By Veronika A common misconception about health insurance is that it is used with mediclaim interchangeably. While it may ring a bell about your peers synonymously using these terms, they aren’t the same. There is a thin line of difference in its meanings. This article elaborates on the differences between a mediclaim plan and a health insurance policy.
What is a mediclaim policy?
Mediclaim policies are health covers that provide coverage during medical emergencies, like domiciliary care, and even take care of hospitalisation expenses which can be due to an illness, surgery or an accident. Cashless and reimbursement are two kinds of claim facilities available under mediclaim facility.
What is a health insurance policy?
Health insurance plans are comprehensive medical insurance policies that cover the features of mediclaim insurance too. These plans cover the expenses beyond hospitalisation and include other costs like ambulance cost, pre and post-treatment expenses, daycare treatments, OPD charges and much more. Health insurance plans too, offer cashless facility at a network hospital.
Let us look at the points of differentiation between mediclaim and health insurance.
Coverage: The coverage for medical policies are limited to domiciliary care, and hospitalisation in the event of accident, illness or surgery. On the contrary, whether you invest in individual covers or health insurance plans for family, they cover a host of features like ambulance services, diagnostic tests, daycare treatments, OPD expenses, AYUSH treatments and many more.
Add-on riders: Mediclaim policies do not offer the facility to increase coverage using additional riders. But health insurance policies can be easily customised to include additional coverage with various add-ons like a maternity cover, personal accident cover, etc.
Sum insured: The maximum amount of sum insured for mediclaim policies are restricted to five lakhs. For health insurance plans, this amount can go as high as six crores and is based on various factors of the policyholder.
Claims: Using the mediclaim facility, you can file insurance claims till the sum insured is completely exhausted. Some health covers like critical illness insurance pay the entire sum assured on diagnosis of the ailment. However, you can still make the claim till you utilise the sum insured of your policy.
Flexibility: Mediclaim policies are beneficial when it comes to making claims for hospitalisation. However, these policies are not customisable exactly to fit your needs, and thus not entirely flexible. But when it comes to health insurance plans, they give you, the policyholder, to add/modify the coverage of your policy exactly how you need it. Thus, having more options for customisation.
How do health insurance covers rank above mediclaim plans?
Health insurance plans offer complete 360-degree coverage for illness as well as ancillary costs involved. This includes seeking alternate forms of treatment like Ayurveda, Homoeopathy, Unani, etc. Having coverage for these alternate forms of treatment helps engulf a larger number of individuals. Moreover, these health covers can be fine-tuned to suit your requirements. That benefits almost everyone who can add/remove the covers to make the policy just the right fit for their healthcare needs.
To sum it up, a mediclaim policy is limited in its scope to hospital dues whereas a health insurance policy offers far more features than it. Now that you know the difference between both the terms, make a prudent choice of selecting a health insurance policy that has other benefits but not limited to medical treatment.
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