Buy Health Insurance Online

Exclusive

Wellness Benefits

24*7 Claims

Support

Tax Savings

u/s 80D

9000+ Cashless Hospitals PAN India

Pincode

+91 Enter Mobile Number

Try agian later

I agree to the Terms & Conditions

Port My Policy

Download Policy

(Incl 18% GST)

Difference Between Mediclaim and Health Insurance Explained

Do you think you are healthy? Well, if yes, we are happy for you. But are you 100% sure you will be healthy in the future too? No, none of us are. It is better to plan for yourself and your loved ones and be stress-free in the future.

If you are confused about where to start, then don’t worry. We are here to help you😊

There are two ways to get the best benefits in case of medical emergencies: Mediclaim and a health insurance plan. In this article, we will explain you the major difference between the two i.e., Mediclaim vs Health insurance and help you evaluate what you must opt for.

Team Digit

What is Mediclaim?
What is Health Insurance?
Mediclaim vs Health Insurance
Benefits of Mediclaim & Health Insurance
Frequently Asked Question

What is Mediclaim?

A Mediclaim insurance policy gives you specified financial protection at the time of a medical emergency. It takes care of all the following expenses when hospitalized:

In case of an accident
In case of sudden illness or surgery
In case of any surgery during the policy tenure

It pays the policyholder's medical bills from the hospital stay, room charges, doctor’s visits, prescription drugs, and other inpatient hospital-related expenditures.

What is Health Insurance?

Health insurance is an insurance cover that gives you complete coverage for medical and surgical expenses in case of emergencies.

A health insurance policy provides coverage for various healthcare services, such as hospitalization, daycare treatments, pre and post-hospitalization expenditures, ambulance charges, medicines, preventative care, etc.

Both sounds similar right? But you will be surprised to know the differences between the two.

Difference Between Mediclaim and Health Insurance

Mediclaim and Health Insurance both provide financial support during medical emergencies but both are different in coverage and scope. Let’s understand the main difference between mediclaim and health insurance depending on certain factors:

Factors	Mediclaim	Health Insurance
Basic Definition	Mediclaim is a type of coverage that only covers the hospitalization charges during any illness or emergency	Health Insurance is a type of policy that provides coverage for expenses incurred beyond hospitalization.
Coverage Offered	Mediclaim covers only hospitalization expenses and you can only claim them if you’re hospitalized	Health insurance offers comprehensive coverage that includes annual health checkups, daily hospital cash, OPD expenses, and alternative treatments (AYUSH)
Add-on Cover	There are no add-on covers with Mediclaim	There are numerous add-on covers such as PED cover, Critical Illness Cover, Maternity Benefit Cover, etc.
Sum Insured	Mostly, the hospitalization cover in Mediclaim is up to Rs 5 lakh and can vary depending upon the insurance provider	The sum insured in health insurance is higher and varies depending on age, city, number of members in a single plan, etc.
Flexibility	Mediclaim offers no flexibility in coverage	Health Insurance plans are flexible and can be customized according to requirements
Hospitalization	The insured must be admitted to the hospital to receive Mediclaim.	The insured does not have to be admitted to the hospital to get health insurance benefits. Benefits like coverage for daycare procedures can be obtained without hospitalization.

Benefits of Mediclaim and Health Insurance

Mediclaim and Health Insurance are your financial superheroes in times of medical emergencies. They ensure that you are protected from unexpected medical expenses, but they provide different benefits when needed. Let’s find out:

Benefits of Mediclaim

You can get immediate coverage for medical expenses when you are hospitalized.
If you opt for a Cashless Mediclaim policy, your insurer directly pays for the expense.s
If you opt for Reimbursement, your money will be reimbursed by the insurer.
You can lower your tax deduction through a mediclaim policy under section 80D.

Benefits of Health insurance

It gives you comprehensive coverage, including hospitalisation expenses, outpatient treatments, diagnostics, maternity benefits, etc.
It provides you with numerous add-ons such as Critical Illness cover, pre-existing disease, etc.
You can opt for a Family Floater Health Insurance plan to cover all family members under one collective health insurance policy.
Pre and Post hospitalization expenses are covered
You can opt for a specific senior citizen health plan for your parents
Cashless claims and reimbursement claims are available

Mediclaim Insurance vs Health Insurance: Which One is Better?

Deciding what is better in Mediclaim vs Health Insurance can be tough but here are certain factors that will help you decide which one is better for you:

Your financial condition
Health issues you and your loved ones are dealing with
Whether you believe in long-term or short-term planning
Whether you need flexibility in your health plan or not
Whether you would need add-on covers and benefits
Willing to pay high or low premium
Keep in mind your or your family members' age, life stage, medical condition

Choosing one out of the two is not difficult if you know what will be best for you and your loved ones, keeping all the factors mentioned above in mind.

