Mediclaim Vs Health Insurance


Mediclaim & Health Insurance are the two terms which are habitually used interchangeably. However,the two are different from each other in Mediclaim Vs Health Insurancetheir own ways. The major difference is that mediclaim limits itself in particular to the hospitalization expenses. However, health insurance is far more comprehensive. It provides you a cover which extends beyond hospitalization expenses.

In this article you will discover more such differences between Mediclaim & Health Insurance. These differences will prove to be very helpful for you to evaluate the benefits of each accurately. Now let’s have a look at some more differences : Mediclaim Vs Health Insurance


Health Insurance

Mediclaim adheres particularly to hospitalization. In simple terms, it covers or includes only hospital linked expenses. Health insurance is far more comprehensive. It definitely covers hospitalization expenses. However, it also includes pre as well as post hospitalization charges, ambulance costs, compensation for lost income & much more.
If you want to file a mediclaim then hospitalization is necessary. If you want to file a claim for health insurance you don’t need to be hospitalized. However, only a possibility of some event is enough. For example a person wants to take insurance cover for a possibility of critical illness. The insured person just needs to do a diagnosis & he will get the cover.
Mediclaim provides a limited cover. Usually, in a Mediclaim policy, the upper limit on the total insured sum does not go beyond 5 lakhs. In terms of Health Insurance, the cover is pretty extensive. The upper limit on the total insured sum can extend till Rs 60 lakhs.
Mediclaim works on the principal of indemnity.  This means that if an insured person incurs any hospitalization expenses, then the sum of the expense is reimbursed to him. This will make up for his losses.E.g. Satish has a mediclaim policy. In the past week, he got severely infected with a disease. Therefore, he got hospitalized for two days. Total medical expenses turned out for Rs 60,000/-. Satish filed a claim & he received Rs.60,000/- from his insurance company.


In terms of Health Insurance, many factors are involved. It works on the principal of benefit. Consider a health insurance rider such as a critical illness rider or an accidental disability rider. If he has a health insurance then the sum assured will be paid to him in case of a possibility. This is rather than make up for the losses as is the case with Mediclaim.E.g. Satish has a health insurance plan with critical illness cover of Rs.1 lakh. In the past week, he was found to be diagnosed with cancer. Satish then filed a claim & he received Rs.1 lakh from his insurance company.
In a Mediclaim policy, an insured person can make any number of claims till the total sum insured is utilized. In a critical illness cover, a personal accident cover & an accidental disability cover, total sum assured is delivered only once to the insured person. Hence, he cannot claim again during that policy period.


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