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Mediclaim vs Health Insurance

Updated on November 15, 2019 , 736 views

Mediclaim vs health insurance? People new to insurance are often confused between mediclaim policy and health insurance policy. Basically, health insurance and mediclaim insurance are both medical insurance plans that provide protection during healthcare emergencies. However, they sharply differ in their coverage and claims. It is important to know the best health insurance plans and best mediclaim policies offered by different health insurance companies in India. But before that, one should know both these health insurance policies in detail. For your understanding, we have given a brief description of both. Have a look!

Mediclaim-vs-health-insurance

Health Insurance

health insurance plan is a type of insurance coverage that compensates you for various medical and surgical expenses incurred. It is a coverage provided by the Insurance companies to protect you from unforeseen medical expenses that might occur in the future. Health insurance companies also offer family plans and family floater plans to provide protection for the entire family. With the rising healthcare costs, the need for health insurance plans is increasing as well. The health insurance claim can be settled in two ways. It is either reimbursed to the insurer or is paid to the care provider directly. The benefits received on health insurance premiums are tax-free.

Mediclaim Policy

Mediclaim policy (also known as medical insurance) is a medical policy that provides coverage for treatment and hospitalisation during a medical emergency. Mediclaim insurance also provides coverage for the pre-hospitalisation expenses incurred few days before hospitalisation and post-hospitalisation expenses. This policy is offered by both Life Insurance and health insurance companies in India. It is important to buy an individual mediclaim policy or mediclaim policy for family (depending on your personal needs) to ensure protection during medical emergencies.

Difference Between Mediclaim & Health Insurance

Parameters Mediclaim Health Insurance
Hospitalisation Covers only Hospitalisation Cover Hospitalisation and other medical expenses
Coverage Limited Hospitalisation Wider coverage
Tax Benefits Max tax deduction up to 25k under section 80D. Extra tax deduction of 25k on premium towards parents. Parents being senior citizens, taxation limits increases from 25k to 30k Tax deduction of 25k under Section 80D

Though both these health insurance plans provide coverage for medical expenses but are slightly different in some aspects. Let’s have a look at those aspects. Some of them are as follows-

Hospitalisation of Mediclaim Vs Health Insurance

Mediclaim insurance policy provides coverage for hospitalisation expenses only and that too for certain specific illness upto the sum assured amount. Although, a health insurance policy provides a deeper and broader coverage. This policy not only covers the hospitalisation expenses but covers the pre and post hospitalisation expenses as well. Some of the health insurance plans offered by the general insurance companies in India cover as many as 30 diseases. Moreover, apart from this, the insurer also gets a cover for ambulance charges. If someone holds a health insurance policy, it is not even essential to get hospitalised to file a claim. For example, a policyholder of Critical illness policy can claim the sum assured amount as soon as he/she is diagnosed with any serious illness without even being hospitalised.

Coverage of these Health Insurance Policies

The covers on a mediclaim policy are limited. On the other hand, for a health insurance plan, the covers provided are wider than a mediclaim insurance.

Payment Mode of Mediclaim & Health Insurance Plan

Under a mediclaim insurance, the insured gets reimbursed for the amount he had to pay at the hospital. The policyholder has to submit the hospital bills to get the spent money back. Of course, there is a cashless mediclaim option available too. However, the clauses for health insurance are a bit different. For some health plans, like the critical illness health insurance or accident coverage plan, the insured is paid a lumpsum sum assured amount and not the amount he spent.

Limit of Claims of Both Medical Plans

With a mediclaim policy, one can make claims on every hospitalisation until the sum assured limit of the policy is exhausted. While if someone has a health insurance policy they can also avail reimbursement of the entire sum assured as a lumpsum amount during the tenure of the plan.

Tax Benefits of Mediclaim Insurance & Health Plan

The mediclaim premium paid under the mediclaim insurance policy for spouse, self and children are eligible for maximum tax deductions of INR 25,000 as per the section 80D of the Income Tax Act. Additionally, one can enjoy a further tax benefit of INR 25,000 on premium paid towards your parents. Furthermore, if your parents are senior citizens, the tax benefits are increased to INR 30,000. Moving forward to health insurance, the health insurance plans are also liable for tax exemption under section 80D.

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Conclusion

Nowadays, many general and life insurance companies offering mediclaim are expanding their coverage beyond hospitalisation. So, considering this there is hardly any difference between health insurance and mediclaim. Even some health insurance plans are named mediclaim nowadays. Therefore, it is important to know our needs well and then decide which policy to buy. Buy smart, buy better!

Disclaimer:
All efforts have been made to ensure the information provided here is accurate. However, no guarantees are made regarding correctness of data. Please verify with scheme information document before making any investment.
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Himanshu Singh, posted on 5 Aug 19 4:33 PM

This is very helpful for insurance knowledge.

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