February 20, 2024

Mediclaim policies are becoming quite popular in recent years. They are often confused with health insurance policies. While a mediclaim policy is limited to only hospitalization, a health insurance plan offers wider options.

What is a Mediclaim Policy?

A mediclaim policy or mediclaim insurance is a type of health insurance cover that helps to mitigate the financial expenses during medical emergencies arising due to hospitalization. To avail a mediclaim insurance, an individual has to pay a premium and can get insured. The sum insured can be availed during hospitalization.

What are the Common Types of Mediclaim Policies?

There are various types of mediclaim policies available in India. The 6 major ones are:

  • Cancer Mediclaim
  • Heart Mediclaim
  • Critical Illness Mediclaim
  • Operation Mediclaim
  • Senior Citizen Mediclaim
  • Overseas Mediclaim

Apart from these, a mediclaim policy can be either individual or a family floater. There are even options for group mediclaim policies as well.

Benefits of Mediclaim Policy

Among the various benefits of a mediclaim policy, the notable ones are:

  • Cashless hospitalization during medical emergencies
  • Facilitates sudden medical expenditures
  • Coverage for pre and post hospitalization medical expenses
  • Lifelong renewability option with other advantages like coverage for alternative treatments, annual health check-ups, day care procedures, etc.
  • Avail income tax benefits under Section 80D of the Income Tax Act, and can claim a deduction up to Rs.75, 000 for the premium paid for a family floater policy.

Types of Claims in Mediclaim Policy

There are two modes by which an individual can avail the coverage for the insurer company:

● Cashless:

At present, most insurance companies like Care insurance, etc. offer cashless claim settlement. As the name suggests, in a cashless claim settlement, hospitalisation bills will be paid directly by the insurance company to the hospital where the treatment is availed. It should be noted that cashless treatment can be only availed at a network hospital of the insurance company.

● Reimbursement:

In a reimbursement process, individuals have to bear the hospitalization expenses from their own pockets first and then will be reimbursed by the insurance company as per their respective terms and conditions. So, an individual has to submit the reimbursement form along with all the bills to avail the coverage charges.

Key Points to Note Before Buying a Mediclaim Policy

Below are some important things that should be noted before buying a mediclaim policy online.

  • Coverage of Sum Insured: Check the coverage amount i.e. the sum insured amount before choosing the premium.
  • Plan Type: Choose between individual or family floater plans, For family plans, the sum insured will be jointly held by the family members who are beneficiaries of the policy amount.
  • Network Hospitals: To avail cashless facility, it is important to get admitted to a network hospital of the insurance company. So, check the proximity of network hospitals of the respective insurance company.
  • Waiting Period: Always check the clause for waiting period beforehand. A waiting period is a period before which the insurance company won’t allow to claim any medical facility. Also, a waiting period might also be there for certain pre-existing diseases.

A mediclaim policy is a must-have for most individuals. However, it is of utmost importance to choose the right medical policy by checking the policies, exclusions, terms and by understanding the individual needs.