What is the Difference Between Mediclaim and Health Insurance?
🆚 Go to Comparative Table 🆚The main difference between Mediclaim and Health Insurance lies in the scope of coverage and the types of expenses they cover. Here are the key differences between the two:
- Coverage: Mediclaim policies strictly cover the cost of hospitalization, including treatment for specified illnesses up to a particular limit. In contrast, Health Insurance policies provide more comprehensive coverage, including pre- and post-hospitalization expenses, daycare procedures, outpatient department (OPD) expenses, and sometimes additional benefits like daily hospital cash.
- Add-on Covers: Health Insurance policies typically offer a variety of add-on covers, such as critical illness, maternity benefits, and infertility covers. Mediclaim policies do not offer additional covers or add-ons.
- Cashless Facility: Mediclaim insurance plans provide cashless facility (direct reimbursement to the healthcare provider) only at network hospitals. In non-network hospitals, you have to pay and the insurer will reimburse later. Health Insurance policies may offer more extensive cashless facilities.
- Claims Process: Mediclaim insurance claims are usually processed based on diagnostic reports, written consultation with doctors, discharge cards, treatment bills, medicine bills, and other documents. Claims under fixed benefit Health Insurance plans are usually processed based on diagnostic reports, with less hassle of submitting bills and other documents.
- Cost and Benefits: Since Mediclaim coverage is restricted, the cost of the insurance policy is also lower than a Health Insurance policy. The coverage under Mediclaim is usually restricted to a specific limit, such as Rs. 5 lakhs. Health Insurance policies offer more comprehensive coverage, leading to higher premium costs and potentially higher sum assured.
In summary, Mediclaim policies are more focused on hospitalization expenses, while Health Insurance policies provide broader coverage, including pre- and post-hospitalization expenses and various additional benefits. The choice between the two depends on individual needs and budget.
On this pageWhat is the Difference Between Mediclaim and Health Insurance? Comparative Table: Mediclaim vs Health Insurance
Comparative Table: Mediclaim vs Health Insurance
Here is a table comparing the differences between Mediclaim and Health Insurance:
| Feature | Mediclaim | Health Insurance |
|---|---|---|
| Definition | Mediclaim is a type of insurance plan that offers specified financial protection against health-related expenses, limited to hospitalization and other medical expenses. | Health insurance covers the cost of medical and surgical expenses incurred by the insured, with coverage that is more extensive than hospitalization expenses and is usually more expensive than a mediclaim policy. |
| Coverage | Covers hospitalization costs and other medical expenses. | Covers medical and surgical expenses, including pre- and post-hospitalization expenses, daycare treatments, and sometimes even alternative treatments. |
| Cost | Generally less expensive than health insurance. | More expensive than mediclaim, but offers broader coverage. |
| Tax Benefits | Tax benefits are available under Section 80D of the Income Tax Act. | Tax benefits are available under Section 80D of the Income Tax Act. |
| Additional Features | None | Can offer additional features, such as lowering payable premium by contributing towards the claim amount, availing tax benefits, and access to network hospitals for cashless treatment. |
Please note that individual insurance policies may have specific differences, and it is essential to read the policy wordings carefully before making a decision.
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