If you need more information, get in touch with us! We are always ready to help you.

Things to Know Before Buying a Mediclaim and Health Insurance Plan in India

Now, you must be clear about the differences between health insurance and Mediclaim, but here are certain things you must know before buying either Mediclaim or health insurance:

Coverage: The coverage provided under both differs widely. You can extend your coverage based on your health insurance needs.
Sum Insured: Generally, both mediclaim and health insurance come with a predetermined sum insured that cannot be altered before renewal.
Premium: The plan's premium is determined by the insured's age, gender, location, and chosen length of the policy coverage.
Claim Settlement: The claim request is handled through cashless treatment and reimbursement.
Tax Exemption: The plan provides tax benefits in health insurance on premiums paid under Section 80D of the Income Tax Act of 1961.
Renewability: Typically, health insurance offers a No Claim Bonus benefit when the policy is renewed after each year without a claim. This benefit may lower renewal premiums.
Co-payment: Certain plans may require a co-payment in which the insured pays a certain part of the treatment costs, and the insurance company pays the remaining sum. This helps lower the insurance premium.

In the battle between medical and health insurance, there is no perfect winner that suits everyone. Mediclaim is for hospitalization coverage, whereas health insurance is for wider coverage.

Assess your health risks and financial goals and choose the best that suits your needs.

FAQs about Mediclaim vs Health Insurance

All

Is a Mediclaim policy the same as health insurance?

No, a mediclaim policy is not the same as health insurance. The mediclaim usually covers only the hospitalization expenses, whereas, in health insurance, the policyholder provides coverage against preventive care, pre-hospitalization and post-hospitalization expenses.

What are the differences between Mediclaim and health insurance policies?

A mediclaim and a health insurance policy depends on several factors:

Mediclaim: It provides coverage against any hospitalization expenses incurred due to an accident or sudden illness.
Health Insurance: It provides wider coverage along with hospitalization, such as preventive care, ambulance coverage, pre & post-hospitalization coverage, etc.

Is it better to take Mediclaim or health insurance?

When it comes to choosing the best for yourself, health insurance is superior to mediclaim as it covers outpatient procedures, preventive care, and pre-existing diseases.

However, decide what suits your needs the most regarding your financial and health conditions.

What are the advantages of Mediclaim insurance?

The mediclaim has several advantages, including the coverage provided for room charges, doctor’s fees, medication, and other sanctioned costs while you are hospitalized for treatment or surgery.

What is covered under a Mediclaim policy?

A mediclaim covers the hospitalization costs related to accidents, surgery or illness. It covers the cost of room, treatment, diagnostic tests, and consultation fees only when you are hospitalised.

What are the key benefits of health insurance?

The key benefits of health insurance include:

It provides wider coverage and financial security during accidents, illness or surgery
Helps to undergo cashless treatment at the hospital
Provides tax benefits on the premiums paid under section 80D
Rewards with no claim bonus every year if you don't file any claim in a policy year
It has several add-on options to provide complete coverage

Are pre-existing conditions covered under Mediclaim or health insurance policies?

Yes, the pre-existing diseases are covered only under the health insurance policy. You must disclose your pre-existing disease to your insurer at the time of policy purchase to get the coverage.

Pre-existing diseases include Diabetes, Asthma, Thyroid problems, High Blood Pressure, Arthritis, Heart Conditions, Kidney Problems, etc.

How do the claim processes differ between Mediclaim and health insurance?

The claim process for mediclaim and health insurance are almost the same.

You can opt for cashless claims or reimbursement claims as per your requirements. For a cashless claim, you can connect with the TPA at the network hospital or apply for a reimbursement claim directly on the website.

Are there tax benefits associated with Mediclaim or health insurance premiums?

Yes, you can claim tax benefits with mediclaim and health insurance premiums under article 80D of income tax. You can save up to ₹25,000 yearly for yourself and ₹25,000 for your senior parents under a health insurance policy.

How does the premium for Mediclaim compare to that of health insurance?

The premium paid for mediclaim is generally low when compared with health insurance. This is because health insurance provides a wider coverage than a mediclaim and thus, the price is slightly higher in health insurance.

What factors should you consider before choosing between Mediclaim and health insurance?

You must consider certain important factors before choosing between mediclaim and health insurance. It includes the coverage, financial condition, sum insured, premiums paid, network hospitals, policy duration, etc.

What are co-payments and deductibles in Mediclaim and health insurance?

