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Coverage & Types of Mediclaim Policies
May 30, 2022

Comprehensive Guide: Types Of Mediclaim Policies & Their Coverage

Types of Mediclaim Policies

There are different types of mediclaim policies available in the market. Choose the best mediclaim policy that suits the requirements. Here discussed are the various types of mediclaim policies:

Mediclaim Policy for Individuals

As the name suggests the mediclaim insurance policy for individuals covers a single policyholder. It implies that the benefits of the mediclaim policy can be availed by only one person. Apart from the policyholder, no other family member can avail of any benefits of the mediclaim insurance policy. *

Mediclaim Policy for Family

Under this mediclaim insurance policy, the individual and their family members including parents, spouse, and children are covered. It indicates that an individual along with the complete family can easily access the benefits of the family health insurance policy. Moreover, one can have a larger cover sum under this type of mediclaim health insurance plan. *

Mediclaim Policy for Senior Citizens

Under the health insurance for senior citizens, anyone above 60 years of age is covered. This type of mediclaim plan is specifically designed to cater to the medical needs of senior citizens. It is suggested to have a mediclaim policy for the senior citizens. *

Mediclaim Policy for Critical Illness

When it comes to any critical diseases such as heart diseases, kidney failure, cancer, etc. the hospital costs can easily deplete the savings. A critical illness mediclaim policy helps to curb such expense and pays the lump sum amount upon any such disease diagnosis. *

Group Mediclaim Policy

Under the group mediclaim policy, a person or an employer is in the charge of a group of people who purchases the policy for the members or employees. Usually, it is an addition to the compensation offered by the employer. * *Standard T&C Apply

Mediclaim Insurance Policy Coverage

The inclusions of a mediclaim insurance policy differ from one insurer to another. Yet, the following are covered in most of the mediclaim insurance policies:
  • Hospitalization Expenses

The mediclaim insurance policy covers the complete direct expenses that incur during hospitalization. It includes donor expenses, diagnostic charges, OT charges, sickness or accident treatment, etc. *
  • Hospital Room Expenses

The best mediclaim policy covers all the regular ward and ICU room expenses. Generally, the charges are covered in the cashless hospitalization claims at the network hospitals. *
  • Day Care Treatment

It covers those expenses, which are incurred that do not need hospitalization and the patient is released in less than 24 hours. *
  • Medical Professional Fees

It includes expenses related to doctors, surgeons, etc. during hospitalization are covered within it. *
  • Pre and Post Hospitalization

The mediclaim insurance policy also covers the costs incurred before and after the insured gets hospitalized. Various expenses are related to the treatment both before and after, which is covered under the mediclaim plan. *
  • Modern Treatment Method

The modern treatment methods and advancements in technologies such as oral chemotherapy, deep brain stimulation, bronchial thermoplasty, etc. will be covered. * *Standard T&C Apply

Exclusions in Mediclaim Policy

A mediclaim insurance policy can be comprehensive. Yet, every mediclaim health insurance plan has certain limitations that are uncovered in the plan. Listed below are those common exclusions of the mediclaim plan:
  • Any dental treatment that comprises dentures, dental prosthesis, dental implants, etc.
  • Any treatment received outside India is not covered under this Policy
  • Treatment for any other system other than modern medicine (allopathy)
  • Treatment for obesity and weight control
  • Change of gender treatment
  • Cosmetic or plastic surgery
  • Hazardous or adventure sport
  • Sterility and infertility
  • Treatment for alcoholism, drug or substance abuse
  • War, invasion, the act of foreign enemies
  • Congenital external diseases or defects or anomalies
  • Intentional self-injury
  • Circumcision unless required for the treatment of illness or accidental bodily injury
*Standard T&C Apply

The Bottom Line

Regardless of whether anyone buys mediclaim online or offline, ensure to read the policy document carefully. Besides, understand all the terms and conditions mentioned in the mediclaim policy document. It enables to make an informed purchasing decision and get the best mediclaim policy coverage suiting the needs. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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