Mediclaim vs. Health Insurance - A comparison

Mediclaim vs. Health Insurance- A comparison

Mediclaim and health insurance policies have been used interchangeably for a long time. Though both of these are concerned with hospitalisation and medical expenses, they are two very different protection plans. How? We explain -

Mediclaim is a policy that covers medical expenseswhen hospitalised and in certain cases when at home due to an accident or illness. Mediclaim can be of cashless or the reimbursement type. While you can avail cashless mediclaim at select hospitals that come under the purview of the policy, the company reimburses the expenses incurred on submitting the medical bills in the reimbursement type.

Compared to this, health insurance covers other allied expenses in addition to the hospitalisation costs. These may include ambulance charges, pre and post-hospitalisation care, doctor fees, among others. As in mediclaim health insurance, too, has cashless and reimbursement options.

Difference between mediclaim and health insurance​

Mediclaim and Health insurance are different in many aspects. We cover the basics and give you a brief overview of mediclaim policy vs health insurance below-

Pre and post-hospitalisation

A mediclaim policy strictly covers hospitalisation costs up to a certain limit and for a specific time and home care in select cases. The claim limit is set at a percentage of the total hospitalisation expenses. On the other hand, health insurance includes pre and post hospitalisation care, diagnostic tests, and doctor fee, among others.

Ambulance charges

Maternity benefits

A health insurance plan has built-in provision for costs incurred before, during and after giving birth for mothers- be it a caesarean, or any medical treatment for the newborn. However, mediclaim covers only the hospitalisation costs and does not include other additional expenses.

Daycare benefits​

A Mediclaim is typically limited to hospitalisation and certain illnesses. However, daycare procedures like cataract surgery do not usually require prior hospitalisation. In this case, your mediclaim does not cover these costs. However, the expenses incurred due to such medical procedures are covered by your standard healthcare insurance.

Cost and benefits

As the scope of health insurance plans is broader than that of a mediclaim, health insurance tends to be more expensive. However, it more than makes up for all the premiums that you pay when you fall ill.

So, which is better mediclaim or health insurance?

As explained above, the scope of mediclaim is limited as compared to health insurance. In the case of health insurance, you do not have to worry about spending out of your pocket. The same does not stand true for mediclaim. However, mediclaim is a compact package with benefits proportionate to what you pay for the plan.

Deciding which is better boils down to your requirements. In case you have just started earning and cannot spend much, it is advisable to go for a mediclaim. However, if you can afford the premiums, a health insurance plan makes more sense. If you can afford it, consider buying both mediclaim, as well as health insurance. A health insurance plan can complement your mediclaim policy. However, you need to know that both cannot be availed at the same time. Also, check the terms and conditions of both plans beforehand, to avoid clashes and claim rejection in the future. 

Mediclaim vs health insurance