Mediclaim Vs Health Insurance: Understanding the Differences, Benefits, and More

Health emergencies can occur unexpectedly, and the COVID-19 pandemic was a stark reminder of that reality. With the rising number of lifestyle disorders, having reliable medical coverage is more important than ever.

Table of content

What is Mediclaim Insurance?
What is Health Insurance?
Difference Between Mediclaim and Health Insurance
Choosing the Right Plan for Medical Coverage

In India, two popular choices that offer financial security against medical costs are health insurance and mediclaim coverage. While both these insurances provide medical coverage, they are very different from one another in terms of costs, coverage, and advantages.

To help you make more informed choices about which plan best meets your requirements, here is a detailed comparison between mediclaim and health insurance:

What is Mediclaim Insurance?

Mediclaim is a type of insurance that covers hospitalisation costs of the policyholder when they are admitted due to an illness, accident, or injury. It reimburses medical expenses incurred during the hospital stay, including medications, room charges, doctor fees, and other sanctioned costs. While mediclaim offers medical coverage, it’s important to understand that it only focuses on inpatient care.

Here are some benefits of a mediclaim policy:

Financial Protection: Mediclaim shields you from the financial strain of hospitalisation, ensuring you get necessary care without worrying about finances.
Cashless Hospitalisation: Many mediclaim insurance providers offer cashless hospitalisation at their network hospitals, sparing you from upfront payments.
Tax Benefits: Under Section 80d of the Income Tax Act 1961, premiums made towards mediclaim insurance are eligible for tax deductions. This helps reduce your annual tax burden and makes your healthcare more affordable.
Family Coverage: You can buy a mediclaim insurance for you and your family, including spouse, children, and parents, ensuring a secure future for your loved ones.

What is Health Insurance?

Health insurance is a complete financial plan that covers more than just hospitalisation costs. To obtain health insurance, an individual has to make regular premium payments to the insurance company. In exchange, the company takes responsibility for covering a range of medical expenses for the insured, including preventive care, prescription medications, hospital stays, surgeries, and more, depending on the details of the plan selected.

Here are some benefits of health insurance:

Comprehensive Financial Protection: Health insurance offers extensive coverage, shielding you from major medical expenses, such as hospitalisation, daycare procedures, home-based care, and ambulance fees.
Tax Benefits: Under Section 80d of the Income Tax Act 1961, health insurance premiums qualify for tax exemptions, helping reduce your overall financial burden.
Critical Illness Coverage: Health insurance offers coverage against severe conditions like kidney failure, strokes, limb loss, bone marrow transplants, and more.
Discount on Policy Renewal: Health insurance offers you a non-claim bonus at the time of renewal, provided that you have not filed any claim during the last policy tenure.

Difference Between Mediclaim and Health Insurance

Here are some key differences between mediclaim and health insurance: -

Parameters	Mediclaim	Health Insurance
Scope of Coverage	Primarily offers financial protection against health-related expenses.	Offers broader coverage, including hospitalisation, outpatient care, diagnostics, maternity, preventive care, and more.
Premiums	Premiums are generally more affordable as they offer limited coverage.	Premiums may be higher due to the comprehensive coverage offered.
Claim Process	Typically involves reimbursement, which means that the insured pays the bills and then claims a refund from the insurance company.	Allows for cashless claims, where the insurer settles medical bills directly with the healthcare provider.
Policy Term	Typically offers an annual policy that requires regular renewal.	Can be availed as both annual and long-term policies, offering continuous coverage over extended periods.
Sum Insured	Lower sum insured options.	A range of sum insured options, allowing for higher coverage limits.
Change in Benefits	Does not offer the flexibility to customise the coverage.	Offer greater flexibility to tailor coverage to specific needs through riders and add-ons.
Critical illness coverage	No such cover in general	Critical illness coverage is available as per the policy terms
Additional Benefits	Limited additional benefits	A wide array of additional benefits, like wellness programs, maternity coverage, and more.

Choosing the Right Plan for Medical Coverage

When choosing between mediclaim and health insurance, here are some things to consider:

Your Needs: Firstly, assess your medical needs and then decide which insurance plan best aligns with them. If you want more comprehensive coverage, then health insurance will be ideal for you.
Budget and Affordability: Consider your budget before choosing an insurance plan. Health insurance tends to be costlier due to its extensive coverage, so evaluate your financial capabilities before making a decision.
Network Hospitals: Check if your preferred hospitals are part of the network of the insurance plan you are considering. This can affect the convenience and cost-effectiveness of your healthcare.
Policy Duration: Understand how long you need coverage. For short-term coverage, mediclaim might be a better option, whereas for long-term coverage, health insurance is ideal.

As we conclude, it is clear that while both mediclaim and health insurance are vital for managing medical expenses, they are not the same. Mediclaim offers limited coverage focused solely on hospitalisation costs, whereas health insurance provides broader protection, including pre- and post-hospitalisation expenses, critical illness cover, and additional benefits. So, if you have ever wondered, “Is mediclaim and health insurance the same?”, you now have your answer!

Ready to secure your health? Explore the comprehensive health insurance plans offered by Muthoot Finance and protect yourself and your loved ones against unexpected medical expenses today.