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health insurance vs mediclaim insurance
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Difference Between Health & Mediclaim Insurance Online

Jay (35) wanted to buy a health insurance plan to secure his healthcare and medical needs. A quick online search for “health insurance plans” popped up scores of websites with hundreds of recommendations for health insurance and Mediclaim plans. 

After thorough research and consulting an experienced insurance agent, Jay ended up buying not one, but two healthcare products – a comprehensive general health insurance plan with a bigger sum insured and a Mediclaim policy with a shorter waiting period and smaller health insurance coverage for accidental medical needs.

By now you must be wondering – Why buy two policies? Isn’t Mediclaim the same as health insurance? What is the difference between the two? Does everyone need to buy both? 

Whether prolonged illnesses or sudden accidents, it is essential to secure healthcare needs with the right kind of insurance plans. We’ll tell you all about the difference between health insurance and Mediclaim; so that you can zero-in on what is more suitable to you. 

  • Mediclaim and health insurance – are they different?
  • Health insurance vs mediclaim – differences and similarities
  • What is better – health insurance or mediclaim?


Mediclaim and health insurance – are they different?

By now you know the two are surely different. Even though the objective for both the plans is the same – to provide coverage against healthcare needs – there are differences between the two. That said, there are numerous similarities, too. Before we delve into the details, let’s look at each of them separately, in brief. 

Health insurance: health insurance plans offer complete, comprehensive protection against a wide range of health care needs and eventualities.

  • Hospitalization
  • Day care procedures
  • Pre and post hospitalization expenses
  • Ambulance and room rent
  • In many cases, critical illnesses
  • Dedicated health insurance plans, e.g., cardiac and cardiovascular illness insurance, cancer health insurance, and more. 

Mediclaim: Mediclaim policies are useful as financial security in times of health emergencies and accidents that lead to hospitalization. They provide protection against:

  • Hospitalization expenses subject to the condition that the insured is hospitalized for more than 24 hours
  • Treatment expense for accidents
  • Treatment expense for specific pre-decided diseases


Health Insurance vs Mediclaim Insurance – differences and similarities

FeaturesHealth InsuranceMediclaim Insurance
DefinitionHealth insurance provides comprehensive coverage towards hospitalization, medical treatment expenses, and a wide range of illnesses. It also provides coverage for related expenses such as hospital room rent and ambulance. Mediclaim provides coverage for medical treatment bills that are generated due to hospitalisation, treatments following accidents and pre-decided diseases; in short, when the insured seeks in-patient care at a hospital. It may or may not cover pre and post hospitalization, depending on the policy. 
Sum insuredThe sum insured in the case of health insurance has a higher range, at times in crores, too.The sum insured in the case of mediclaim insurance is usually smaller as it is mostly for accidental emergencies. 
Add-on coverageHealth insurance plans have add-on features, meaning, additional coverage for certain medical conditions, usually at added costs.  Mediclaim plans do not provide add-on facilities. Its coverage is limited to the sum insured.
FlexibilityMost health insurance plans provide flexibility. This means the plans allow increasing or decreasing the sum insured, possibility of change of plan (portability), and changing the duration of the plan. Mediclaim insurance policies do not offer flexibility and are often rigid and limited.
Critical illness coverageMany health insurance plans provide critical illness coverage, such as cancer, cardiac diseases, heart attack, kidney ailments and more. Mediclaim insurance does not provide coverage for critical illnesses.
HospitalizationHealth insurance coverage can be availed by the insured even in cases that do not require hospitalization. It covers daycare, pre-hospitalization, ambulance and other expenses.  Mediclaim insurance coverage can be availed only if the insured is hospitalized. 
Benefit quotientHealth insurance helps secure healthcare needs of various kinds, not just emergencies. Mediclaim helps avail financial protection during medical emergencies.
RenewabilityMost health insurance plans come with lifelong renewability.  Most mediclaim policies can be renewed for a lifetime.
Plan basisHealth insurance plans can be purchased on an individual basis or family floater plan.Mediclaim plans can be purchased on the basis of individual or family floater plans. 
Tax benefitsHealth insurance policyholders can avail of tax benefits on the premium paid. Mediclaim plans offer tax benefits on the premium paid.
Claim settlementThere is no restriction to the number of claims that a policyholder can make in a year.Mediclaim policies allow policyholders to make claims until the sum insured is exhausted.


What is better – mediclaim or health insurance?

A lot of people who are unaware that Mediclaim and health insurance are two different things, end up buying Mediclaim assuming that it will provide them with adequate and comprehensive coverage against all kinds of healthcare needs. This might prove costly to their pocket. To assess which type of plan is better for your needs, ask these questions:

Do both mediclaim and health insurance provide the same extent of coverage?

To begin with, mediclaim, even though it provides coverage for hospitalization, is definitely not adequate to provide coverage for all kinds of diseases, illnesses and health issues. Hence, if you are looking to invest in a health insurance policy that provides wider protection to you and your family, choose health insurance. 

Are tax-saving benefits of mediclaim and health insurance the same?

If you’re investing in health insurance plans as a tax-saving tool, health insurance policies can provide more tax benefits compared to mediclaim plans. Both types of plans offer tax deduction benefits under Section 80D. 

What kind of add-on benefits do mediclaim and health insurance offer?

While health insurance plans offer add-on benefits such as addition of critical illnesses, flexibility of adding new members in a plan, accident coverage, maternity coverage, and more, mediclaim policies lack these benefits. 

How should one choose between the two – mediclaim or health insurance?

Make sure you compare the two. Assess your health needs, your budget, your current financial position, and all the factors that would affect your decision. Most experts recommend buying health insurance because its benefits clearly outnumber those of mediclaim insurance.


Over to you

Before you buy an insurance plan – health insurance or mediclaim insurance – for your family or yourself, it is important to assess your healthcare needs. Both these types of insurance serve the purpose of providing financial protection towards healthcare, but of different kinds. You could even utilize the expertise of our insurance experts at IIFL to understand what would work best for you.


FAQs: Health Insurance vs Mediclaim

What should I buy, mediclaim insurance or health insurance?

The kind of healthcare plan that one must buy depends on a person’s individual needs. Most experts recommend buying health insurance as it provides more comprehensive coverage against more kinds of health needs, diseases and is generally more flexible compared to mediclaim policies.

Mediclaim policies are limited in terms of the healthcare needs that they provide coverage against. Moreover, a mediclaim policyholder can claim the coverage only upon being hospitalized for 24 hours or more, and not for any other medical expenses, unless specified in the policy. If you’re looking for a shorter waiting period and to cover expenses related to accidents and emergencies.

What is critical illness health insurance?

Critical illnesses are those that might prove fatal and require thorough treatment and medical care. Some of the most common critical illness plans offered by insurance companies are for cancer, cardiac diseases, heart attack, and kidney failure. Certain kinds of diseases, such as AIDS/HIV are not included in the critical illness category by certain insurers.

What are the factors that decide health insurance premium?

Various factors affect the health insurance premium. If you’re looking to buy a health insurance plan, you must consider these factors before zeroing-in on a plan. Some of the factors are: age, type of plan, the sum insured, medical history, and claim history, among others.

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