The co-payment and deductibles are differently defined in mediclaim and health insurance:

Co-payment: This is the set sum that a policyholder must pay for a particular medical treatment, such as a prescription drug or doctor's visit. The insurance company covers the rest of the cost. Co-payment can be applied directly or after a deductible.
Deductibles: This is the fixed amount a policyholder must pay out of pocket before the insurance provider pays for medical expenses.

What are the common exclusions in Mediclaim and health insurance policies?

Certain common exclusions that are not covered under mediclaim and health insurance policies include cosmetic surgery, self-harm injuries (suicide attempts), ART procedures (IVF, IUI), etc.

Can Mediclaim and health insurance policies be customized to meet individual needs?

Yes, mediclaim and health insurance policies can be customised as per your needs and on the mutual agreement of you and your insurance company.

Are there waiting periods for coverage in Mediclaim and health insurance policies?

Yes, there are waiting periods in health insurance for a coverage in both, mediclaim and health insurance policies. The waiting period differs from policy to policy:

Initial Waiting Period - 30 days
Pre-existing Disease Waiting Period - 3 years
Specific Disease Waiting Period - 2 years
Accidents - No waiting period in Mediclaim or health insurance

Do Mediclaim and health insurance policies cover preventive health check-ups?

Only a health insurance policy covers the cost of preventive health check-ups. Mediclaim doesn't.

What should I do if I cannot afford health insurance?

If you cannot afford health insurance, you can modify your plan’s coverage to decrease the cost of premiums. You can opt for health insurance that is easily affordable and within your budget.

Is it worth buying Mediclaim insurance?

Despite the distinction between health insurance and mediclaim policies, a mediclaim plan may also be worthwhile based on your particular requirements. It covers the expenses related to hospitalisation during accident and any illness.

If you want more coverage than a mediclaim provides, go for health insurance.

Does Health Insurance mean Mediclaim?

No, Mediclaim is not the same as health insurance. Both terms vary depending on coverage, duration, premiums, sum insured, hospitalisation, etc.

More articles related to Health Insurance

Domiciliary Hospitalization Cover

Group COVID Insurance for SME's Industries & Companies | Digit

Health Insurance Tax Benefits for Senior Citizens

Mental Health Insurance

Air Ambulance Cover in Health Insurance

Benefits of Critical Illness Cover

Health Insurance Glossary India: Terminology, Terms and Definitions

Senior Citizen Health Insurance

GMC and GPA in Health Insurance Policy

Coinsurance vs Copay vs Deductible

Myths about Health Insurance

Increase of Health Insurance Premium on Renewal

What is ABHA Card

What is Health Insurance?

Super Top-up Health Insurance for Corporate Employees - Check Prices

Difference between Mediclaim and Health Insurance

Copay in Health Insurance

Pre & Post Hospitalization Expenses in Health Insurance

Health Insurance with Cancer Cover

Health Insurance for Vector Borne Diseases & COVID-19 Online

Life Insurance vs Health Insurance

Health Insurance for Vector Borne Diseases & COVID-19 Online

Indemnity Health Insurance

Health Insurance Plans for Family

Cooling-off Period in Health Insurance

Add-Ons in Health Insurance Policy

Consumables Cover in Health Insurance

Waiting Period vs Survival Period in Health Insurance

TPA in Health Insurance

Types of Health Insurance Plans

Health Insurance for Parents

Reimbursement Claims in Health Insurance

What to do if you are tested Positive for COVID-19?

Health Insurance Non-Medical Expenses

Critical Illness Health Insurance Cover

Grace Period in Health Insurance

Waiting Period in Health Insurance

Road Ambulance Health Insurance

Nominee in Health Insurance

Health Tips & Guides

Anywhere Cashless Hospitals - Hassle Free Hospitalization Anywhere in India

Day Care Treatment in Health Insurance

Health Insurance Premium Calculator

Health Insurance for Disabled Person

Yoga Asanas & Exercises for Better Lifestyle

Is Dental Covered in Health Insurance?

Zone Based Health Insurance in India

Health Insurance for Government Employees

Health Insurance for Smokers

Restoration Benefit in Health Insurance

Check Health Claim Status Online Instantly

Comprehensive Health Insurance

Compare Health Insurance

Coronavirus Cover: Health Insurance for Coronavirus Treatment

Healthy Lifestyle

Health Insurance for Self Employed/Freelancer

Types of Health Insurance Claims

Benefits of Health Insurance

Reason to Buy Seperate Health Insurance for Parents

Daily Hospital Cash Benefit in Health Insurance

Health Insurance on EMI

Health Insurance for Mother

PED in Health Insurance

Cashless Health Insurance

How to Port Health Insurance?

