Shipra Verma en health insurance, Healthcare, Public Health 4/6/2018 · 2 min de lectura · +200

How Mediclaim differs from a health insurance policy?

How Mediclaim differs from a health insurance policy?In a startling revelation, India with a population second only to China a mere 27 percent of its people have any sort of insurance coverage. Central Bureau of Health Intelligence, under the Ministry of Health and Family Welfare, made the observation in 2015-16. And there has not been a substantial increase in the numbers in the corresponding years as well. For the majority of the population in India insurance is still a luxury, not a necessity. This is indeed sad for a populous country like India. This is something that needs to change. Well, that is a story for another day.

Now let us focus on medical and health insurance policies. Many in India think that both are same. For them, medical and health insurance go hand in hand. This notion is not true. The medical and health insurance policy are as diverse as chalk and cheese. So, don't confuse mediclaim insurance policy with a medical insurance policy in India.

Mediclaim Insurance: This is the kind of insurance that provides certain monetary protection against health-related expenditures. It is quite economical in nature and can reduce the cost arising out of any health-related emergency. Mediclaim policy provides cover for hospitalization expenses related to pre-specified illnesses till a certain period of time in accordance with the promised amount. Hospitalization is an absolute necessity to make any kind of claim under this policy.

Health Insurance: This provides cover to medical and surgical expenses incurred by the insured. This is quite comprehensive and very expensive than a mediclaim policy. In this case, either the insured has to pay money from his wallet which gets reimbursed later on by the insurer or the insurance company pays the bill directly to the hospital.

What All Sets the Duo Apart?

The scope of Coverage: In mediclaim, coverage is confined to hospitalization, accident-related treatment and diseases which were agreed upon earlier for a pre-specified time limit. In the case of health insurance, coverage extends to hospitalization charges, cost prior to hospitalization, charges after hospitalization and ambulance expenses. It also compensates you for losing money as a result of an accident.

Flexibility: Mediclaim is quite rigid as it offers no scope for any kind of changes or modifications later on. On the other hand, a health insurance plan has ample scope for flexibility. Policyholders can minimize their health insurance premium amount after a certain period. Also, the insured can even change their duration of the policy.

Critical Illness Involved: Mediclaim has no coverage for critical illnesses. Whereas health insurance gives coverage to over 30 critical diseases such as cancer, stroke, kidney failure, etc.

Promised Amount: The assured amount in a mediclaim policy doesn’t go beyond 5 Lakh Rupees. However, the ceiling of the promised amount in a health insurance plan is 6 crore Rupees annually. This exemplifies the holistic aspect of health insurance.

Number of Claims: With regard to mediclaim plan, a policyholder can file claims till the entire assured amount is

used up. However, health insurance claims can only be made once, either during the total duration of policy or the policy tenure.

Terms and Conditions: To reap rewards of mediclaim, policyholder needs to be hospitalized. To derive benefits under health insurance, hospitalization is not required. Even for other benefits like daycare procedure cover hospitalization is not needed in health insurance.

So, now it is very much evident what is a mediclaim policy and what is a health insurance. There is a huge difference between the two in scope and other aspects. This analysis would make people to take decision wisely with regard to insurance policies. One thing people planning to buy insurance should keep in mind is that there is nothing called perfect in terms of insurance policies. In case you find a policy which matches your expectation by 85-90 percent just go for it. It is better to have an insurance policy rather than not having one despite spending a lot of time and effort looking for the same