Health insurance and mediclaim are two types of insurance policies that are commonly confused. While both types of insurance provide coverage for medical expenses, there are some key differences that are important to understand.
First, let’s define each term:
A health insurance policy is a broad-based insurance policy that covers a wide range of medical expenses, including hospitalisation, surgeries, doctor’s visits, and prescription medication. It also typically includes coverage for preventive care, such as annual check-ups and vaccinations.
A mediclaim policy is a more specific type of insurance policy that provides coverage only for hospitalisation and related medical expenses. It does not typically cover other medical expenses, such as doctor’s visits and prescription medication.
Now, let’s look at some of the key differences between health insurance and a mediclaim policy:
1. Coverage
One of the main differences between health insurance and a mediclaim policy is the scope of coverage. Health insurance policies typically offer a broader range of coverage, including pre and post-hospitalisation expenses, preventative care, outpatient services, and chronic care management, while mediclaim policies are more limited in scope and are typically more focused on hospitalisation and related expenses. Thus, with a health insurance policy, you will have more protection against medical expenses than if you have a mediclaim policy.
2. Sum Insured
A sum insured clause means that the sum insured amount is agreed upon by both parties before starting the policy. This amount may be higher or lower depending on your needs.
While the sum insured cannot exceed Rs. 5 lakhs for a mediclaim policy, it can be much higher for a health insurance policy.
3. Add-ons
Health insurance providers have many add-ons such as dental care, vision care, maternity benefits, daycare procedures, etc., but mediclaim does not offer any add-ons to its policyholders.
4. Flexibility
A flexible clause allows you to change your policy coverage after a certain period of time if you feel it is not sufficient for your needs. While a mediclaim policy allows no flexibility, a health insurance policy has the option to modify the coverage and premium after a specified period of time.
5. Claims
Another key difference is the way that claims are handled. Health insurance policies often have a network of providers that the insured can use to receive medical services. For critical illnesses or disabilities arising due to accidents, the claim can be filed once with the sum insured paid as a lump sum. With a mediclaim policy, the insured is typically responsible for paying the medical expenses upfront and then seeking reimbursement from the insurer. The claims can be made multiple times till the assured amount gets exhausted.
In summary, while both health insurance and mediclaim policies provide financial protection against medical expenses, health insurance policies offer a wider range of coverage and more flexibility, while mediclaim policies are more focused on hospitalisation and may have lower premiums. There are a number of plans available now for you to choose from. It is important to understand your requirements and pick a policy best suited for you. Click here to have a look at the various policies offered by Chola MS to protect your health.
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