Top Distinction Between Mediclaim Insurance & Health Insurance

All of us require health insurance coverage to protect ourselves and our loved ones from unforeseen events and meet the ever-increasing healthcare costs. As many hospitals demand cash settlement of expenses, many insurance companies have started providing cashless health insurance policies. 

Moreover, specific health insurance plans are needed to insure you against different types of health hazards or illnesses. For instance, an accident insurance plan financially secures you against death or physical disability caused by an accident. A critical illness insurance plan helps you manage the exorbitant treatment costs and associated hospitalization and surgery expenses pertaining to life-threatening health conditions.

An important point to note here is that two terms, ‘mediclaim’ and ‘health insurance,’ are often interchangeably used. Considering them synonymous is a common mistake made by most people. However, they are different.

Mediclaim Vs. Health Insurance

  1. Extent of coverage

Mediclaim policies can be rightfully called subsets of health insurance policies. The former offers limited coverage benefits as opposed to the latter. Mediclaim policies function more like pocket health insurance packages.

For instance, the maximum sum assured under the Bajaj Allianz Mediclaim policy is Rs 10 lakhs instead of the maximum sum assured of Rs 50 lakhs under Bajaj Finserv health insurance policies. Moreover, the former reimburses ambulance charges up to Rs 3000, while the latter reimburses up to Rs 20,000 in a policy year. Even the compensation offered for organ donor charges is lower in Bajaj Finserv mediclaim policy than that offered under Bajaj Finserv critical illness insurance.

In short, the coverage of pre and post-hospitalization expenses, day-care costs, alternative treatment costs, pre-existing conditions treatment costs, etc., are much lower in mediclaim policies than that in health insurance policies.

  1. Add-ons

Add-on coverages are not a part of mediclaim policies. On the other hand, health insurance policies offer a wide range of add-on protection covers like personal accident cover, critical illness insurance, maternity health insurance, parental medical insurance, cancer insurance, group/employee medical insurance, etc. 

Bajaj Finserv health insurance plans offer an extensive range of add-on covers. Some of the unique add-on coverages offered by Bajaj Finserv health insurance are bariatric surgery cover and Ayurvedic/Homeopathic hospitalization cover.

  1. Free medical check-ups

Mediclaim policies usually do not offer free medical check-ups like comprehensive health insurance policies. For example, under the Bajaj Finserv family health insurance plan, you and your family members can avail of free health check-ups every 3 years, irrespective of whether you file a claim.

  1. Discounts and Bonuses

These days, many medical insurance policies offer long-term policy discounts, cumulative bonuses for claim-free years, or family discounts. Claim-free bonuses enhance your indemnity cover. Such privileges may be absent in mediclaim policies.

Under the Bajaj Finserv health insurance plan, you can receive long-term policy discounts of 4% for 2 years and 5% for 3 years. You can claim family discounts up to 10% for 2 family members and 15% for 3 family members. You are also entitled to avail of a 10% cumulative bonus for every claim-free year. The claim-free bonus goes up to 50% for the Bajaj Finserv accident insurance plan. 

  1. Additional benefits

Many medical insurance policies have value-added benefits like child education bonuses, disability compensation, cashless health insurance, medical test exemptions, etc. Such value-added benefits are usually not offered by Mediclaim policies.

With Bajaj Finserv personal accident insurance, you get 10% of the sum assured or Rs 5000 per child, whichever is lower, as a child education bonus. You are also entitled to receive a high disability compensation of 125% of the sum assured in permanent total disability.

Moreover, with Bajaj Finserv health insurance plans, you can avail of cashless treatment at 5700+ network hospitals and medical test exemptions for individuals aged below 45.

Final word

If you meet with major accidents, suffer from critical illnesses, or incur very high medical expenditure, then a mediclaim policy may not benefit you. Nevertheless, you may consider Bajaj Finserv mediclaim or health insurance policies to be the best in the industry.