of your family.