Health Insurance Tips

Moratorium Underwriting vs Full Medical Underwriting

Government Insurance Schemes

Loading in Health Insurance

AYUSH Health Insurance Benefits

Health Insurance Tax Benefits

Super Top-up Health Insurance for Employees Retiring Soon

Personal Accident Insurance

Super Top-up Health Insurance for Senior Citizens in India - Check Prices

Saral Suraksha Bima Policy | Go Digit Insurance

Sum Insured in Health Insurance

What is Long-term Health Insurance? Features & Benefits Explained

Individual Health Insurance

Term Insurance vs Health Insurance

Health Insurance for Diabetes Patients

Corona Kavach Policy: Buy COVID Kavach Health Insurance Online

File Health Claims Online on Digit App

Health Insurance After Retirement

Organ Transplant Cover in Health Insurance

List of Excluded Hospitals

Family Floater vs Individual Health Insurance

How to Choose the Right Sum Insured in Health Insurance?

Room Rent Capping in Health Insurance

How to Reduce your Health Insurance Premium?

Check Digit Health Insurance Claims Status on Digit App

Family Floater Health Insurance

Cumulative Bonus in Health Insurance

Download your Health e-Card

Wellness Benefits with Digit Health Insurance

City

Inpatient vs Outpatient Hospitalisation

Health Insurance with Free Medical Check Up

Deductible in Health Insurance

List of Excluded Hospitals

Maternity Health Insurance

Indemnity Based vs Fixed Benefits Health Insurance

Maternity Coverage with No Waiting Period

GHC

Health Insurance Bariatric Surgery Cover

Super Top up Health Insurance

Cataract Health Insurance

Best Health Insurance Policy

Corona Rakshak Policy Online: Health Insurance for COVID-19 in India

Arogya Sanjeevani Policy

Health Insurance OPD Cover

Coronavirus Health Insurance: COVID-19 Insurance Policy in India

Government Health Insurance Scheme

Health Insurance for NRI Parents

Exclusions in Health Insurance

Sub Limit in Health Insurance

Health Insurance for Disabled & HIV/AIDS Patients: Check Coverage and Benefits

Terminal Illness vs Critical Illness

Health Insurance Plan that Covers Infertility Treatments

Health Insurance Options for Retirees

Check Pending Challan only on Digit App

Install

Check Pending Challan only on Digit App

Latest News

Currently there are no news to show.

Renew & Download Policy Document, Check Challan, Credit Score, PUC & more

51K+ Reviews

4.8

Rated App

51K+ Reviews

10K+ Reviews

4.3

Rated App

10K+ Reviews

Download the App

CIN: U66010PN2016PLC167410, IRDAI Reg. No. 158.

Go Digit General Insurance Limited (formerly known as Oben General Insurance Ltd.) - Registered Office Address - 1 to 6 floors, Ananta One (AR One), Pride Hotel Lane, Narveer Tanaji Wadi, City Survey No.1579, Shivaji Nagar, Pune-411005, Maharashtra | Corporate Office Address - Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru-560095, Karnataka | Trade logo of Go Digit General Insurance Ltd. displayed above belongs to Go Digit lnfoworks Services Private Limited and is provided and used by Go Digit General Insurance Ltd. under license.

Difference Between Mediclaim and Health Insurance Explained

Table of Contents

What is Mediclaim?

What is Health Insurance?

Difference Between Mediclaim and Health Insurance

Benefits of Mediclaim and Health Insurance

Benefits of Mediclaim

Benefits of Health insurance

Mediclaim Insurance vs Health Insurance: Which One is Better?

Things to Know Before Buying a Mediclaim and Health Insurance Plan in India

FAQs about Mediclaim vs Health Insurance

Is a Mediclaim policy the same as health insurance?

What are the differences between Mediclaim and health insurance policies?

Is it better to take Mediclaim or health insurance?

What are the advantages of Mediclaim insurance?

What is covered under a Mediclaim policy?

What are the key benefits of health insurance?

Are pre-existing conditions covered under Mediclaim or health insurance policies?

How do the claim processes differ between Mediclaim and health insurance?

Are there tax benefits associated with Mediclaim or health insurance premiums?

How does the premium for Mediclaim compare to that of health insurance?

What factors should you consider before choosing between Mediclaim and health insurance?

What are co-payments and deductibles in Mediclaim and health insurance?

What are the common exclusions in Mediclaim and health insurance policies?

Can Mediclaim and health insurance policies be customized to meet individual needs?

Are there waiting periods for coverage in Mediclaim and health insurance policies?

Do Mediclaim and health insurance policies cover preventive health check-ups?

What should I do if I cannot afford health insurance?

Is it worth buying Mediclaim insurance?

Does Health Insurance mean Mediclaim?

Latest News