Mediclaim vs health insurance: key differences to note

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Typically, the terms ‘health insurance’ and ‘mediclaim policy’ are used interchangeably. However, these two are completely different from one another and tackle different issues.

Indeed, mediclaim and health insurance are means to insure health-related expenses but they differ vastly in terms of their scope of coverage. Health insurance policies are more comprehensive than mediclaim plans but that does not mean it is the best for you. Hence, to know which one is the better option in Mediclaim vs health insurance it is important to weigh their features, especially their scope of coverage and limitation. Once an individual gains an overall insight into these aspects, they can decide which of the two is best suited for them and their needs.

On that note, let’s proceed to know more about Mediclaim vs health insurance and their key traits.

What Is Health Insurance?

A health insurance plan is essentially a financial protection plan that extends financial coverage to account for medical expenses. It requires individuals to pay premium or a regular fee and in turn, the insurer pays for medical costs of the insured based on the agreed terms of health insurance policy.

Typically, a health insurance policy covers for the cost of hospitalisation, post-hospitalisation expenses, daycare procedures, medication charges, ambulance charges, preventive care, and more. Some health insurance plans may also include additional medical services, such as dental care and vision care.

Usually, the best health insurance works in two ways. Either the insured pays for the expenses upfront and then raises a reimbursement claim or the insurer settles the bill directly with the networking hospital through a cashless arrangement. The cashless treatment option is the more popular of the two and can mostly be opted for at network hospitals under the insurance policy. These features help lower the financial burden of an individual’s healthcare expenses and ensure access to much needed medical treatments and services.

What Is Mediclaim?

This type of insurance policy typically covers the cost of hospitalization of the insured. It is widely considered to be a cost-effective means to lower financial burden in case of hospitalization or medical emergency. However, one must note that mediclaim policies do not cover other major medical expenses such as consultation fees, outpatient care, and even prescription drugs.

That said let’s check out the mediclaim vs health insurance differences in brief. 

Major Differences between Health Insurance and Mediclaim

The major differences are listed below –

Cover: Mediclaim covers only hospitalization expenses. On the other hand, health insurance is a comprehensive insurance policy that covers all expenses in the pre and post-hospitalization period and also accounts for the treatment expenses.

Add-on: Mediclaim does not offer necessarily add-on coverage. However, health insurance allows individuals to increase policy coverage of the existing policy. Some of the most crucial add-ons that one can opt for include – critical illness cover, accidental disability, daily hospital cash, accidental cover, and loss of income.This feature helps individuals to customize their health plan as per their requirement and build a desired financial safety net. 

Flexibility of features:  The key features of mediclaim policies are fixed by the insurance provider and there is no scope for customization whatsoever. However, in case of health insurance, the policy buyers have more flexibility and more scope to customize the coverage as per their requirements. Moreover, the health insurance premium is determined on the basis of the chosen features and coverage. 

Coverage limit: Typically, the media claims cover the expenses that the insured incurred in a year. However, there is usually no upper limit on the coverage and the same depends on the policyholder’s age, health condition, and premium payment capacity.   

Cost of coverage: In case of a medical plan, the premium for coverage typically does not change over the years. However, in a can of health insurance, the cost of the plan can change if the insured does not raise any claim on policies with longer duration, they can receive discounts.

Mediclaim vs health insurance – which one is best for you? 

Both options help individuals prepare better for medical emergencies and seek timely treatment. However, which option is better for an individual depends entirely on their needs, financial standing, and health requirements. 

Typically, individuals are more likely to pick a plan that offers high coverage at affordable premiums and flexible terms. 

However, individuals must weigh in each feature of mediclaim policy and health insurance plans to determine which one is better. Additionally, they should also check the insurance provider’s claim settlement history and network hospitals to understand which plan would help them gain access to quality healthcare and timely financial aid. 

To make a better pick, it is advisable to analyze which of the two options are more suited for a given circumstance and can be useful for the policyholder. 

Take for instance, a young and healthy individual who wishes to have a safety net for meeting an unexpected hospitalization cost. In such a situation opting for a mediclaim policy would be more suited for many. 

However, individuals with a long history of critical illness or reckless lifestyle could be better off having a health insurance plan. Such an insurance plan serves as a financial safety net for the future and protects family members from impending financial burden. Individuals also have the option to avail desired add ons to their existing health insurance plan and customize coverage as per requirements. 

However, it is recommended to avail a health insurance plan only after thorough comparison and analysis. To begin with, individuals should compare the premium and features of leading health insurance policies to make the most of such a plan. Additionally, they should find out the claim settlement ratio of the insurance provider and pick one with a percentage of over 80% to ensure your claim has a higher possibility of getting approved. 

Notably, the difference between mediclaim policy and a health insurance plan is thin. However, what sets them apart is their suitability for different individuals and their circumstances. Hence, based on one’s need and requirement individuals can avail a mediclaim Or a health insurance plan and customize their future safety measures accordingly. 

  • Post published:October 5, 2023
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  • Post category:Health

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