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Mediclaim & health insurance terms decoded with the right differences you should know about

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Published on April 16, 2021. EST READ TIME: 3 minutes

Keeping your health in check through your lifestyle is one of the best ways to improve longevity. However, even the healthiest of us succumb to the perils of illness, be it in the form of a critical disease, an inherited autoimmune ailment, or simply an aging body. To ensure your finances are secure during a time where exorbitant healthcare expenses can force you to crack open your emergency piggy bank, insurers offer health and mediclaim insurance.Both these options help you seek out health-related claims from your insurer, and if accepted, prevent you from having to pay the cost of treating your illness.

If you’re seeking either of these options but don’t know which is right for you, you’re in the right place. Both plans are advantageous and disadvantageous in their own way. Wondering what terms like ‘claim’ and ‘copayment’ signify? Are you also curious about the key differences between health insurance and mediclaim insurance? Keep reading to find out what these are.

Mediclaim insurance: A type of insurance offering specified financial protection against health-related expenses, and a pocket-friendly way to mitigate health expenses. However, coverage is limited to hospitalization and expenses are to be paid for by the insured themselves.

Health Insurance: Usually offers more extensive medical coverage than mediclaim insurance. Due to its extensive cover, health insurance is also typically more expensive than mediclaim insurance.

Mediclaim Insurance vs Health Insurance

Here are some of the essential differences between mediclaim insurance and health insurance.

● Coverage Offered: Mediclaim insurance provides coverage solely for accident-related treatment, hospitalization, and pre-decided diseases for a limit that has been pre-specified. Alternatively, health insurance offers comprehensive coverage both pre and post-hospitalization charges and ambulance charges as well. In case of the loss of one’s income, compensation will be provided.

● Add-on Coverage: Mediclaim policies tend not to offer any add-on coverage options. To enhance one’s coverage, health insurance tends to offer maternity coverage, personal accident disability coverage, critical illness coverage, and more.

● Flexibility: When it comes to making changes in one’s coverage options, mediclaim policies tend not to offer any coverage. Alternatively, health insurance plans offer people much-needed flexibility. Premium costs can be reduced after a certain duration, and one’s policy duration can also be altered.

● Claim Procedure: In a mediclaim policy, the insured has the option to file claims until the total amount assured is exhausted. Alternatively, in health insurance, when claims related to accidental disability coverage or critical illness arise, the Sum Assured is paid out as a lump sum.

● Hospitalisation: So that one can avail of mediclaim benefits, it's necessary for the insured to get hospitalized. To avail of health insurance, the insured need not get hospitalized. One can avail of benefits such as daycare cover without getting hospitalized.

● Copayment Option: Mediclaim policies do not offer a co-payment option. Health insurance tends to offer copayment. This is where one can decrease their insurance premium since a certain percentage of one’s treatment is paid for by one’s insurance company itself.

Which is better: Mediclaim Insurance vs Health Insurance

So which is better – Mediclaim insurance or health insurance? The answer requires acknowledging your context. Both policies offer individuals differing amounts of coverage, flexibility, and claim procedures. Assess your needs and consider which policy fulfills them best. This means there is no superior policy, and the answer really depends on your individual case.

Conclusion

There is no one insurance plan for all. What’s essential is to compare policies across insurers so that you can figure out which plan is ideal for you. Before opting for a plan, ensure you chart out what your insurance expectations are. These expectations could be the amount of coverage you receive, how flexible your coverage is, the duration of your policy, how your plan works, and more.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.