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Understanding the difference between mediclaim and health insurance

Unfortunate instances of medical emergencies don’t come with a warning but when they do come, it surely does burn a hole in your pocket. We all know that medical emergencies are inevitable in one’s life. Be it an accident, a sudden illness, or surgery, it’s better to be prepared to face these unannounced events. There are many ways in which you can avail the best benefits of a medical cover. The most popular ones are through a mediclaim and through a health insurance policy. Although both of them sound the same, there’s a thin line of difference among the two when it comes to availing medical benefits from these two sources. Let’s take a look at what both of them exactly.

Benefits and features of each of these and understand how they differ from one another -

A mediclaim is a policy that lets you avail specific financial protection during cases of emergencies. It includes hospitalisation expenses during road accidents and sudden illnesses or surgery. It also includes surgery during the policy tenure. A health insurance policy, on the other hand, gives you a comprehensive cover that includes more than just hospitalisation expenses. For instance, it also covers things like alternative treatments, annual health checkups, Out Patient Department expenses, daily hospital cash, etc. As you can see, a health insurance plan is much more extensive than a mediclaim policy. One can even call mediclaim policy a budget-friendly way to deal with health-related emergencies.

Another important difference between the two is that a health insurance policy covers more than twenty critical illnesses whereas a mediclaim policy does cover any of the critical illnesses. It only covers accident-related injuries in general.

When it comes to coverage, a health insurance policy covers your pre and post-surgery expenses as well, which is not the case with mediclaim policies. Even with regards to adding on covers, a health insurance policy is one step ahead of mediclaim insurance. The former lets you enjoy numerous add ons like critical illness cover, maternity benefits, infertility cover, accidental disability coverage, etc while there is no add on covers in a mediclaim policy. This brings us to the next difference, which is flexibility. A health insurance policy is much more flexible when compared to a mediclaim policy. One can even enjoy customizations in health insurance. As a health insurance policyholder, you can reduce the premium amount after a certain time period or even change the duration of your insurance policy.

In a mediclaim policy, the sum assured doesn’t exceed Rs 5 lakhs whereas, in a health insurance policy, the sum assured is not more than Rs 6 crores. This clearly means that the coverage given by insurance is much more extensive than that of a mediclaim policy. A mediclaim policyholder is entitled to file claims as and when needed and exhaust the total amount assured. However, a health insurance policyholder will be paid the claim in a lump sum.

This brief comparison of a health insurance policy and a mediclaim policy must have given you an idea about which kind of policy would be suitable for you and your lifestyle. No matter which one you choose, it’s always advisable to go through every clause and ensure that you make the best use of these medical claims. Remember, no amount of preparation is gonna help you bear the brunt of unannounced medical visits to the hospitals. Hence make an informed decision and pick what works the best for you.

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