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Aug 22, 2018

What is the Difference between Mediclaim and Health Insurance?

Bajaj Allianz Health Insurance

The two terms - mediclaim and health insurance are both related to the coverage provided to you, i.e. the policyholder for the expenses incurred due to some medical treatment. As the background for both these terms is similar, it is often confusing for people to use them in the correct context and many of people use them interchangeably.

What is difference between mediclaim and health insurance?

There is just a thread-line difference between mediclaim and health insurance. The following table presents some points of contrasts between them:

S.no. Mediclaim Health Insurance

A Mediclaim policy covers you for:

  • Hospitalization
  • Accident related medicaments
  • Limited number of illnesses for a limited amount of time
  • Domiciliary care

A health insurance covers you for:

  • Pre and post hospitalization expenses
  • In-hospital expenses
  • Medical examinations
  • Ambulance charges
  • Doctor Consultation fees
  • Pre-existing diseases with some waiting period
  • Day care procedures
2 Hospitalization is mandatory to avail benefits of mediclaim policy. Hospitalization is not mandatory and you can also avail the benefits of health insurance for day care procedures as well.
3 Claim settlement is done via cashless or reimbursement process. Claim settlement is done either via cashless, reimbursement process or lump sum payment like in case of critical illness.
4 Critical illnesses are not covered. Critical illness insurance is especially designed to cover major critical illnesses.
5 SI (Sum Insured) is limited to INR 5 lakhs. At Bajaj Allianz, SI (Sum Insured) options range from 1.5 lakhs to 50 lakhs.
6 Discounts are offered on mediclaim policies only at the time of buying the policy. Discounts are offered on premium amount during buying the policy as well as during the renewal process.
7 Mediclaim policies do not offer any add-on covers. Health insurance offers add-ons and top up health insurance policies to enhance the coverage of your base plan such as Bajaj Allianz's Extra Care Plus policy.
8 Mediclaim policies do not offer co-payment option. Health insurance policies give you an option for choosing a co-pay percentage, which can help you to reduce your premium amount.

We hope that the thin line of difference between mediclaim and health insurance must have been cleared by now. While it is up to you to choose the plan that best suits your requirements, we recommend that you get the policy that can provide comprehensive coverage to you and your loved ones.

Visit our website to know more about the various health insurance plans and the features & benefits offered by them.


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