It is not uncommon to find people who think that typical health insurance is the same as Mediclaim. However, this cannot be farther from the truth, as both medical insurance policies differ. This post states the differences between the two policies while highlighting the types and features of Mediclaim insurance. But first, we begin by letting you know what Mediclaim is about.
Mediclaim – What it is and how it works
Mediclaim is a type of Medical Insurance policy that caters for your healthcare needs by reimbursing you after you have made out-of-pocket medical payments. These payments can be for emergencies, general surgeries and treatment for critical illness medical conditions.
Mediclaim functions in a similar way as medical insurance in the sense that it provides health coverage, such as;
- hospitalisation costs for accident emergencies,
- general surgeries, and
- critical Illness treatment within the policy tenure.
Like other forms of insurance, you also need to make premium payments to keep this policy alive and enjoy the benefits that the insurance plan provides. With Mediclaim, you also have two settlement options. The first is a cashless option, while the second is a reimbursement option (more on these later).
Health insurance vs Mediclaim
While these two medical insurance plans seem similar at face value, they do have some distinct differences as follows;
- Add-ons: Health insurance policy offers policyholders the opportunity of benefitting from add-ons, such as; COVID care and maternity coverage. However, Mediclaim does not offer add-ons. The coverage under a Mediclaim policy is specified to policyholders from the start. Nevertheless, Mediclaim is quick in providing reimbursement, and the plan does offer specialised benefits such as room rent adjustments.
- Flexibility: Health insurance is more flexible than Mediclaim, as the former allows you to customise your coverage per your peculiar health challenge. However, this is not the case with Mediclaim, but that does not mean that Mediclaim is not a beneficial medical insurance plan in its own right.
Types of mediclaim insurance policies
There are five types of Mediclaim Insurance policies, and these are:
- Individual Mediclaim: This policy covers the medical expenses incurred by a single individual. These expenses include accidents, general surgeries and critical illness.
- Family Floater Mediclaim: This Mediclaim policy provides coverage for the policyholder and other members of their family, including a spouse, children and parents.
- Senior Citizen Mediclaim: For anyone aged 60 years and over, a Senior citizen Mediclaim is helpful as it covers the cost of treatment of age-related ailments. This plan can be purchased for your elderly biological parents or even in-laws.
- Critical Illness Mediclaim: You can purchase a Mediclaim plan that is specific for providing coverage for critical illnesses, such as; cardiovascular diseases, cancer, liver disease, kidney failure, and so on.
- Personal Accident Mediclaim: Accidents can occur with or without warning. But with a personal accident Mediclaim plan, you will be protected from out-of-pocket expenses if you are rushed to the hospital in an emergency, for example. This policy also covers partial and full disability and accidental death.
Key features in a mediclaim insurance policy
There are key features that you should be aware of when purchasing a Mediclaim policy, and these include;
- Settlement Options: There are two settlement options available when purchasing a Mediclaim policy. The first is a reimbursement settlement option. That is where you incur out-of-pocket medical expenses and then make reimbursement claims with your insurer after your treatment. However, the cashless settlement option is quite different. In this scenario, you can receive treatment for the medical conditions covered under your policy without spending a rupee. Your insurer settles your Medicare provider after your treatment.
- Tax Benefits: According to the Income Tax Act (Mediclaim – 80D section), you are entitled to tax benefits. You can claim tax deductions to 25,000 INR on your income tax amount for regular premium payments to keep your Mediclaim policy active. However, in the case of senior citizens, this tax deduction amounts to about 50,000 INR.
- Mediclaim offers different policy options: As mentioned already, you can purchase an individual Mediclaim policy, or you can get it for your family, elderly parents or specific to your critical illness medical needs.
- Protection from bankruptcy: Huge medical bills can tap into your life savings and render you bankrupt. But with a Mediclaim plan, you can get reimbursed for out-of-pocket medical expenses or use the cashless settlement option to get medical treatment without spending your personal funds in the process.
In conclusion
As you can see, Mediclaim and health insurance are two different medical insurance policies. But the importance of providing quality healthcare and financial protection cannot be overemphasised. It is also worth noting that Mediclaim offers useful inclusions like daycare treatment, in-patient hospitalisation, domiciliary hospitalisation, pre and post-hospitalization cover, annual medical check-up cover, and no claim bonus.
