Distinguishing Between Health Insurance and Mediclaim


Planning for healthcare expenses is important, especially for senior citizens who may need more medical care. There are two main categories that you may consider: health insurance and mediclaim.

Understanding the complexities of health coverage can be challenging sometimes. With so many options in the market, for example, senior citizen health insurance, student health insurance, family health insurance, critical illness insurance, etc., you may find it difficult to choose the right plan to cover your medical bills. 

Let us explore the differences between a health insurance plan and a mediclaim policy so that you can make an informed decision while taking coverage.

Both mediclaim policy and health insurance provide coverage for medical expenses. However, they differ in their scope of coverage. 

 What is Health Insurance?  

Health insurance provides more comprehensive coverage. It covers pre-hospitalisation charges, doctor consultations, and outpatient department (OPD) care, along with hospitalisation charges. A basic health policy may cover the following:

  • Hospitalisation bills
  • Doctor visit charges
  • Surgery cost
  • Diagnostic and lab tests
  • Medications

 What is Mediclaim?  

Mediclaim is a type of health policy that provides coverage only against hospitalisation bills arising from accidents or illness. It covers the bills if you need to be admitted to a hospital. Mediclaim generally covers the following when a policyholder is hospitalised:

  • Hospital room charges
  • Doctor’s fees during hospitalisation
  • Nursing care
  • Medicine expenses during hospitalisation
  • Ambulance charges

 Key Differences between Health Insurance and Mediclaim  

Here is a quick comparison of health insurance and mediclaim. However, it is wise to check the policy document to get to know what exactly your policy covers. 

Feature Health Insurance Mediclaim
Coverage More comprehensive coverage Covers hospitalisation bills only
Pre-Hospitalisation Expenses Covered as per policy terms Not covered
Post-Hospitalisation Expenses Covered as per policy terms Not covered
OPD Expenses Covered as per policy terms Not covered
Maternity Coverage Covered as per policy terms Not covered
Pre-existing Health conditions Covered with a waiting period May not cover
Add On Services Covered as per policy terms Not Covered
Ambulance Charges Covered as per policy terms Not Covered
Multiple Claims Covered – until the sum assured limit is not exhausted Only one claim

Choosing the Right Medical Insurance Plans  

Health insurance is the right choice if you are looking for a more comprehensive plan that covers a wide range of medical expenses. It can be helpful for individuals and older adults with pre-existing health conditions.  

Mediclaim is a good option if you are looking for a basic plan that covers only hospitalisation bills. Mediclaim policy can be a good choice for younger, healthy individuals who do not require much coverage and only want to be prepared for any unforeseen events.

Consider the following aspects in addition to the above-mentioned ones, while choosing a health insurance plan and mediclaim.

  • Your Age and Health: If you are older and have pre-existing health conditions, you may choose a health insurance plan with broader coverage.
  • Your Budget: Health insurance plans cost more than mediclaim. Know your budget before buying health coverage for yourself and your family.
  • Your Requirements: Understand what kind of medical care and coverage you require for yourself and your family. Buy your health coverage accordingly.

Both health insurance and mediclaim plans have some exclusions. Read the policy document carefully to understand what is not covered in your plan. You can renew your health insurance or mediclaim policies every year. 

 How to Find The Best Health Insurance and Mediclaim  

There are many health insurance and mediclaim plans available in the market. It is important to compare plans before choosing one that fits your needs and budget. Consider the following before finding the best health coverage.

  • Compare the available online mediclaim policy and health insurance plan from different insurance companies
  • Read the policy details carefully to understand what is covered under it
  • Consider factors like network hospitals, cashless hospitalisation options, and the claim settlement process.

 Conclusion  

Having the right health insurance or medical insurance plan can give you peace of mind, knowing that you are covered in case of a medical emergency. By understanding your options, you can make an informed choice and ensure the best medical coverage for you and your family.

Choose your health insurance or mediclaim now and take charge of your health and well-being.

 FAQs  

 What is the difference between health insurance and mediclaim?  

Health insurance generally provides broader coverage, including hospitalisation, surgery, pre and post-hospitalisation expenses, etc. Mediclaim provides coverage only in case of hospitalisation. 

 Can I buy health insurance or mediclaim for my parents or other family members?  

Yes, you can buy health insurance or mediclaim for your parents or any other members of the family. Many insurance companies offer family floater plans that cover the entire family under a single policy. 



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