Mediclaim Vs Health Insurance: What’s The Difference

Mediclaim and health insurance are two of the most commonly used terms in the medical insurance sector. While they put forth coverage for health expenditures, they are still pretty different from one another. This article will tell you all about how a health insurance policy differs from mediclaim and what you must know before purchasing any of the two.

Health Insurance Explained

Health insurance, also called medical insurance, covers various healthcare costs, from surgeries and hospital stays to daycare treatments and modern procedures. Many health plans also include ambulance charges, OPD expenses and even non-consumable items.

You pay for such costs out-of-pocket and are later compensated by the insurance company, or the insurer directly settles the bill with the medical facility, which is commonly called “Cashless Hospitalisation.” The coverage under health insurance is predominantly more extensive than mediclaim insurance and is usually pricier due to this.

Benefits of a Health Insurance Policy

• Extensive Coverage: This health policy covers your health needs comprehensively, including critical illness health insurance coverage for a predefined list of illnesses or health conditions.
• Tax Advantages: The premium amount you pay for purchasing a health insurance policy qualifies you for tax deductions.
• Availability of Riders: You may enhance the benefits of a health insurance policy by adding riders or add-ons. The availability of these might vary from one insurance provider to another.
• Discount on Health Policy Renewal: Stick to a clean record and your health insurance will reward you. If you do not make any claims during the policy term, you get a No Claim Bonus when renewing.

Mediclaim Policy Explained

A Mediclaim policy is a relatively low-cost medical insurance plan that protects against healthcare expenses. It is a slightly budget-friendly option to take care of any sudden medical-related emergency.

A mediclaim policy provides coverage up to a fixed sum insured for hospitalisation and specific treatments. However, its coverage is often limited, both in terms of hospital expenses and treatment costs for certain illnesses. These plans generally cover nursing charges, room rent, doctor’s fees, ICU expenses, etc., caused by illness or injury. Any extra costs not covered by the policy will need to be paid by you or your family.

Benefits of a Mediclaim Policy

• Health Coverage: A mediclaim policy mainly covers hospitalisation expenses and treatment done for a disease.
• Straightforward Claim Resolution: A mediclaim policy settles claims via cashless or reimbursement methods for medical costs.
• Flexibility: Usually, these plans do not offer the option to add riders or add-on benefits to the plan and the coverage is not flexible.
• Low Premium: Since these plans have a low, pre-defined coverage, their premium is relatively low.

Health Insurance vs. Mediclaim Policy: Key Differences

Aspects	Mediclaim Plans	Health Insurance Plans
Sum Insured	Mediclaim policies usually have a lower sum assured. It covers only hospital expenses and not much else.	Health insurance gives you bigger coverage, with amounts ranging from lakhs to several crores, so you do not have to stress about huge medical bills.
Policy Coverage & Benefits	A mediclaim policy mostly takes care of just hospitalisation bills due to accidents and illnesses and does not offer much beyond that.	Health insurance covers a lot more, like hospital stays, pre- and post-hospitalisation, daycare treatments, OPD visits and even critical illnesses.
Flexibility	A mediclaim policy has fixed benefits with little room for customisation.	Health insurance gives you more flexibility with options like family floater plans, top-ups and super top-ups to increase coverage as needed.
Add-on Covers	With a mediclaim policy, you usually just get hospitalisation coverage without any of these additional perks.	Health insurance lets you add extra benefits like OPD coverage, maternity benefits, critical illness coverage and wellness programs.
Premium	Mediclaim is a more budget-friendly option but is limited to hospitalisation costs. If comprehensive protection matters, health insurance is the smarter pick.	Health insurance has a higher price tag, but it is for a reason. It covers everything from hospitalisation and OPD visits to pre- and post-hospitalisation expenses and advanced treatments.

Invest in Your Health Today with TATA AIG

While mediclaim and health insurance protect you against medical expenses, the latter offers broader, more comprehensive protection.

If you are looking for a reliable and customisable health insurance solution, TATA AIG is a trusted partner in your healthcare journey. They offer various health insurance plans designed to meet diverse needs—from individual and family floater plans to critical illness and top-up coverage.

For each claim-free policy year, you can earn a cumulative bonus of 10% to 100% on your sum insured, depending on the specific health insurance plan you choose.

Whether opting for the affordability of a mediclaim policy or the all-around coverage of a comprehensive health insurance plan, TATA AIG has plans that are tailored to your lifestyle and health goals.