Compare Mediclaim Policy – Features, Benefits, Types and Comparison Chart
Mediclaim policies cover medical expenses in any unforeseen situation. It reimburses treatment costs up to the sum insured. Choosing the best mediclaim policy can be a difficult task as there are several options available in the market.
One should compare mediclaim policies to make a selection from the available options wisely and effortlessly. In this article, you will find everything about how to compare mediclaim policies so that you can make an informed decision while purchasing a policy.
What is Mediclaim in Insurance Policy?
Mediclaim is essentially an insurance plan that offers protection against medical expenses. Depending on the coverage amount, you can avail compensation or cashless claim to cover your medical expenses in case of emergencies. It also covers protection against complex ailments like kidney failure and heart strokes etc. Some mediclaim plans also cover hospitalisation and other expenses involved.
There are certain conditions that an applicant must fulfil to obtain a policy. Cashless claims, for example, are valid only when the insured gets admitted to a network hospital. For normal claims, you can receive reimbursements against the medical bill you are claiming for.
Mediclaim: Features and Functioning
Unlike health insurance policies that are comprehensive and cover several expenses, mediclaims only cover hospitalisation costs. Medical insurance policies cover both pre and post hospitalisation costs which may also include ambulance charges, daycare treatments, domiciliary care, etc. Mediclaims, however, pay or reimburse bills during hospitalisation, and the coverage amount is plan specific.
There are four general properties of mediclaim policies:
- Coverage: A typical mediclaim policy covers hospitalisation costs for accidents, surgeries or critical illnesses during a specified period.
- Premium: Policy buyers must routinely pay a premium to avail a mediclaim.
- Renewal: Normally, mediclaims have pre-specified insurance covers, the terms of which must be specified during each renewal.
- Settlement options: Mediclaims offer two avenues for claiming benefits for hospitalisation – reimbursement of settlements and cashless hospitalisation. While the former requires you to initially pay the expenses and then request a reimbursement, the latter is settling the bills between the insurance provider and hospital.
Mediclaim policies do not provide cover against contagious and pandemic diseases like Covid-19. Despite the inflexible nature of mediclaim policies, they can provide immediate benefit for medical emergencies.
Mediclaim Policy: Types and Comparison Chart
1. Types of Mediclaim Policies:
- Individual Mediclaim Policy: Only a single insured person can benefit from this policy against the paid premium amount.
- Family Floater Mediclaim Policy: This policy provides coverage to an individual and his/her family, that includes their parents, spouse, and children. You can compare Mediclaim policies for a family from several insurance providers.
- Senior Citizen Mediclaim Policy: Senior citizens above 60 years of age can get their treatment expenses covered under this policy type.
- Critical Illness Mediclaim: This type of policy includes coverage for critical illnesses such as kidney failure, cancer, heart attack, and more.
Other than this, a group of employees in a company can get a group medical policy by paying the premium amount. Comparing group mediclaim policies for employees allows one to settle for the best insurance plan that offers maximum coverage at affordable rates.
2. Mediclaim Policy Comparison Chart:
| Policy Name | Sum Insured (In Rs.) | Network Hospitals |
| Navi Health Insurance | 2 lakhs to 1 crore | 10,000+ |
| Bajaj Allianz | 1.5 to 50 lakhs | 6500+ |
| Bharti AXA | 3 to 5 lakhs | 4300+ |
| Digit | 2 lakhs – 25 lakhs | 5900+ |
| Edelweiss | 5 lakhs to 1 crore | 2500+ |
| Max Bupa | 3 lakhs – 1 crore | 4000+ |
| United India | 1 to 10 lakhs | 7000+ |
By referring to the above table, policyholders can compare available mediclaim policies before purchasing them.
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Mediclaim Policy Comparison Procedure
There are online and offline procedures for mediclaim policy comparison. The details about both the processes are explained in the following section:
1. Online
To draw a comparison between two or more Mediclaim policies online, you must follow these steps:
- Firstly, you need to conduct proper research and find out the companies that provide policy comparisons. In this regard, use a health insurance premium calculator and form a comparison chart to streamline the choices.
- On choosing any one web aggregator, you must enter necessary information such as the number of members in your family, sum insured, contact details, etc. After processing these details, the portal will show a quote, and then you can select your appropriate provider and mediclaim plan effortlessly.
- While comparing mediclaim policies, insurers will check your pre-existing illness and other factors that might affect the amount of premium. Therefore, it is advisable to settle for a policy that comes with a low premium and maximum benefits.
- After selecting a plan, you must proceed to complete the application process by furnishing the necessary documents and details.
Alternatively, you can compare Mediclaim policies offline. Here is the procedure to follow:
2. Offline
For the offline mediclaim comparison process, refer to the following steps:
- Visit an insurance agent who can offer you a policy.
- Disclose your requirements concerning the mediclaim policy.
- Submit your information in detail for a fair comparison.
