Mediclaim vs Health Insurance - Which One to Buy?

Are you wondering whether it is better to opt for a health insurance policy or a mediclaim? Even though both the policies sound the same and have similar features, there is a thin line of difference between the two that you must be aware of to decide accordingly. Understanding the nuances between a mediclaim policy and health insurance is crucial for selecting the right coverage.

This article uses a comparative method and highlights their differences in coverage, sum insured, and more to help you make an informed decision.

What is the Difference Between a Mediclaim Policy and a Health Insurance?

The terms mediclaim policy and health insurance have similar meaning, but they are not the same. To understand which suits your needs better, you should dive deep into their nuances with the help of the table below:

Which Policy to Buy - Mediclaim or Health Insurance?

You have seen the overall similarities and differences between mediclaim and health insurance plans in the table above. If you still have doubts about what to buy, the pointers below will help you make a better decision:

Comprehensive Coverage

Purchasing a suitable health insurance policy is wise if you have no problem spending a considerable amount yearly for complete financial security.

Importance of Insurance

Choosing mediclaim for now due to budget constraints is better than waiting to get a better policy.

Group Policies

Employer-offered group policies have limited features. Therefore, you cannot rely on them long-term.

What are the Factors to Consider While Buying a Mediclaim Policy?

Consider the following aspects of a mediclaim policy before making a purchase decision:

1.Comprehensive Coverage

Look out for a plan that provides extensive coverage, including pre and post-hospitalization costs,  hospitalisation expenses, ambulance charges, and additional benefits. Ensure coverage for critical illnesses, as they can result in significant financial strain. A policy that covers a broad spectrum of illnesses provides comprehensive protection.

2.Cashless Facilities

Select a policy that offers cashless services at network hospitals. During hospital stays you do not have to pay upfront and the insurer will handle it leaving no financial strain on you. Get acquainted with the network hospitals linked to the insurer so that during an emergency it is easy to access high-quality healthcare services.

3.Waiting Periods and Exclusions

A policy may have waiting periods for specific pre-existing conditions and illnesses. These waiting periods will change depending on the policy. Therefore, it is wise to read the policy carefully so that you can avoid any surprises later. It is also equally essential to read what the policy does not cover or the exclusions. This will help manage expectations and eliminate misunderstandings during claims.

4.Affordability

This is a primary thing to consider while purchasing a mediclaim. Compare a lot of plans and try to find a balance between cost and coverage.

5.Sub-Limits 

Be aware of sub-limits on particular medical expenses like surgical charges, doctor’s fees, or room rent, etc. Try to buy a policy with as little as possible or no sub-limits on coverage.

What are the Things to Consider While Buying a Health Insurance Policy?

Here is a list of things you should check and ensure before purchasing a health insurance policy:

• Go through both the inclusions and exclusions to avoid unexpected expenses.
• Be aware of waiting periods, especially for maternity benefits and pre-existing conditions.
• Consider the relationship between policy premium, coverage, and sum insured.
• Confirm coverage for daycare procedures and specific diseases.
• Check if alternative treatments like AYUSH are covered.
• Be aware of room rent limits and their impact on total hospital bills.
• Look for coverage for new-age treatments and the availability of add-on covers.
• Verify pre and post-hospitalisation coverage details.
• Ensure a wide network of hospitals for cashless treatment.
• Consider age-related premium variations and the age of family members in family floater plans.
• Confirm coverage for preventive health checkups to avoid high out-of-pocket costs.

The Bottom Line

Choosing between a mediclaim and health insurance policy depends on your current financial situation and coverage needs. While a mediclaim policy offers minimalistic coverage at cost-effective premiums, health insurance provides extensive coverage, making it ideal for those seeking complete financial security. However, you should keep in mind that some security is better than none.

If you have more questions about health insurance policies, make sure to contact ACKO to get the affordable insurance options.