Mediclaim and Health Insurance – same or different?

As kids, we all would have heard at some point of time our elders talking about having a Mediclaim policy, we knew that it was something to do with hospitalization. In recent years, we have started hearing a new term Health Insurance. Is this health insurance same as Mediclaim? Is health insurance just a new name given to Mediclaim by the private insurers or is it something different? This is a question many people have. Let us find out in this post.

Mediclaim deals with hospitalization (only). It aims to do good the monetary loss that has taken place due to hospitalization.  For eg: Amit is diagonized with Dengue and is hospitalized for four days. The final hospital bill is Rs 35,000/-. Amit pays the amount and subsequently files a claim with the insurance company by submitting the discharge summary, final bills and payment receipts. After requisite checks the insurance company reimburses Rs 35,000/- to Amit thereby making good the financial loss incurred by him.
Till the sum assured limit is exhausted, any no. of hospitalization expenses can be claimed subject to the terms and conditions of the policy contract. Cashless facility on hospitalization is also available in Mediclaim policies.

Now coming to Health Insurance.
Health insurance is much more comprehensive. It is not limited to hospitalization and also includes pre and post hospitalization expenses. It provides for ambulance charges, periodic health checkups, higher coverage amount, bonus for no claims, restoration of sum insured etc. Also, hospitalization is not a mandatory requirement to claim health insurance benefits. For eg: In case of a critical illness cover, a diagnosis of an illness covered under the policy will lead to payment of the sum insured amount.


From the above, we can see that there is a difference between a Mediclaim and a Health Insurance policy. So, which one should you opt for? Since health insurance covers a wide gamut of situations from pre-hospitalization to post-hospitalization, it may be best for the current times considering that pre and post hospitalization medical tests, doctor consultations and procedures can be very steep. However, the benefits offered by Health Insurance products come at a charge and premiums for health insurance policies may be higher than Mediclaim policies. Hence it is best to weigh the benefits offered with the premiums to be paid and your individual situation before deciding whether to opt for Mediclaim or Health Insurance.

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