- The agent will collect quotes from various insurers and submit the same to you.
- After going through the details, you can select an insurance provider and policy of your choice accordingly.
Prime Areas of Focus While Comparing Mediclaim Policies
While comparing Mediclaim plans, it is pertinent to focus on the following prime areas:
1. Limitations on Certain Medical Treatments
Some insurers offer Mediclaim policies with a cap on certain treatment expenses. In this way, the insurance company decreases its spending in case the hospital overcharges. Therefore, it is crucial to learn about these limitations while comparing mediclaim plans.
2. Waiting Period
Coverage for some specific diseases is effective only after a certain span. Hence, you should consider the waiting period of mediclaim policies while drawing a comparison. Ideally, policyholders choose a mediclaim plan with a minimal waiting period.
3. Co-payment
Co-payment is the amount you need to bear at the time of claim settlement. This amount varies across mediclaim plans. For instance, if your policy reads a co-pay of 10%, then 90% is payable by the insured, and you must pay the rest 10%. Therefore, you must check policies for co-payment conditions while buying them.
4. Renewability
Several mediclaim policies come with a renewal till certain age or lifetime renewability. Policies with an upper age limit of 65 or 70 years might not allow members to renew their plans.
5. Pre-existing Diseases
Individuals with pre-existing illnesses can get coverage benefits under a mediclaim plan after a certain waiting period. Thus, it is advisable to compare Mediclaim policies concerning pre-existing diseases and choose one with a lower waiting period.
Benefits of Comparing Mediclaim Policies
By comparing Mediclaim plans, you can enjoy the following benefits:
1. Affordable Premiums
Insurance providers across India provide Mediclaim policies under different premium ranges. Therefore, to select a plan that best suits your budget, compare the ones available.
2. Tailor-made Mediclaim Policy
Several insurance companies in the market offer policies with distinctive features. By comparing mediclaim policies, you can select an appropriate plan for you that meets your requirements.
3. Add-ons
Insurers provide additional benefits on a mediclaim policy. To be aware of these offers, it is essential to compare the plans from different providers and settle for the best deals.
Key Benefits of Getting a Mediclaim
Mediclaim policies are geared towards safeguarding your finances in times of medical emergencies. Some benefits of obtaining a mediclaim policy include:
1. Covers Medical Expenses
With the exponential growth in medical expenses, mediclaim is a necessity. Not only does it provide protection against high medical costs, but also covers hospitalisation expenses and ambulance charges, etc.
2. Enjoy Cashless Claims
When you choose a mediclaim policy that provides a cashless claim facility, the hospital settles expenses with the insurer. However, this requires you to get hospitalised at a hospital within the insurer’s network. You need to fill out a pre-authorisation form before proceeding with the cashless claim.
3. Coverage against Critical Illnesses
Mediclaim providers can provide a standalone all round plan that covers life-threatening diseases like kidney failure, heart stroke, etc. Upon diagnosis of any critical illnesses mentioned, you are eligible for a lump sum payment. Some providers also cover treatment and other costs.
4. Get Tax Benefits
Section 80D of the IT Act states that premiums paid for healthcare plans have tax benefits which include:
- Deductions of up to Rs. 25,000 for the policyholder and his/her family.
- Senior citizens will receive tax deductions of up to Rs. 50,000.
- Insurance for parents is also open to tax deductions up to Rs. 25,000 and up to Rs. 50,000 for senior citizens.
- Uninsured super citizens are liable for tax deductions up to Rs. 50,000.
Aids in making an informed decision
If you compare mediclaim policies, you can get clarity on certain policy norms like a waiting period, critical illnesses covered, and claim procedures beforehand. Knowing about these factors will enable you to obtain the best deal from an insurance provider.
Additionally, insurance providers such as Navi offer comprehensive health benefits coverage and paperless claims under 20 minutes with monthly premiums starting at Rs. 241. Download the Navi app today to enjoy these benefits and more.
Final Word
To conclude, mediclaim policies are a crucial investment that requires an appreciable amount of research and focus. From the aforementioned areas of focus, one can conveniently compare mediclaim policies.
Further, you can select an affordable plan that provides maximum coverage with a minimum waiting period on comparing policies. Also, your selection process will get even easier by referring to the comparison chart from this article.
FAQs
Ans: Selection of a mediclaim policy requires you to focus on certain areas like the type of plan (individual or family), policy renewability, and pre-existing diseases covered. To further streamline your options, you can compare various plans and their benefits.
Ans: A Mediclaim policy reimburses a policyholder’s actual medical expenses, whereas, in health insurance plans, he/she receives a lump-sum amount irrespective of the medical expense. Also, a mediclaim policy includes a wide range of critical illnesses as it covers accident treatment as well. However, a health insurance plan covers only a certain number of diseases.
Ans: It extends coverage to employees of an organization and their beneficiaries during hospitalization.
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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