WHAT IS THE DIFFERENCE IN MEDICLAIM AND HEALTH INSURANCE

Health is our priority whether you secure it by using health insurance or consider any mediclaim. Usually, people secure their health with insurance benefits, and buying a mediclaim policy means protecting your health against healthcare expenses or health emergencies. Mediclaim vs Health Insurance policies are both financially secured instruments designed to cover medical expenses incurred due to illness or injury. However, they differ in their scope and coverage.

 

 

According to the recent Healthcare Sectors stats; “The Healthcare Insurance field is growing fast because more people are getting medical care, the services are improving, and both the government and private companies are spending more money on it. In the budget for 2023-24, the Ministry of Health and Family Welfare got INR 89,155 crore, which is 3.43% more than what they got in the previous year, which was INR 86,200.65 crore.”

 What is Mediclaim Policy?

Mediclaim is a type of health insurance policy specifically planned to cover all hospitalization expenses in specific hospitalization along with medical benefits. It typically reimburses the insured costs of hospitalization, surgery, and medical procedures up to a predetermined limit you have claimed. Mediclaim policies are usually more focused and offer coverage for specific medical concerns.

 

 What is Health Insurance?

On the other hand, Health insurance is a broader term encompassing numerous insurance policies to provide financial protection against medical expenses. Health insurance policy plans cover every family member with a wider range of medical services beyond hospitalization, such as outpatient care, prescription drugs, preventive care, and sometimes even dental and vision care depending on selection of your health insurance coverage considering your health concern.

Understanding the differences between mediclaim vs health insurance policy can help you and the individuals make informed decisions when choosing the right insurance plan for yourself and family members.

 

How to Choose a Medical Insurance Plan?

 Assess Your Healthcare Needs

Estimate your medical history, current health status, and any anticipated medical claim policy needs. While choosing medical coverage make sure you have to consider factors like age, pre-existing conditions, family medical history, and lifestyle habits.

 Understand Plan Options

Research and compare different types of health insurance plans available, such as individual plans, family floater plans, employer-sponsored plans, or government schemes. Ensure the coverage, benefits, limitations, and exclusions of each plan.

 Decide Coverage Scope

Determine the level of coverage you need, considering factors like Pre-post hospitalization, and coverage for existing and pre-existing conditions.

 Review Network Providers

Check the network of hospitals, clinics, and healthcare providers included in your health plan. Ensure that your preferred healthcare facilities and specialists are within nearby areas and networks to maximize coverage and minimize out-of-pocket expenses.

 Compare Premiums and Costs

Always compare the premiums, deductibles, co-payments, and co-insurance of different health insurance plans. Balance the cost of the premium with the level of coverage provided to find the best health plans and quotes that offer the best value for money.

 Check Policy Limits and Exclusions

Review the policy limits, waiting periods, and exclusions carefully to understand what is covered and what is not. Pay attention to coverage caps, restrictions on certain treatments or procedures, and any pre-existing condition clauses.

 Consider Additional Benefits

Look for additional benefits and features offered by the plan, such as wellness programs, telemedicine services, preventive care coverage, health check-ups, and emergency assistance services.

 Read Customer Reviews and Ratings

The most important thing is the reputation of a service provider, customer service quality, their claim settlement process, and overall satisfaction ratings. Always read their customer's reviews and feedback from existing policyholders to gauge their experiences with the insurer and the plan.

 Seek Expert Advice

Consider consulting with an insurance advisor or healthcare professional to help you understand your coverage options and make an informed decision based on your unique needs and circumstances.

 Review Policy Terms and Conditions

Check things before finalizing health insurance plan like review policy documents, terms, and conditions.

 

Also Read: KNOW ABOUT GROUP MEDICLAIM POLICY AND GROUP PERSONAL ACCIDENT INSURANCE

 

Difference Between Mediclaim and Health Insurance?

Features	Mediclaim	Health Insurance
Scope	Mediclaim has a limited scope, it covers the expenses related to hospitalization and associated medical procedures.	Health insurance has a broad coverage that encompasses a wide range of medical services beyond hospitalization, it includes doctor visits, diagnostic tests, preventive care, and more.
Coverage	It covers hospitalization expenses, surgeries, and medical procedures during the insured's stay in the hospital.	It covers various medical expenses, including Pre-post hospitalization, outpatient care, prescription drugs, preventive care, maternity care, and sometimes dental and vision care.
Reimbursement	Mediclaim provides reimbursement for hospitalization expenses met with the insured, up to a predefined limit specified in the policy.	Offers reimbursement for a wide range of medical expenses, depending on the coverage provided by the policy.
Customization	Offers limited options for customization, typically with predefined coverage limits and benefits.	Health insurance provides more flexibility for the customization of coverage, allowing individuals to choose coverage options and add-ons based on their specific healthcare needs and budget.
Long-Term Care	Generally, mediclaim does not include coverage for long-term healthcare needs or chronic conditions beyond the hospitalization period.	Health insurance often includes coverage for chronic conditions, ongoing medical treatments, and long-term healthcare needs, providing comprehensive protection over an extended period.
Flexibility	It has flexible coverage options that are event-based, and triggered by specific medical events requiring hospitalization.	Health insurance offers flexible coverage for various medical needs, including preventive care, routine check-ups, and ongoing treatments, providing continuous protection ad support against healthcare expenses.

 

Conclusion

Before you claim for medical expenses or buy health insurance for your family members connect with us to clarify any doubts or questions with the insurer to ensure you have a clear understanding of the coverage and obligations under the policy. Make sure you have compared the plans and claim facilities with the Best Insurance Quotes.

Ensure your all coverage needs with us, our health insurance quotes help you provide essential coverage based on your needs, while our mediclaim policy quotes focus on hospitalization expenses, compare your health insurance that offers comprehensive coverage for a broader range of medical services, and provides benefits for individuals with greater financial protection and flexibility in managing your healthcare needs.

 

 FAQs on Mediclaim and Health Insurance

 

Can I have both health insurance and Mediclaim at the same time?

Yes, you can have both health insurance and Mediclaim policies at the same time. Having both can offer broader coverage as Mediclaim policy can cover your hospitalization expenses, whereas Health Insurance can cover your post hospitalization or day-care treatment expenses.

Which is better for critical illness coverage: Health insurance or Mediclaim?

For critical illness Health Insurance is considered to be better option than Mediclaim as they are designed to cover life-threatening diseases like cancer, attack, kidney failure and offer lump-sum benefit.  

Does Mediclaim cover day-care procedures?

Traditional mediclaim policies generally do not cover expenses for day-care procedure, but some modern mediclaim have started including limited coverage for day-care procedures.

Is Mediclaim sufficient for families with aging parents?

Mediclaim may not be sufficient for families with aging parents as it comes with limited coverage and does not provide coverage to critical illness. Medi Claim also lack of coverage to outpatient and day care.  

Can I convert my Mediclaim into a health insurance policy?

Generally, you cannot upgrade Medi Claim to Health insurance but you can opt for portability options where you can convert one policy to other with extra benefits.