We’ve all heard our grandparents tell us stories about the meagre costs of living when they were young. They could buy gold for a mere hundred rupees and properties in cities like Mumbai for a few thousands. Those numbers seem almost a myth today, when a 5-minute consultation with a doctor cost ₹1,000+ and a simple medical procedure costs lakhs of rupees. This number is only expected to increase in the coming years. As inflation continues to be at an all-time high, the only way to protect your savings during medical emergencies, is through Mediclaim and Health Insurance plans. Let’s find out what is Mediclaim, and asset the different types of Mediclaim policies offered by insurers.

What is Mediclaim Insurance?

Mediclaim is a type of insurance plan that provides coverage for medical expenses incurred by you. Essentially, Mediclaim serves as a financial safety net, helping you manage the costs associated with healthcare services and treatments. In India, the term Mediclaim is often used interchangeably with Health Insurance, but there are factors that distinguish the two concepts considerably.

How Does Mediclaim Insurance Work?

Mediclaim insurance operates on a simple idea – you pay a regular premium to the insurance provider, and in return, the insurer covers a portion or your entire medical expenses. When you require medical attention, you can avail of cashless treatment at network hospitals or opt for reimbursement by submitting the bills to the insurance company. This system makes sure that you have access to medical services without facing a significant financial burden.

Mediclaim Insurance Vs Health Insurance

Following are a few key differences between Mediclaim and Health Insurance:

Aspect	Mediclaim Insurance	Health Insurance
Premise	Mediclaim policy coverage mostly focuses on hospitalization-specific expenses.	Health Insurance provides broader coverage, including preventive care, outpatient treatments, etc.
Premiums	Mediclaim policy premiums are usually low.	Health Insurance premiums may be high due to extensive coverage.
Policy Duration	These policies come with a one-year validity, which you must renew each year	You can find both, annual and long-term policies with 2-3 years of coverage.
Coverage	Insurer may cover only a few, specific medical expenses.	You can enjoy comprehensive coverage for various health-related costs.

 

The Different Types of Mediclaim Policy

If you’re looking for the right type of Mediclaim policy, you can choose from these options:

• Individual Mediclaim Policy

An Individual Mediclaim Policy caters to one person, providing personalized health coverage. The premiums are determined based on your health profile and age, ensuring a personalized and targeted approach to healthcare coverage.

• Family Floater Mediclaim Policy

A Family Floater Mediclaim Policy, also known as Mediclaim for family, offers collective health coverage. This cost-effective option covers medical expenses for all family members under a single policy wherein the covered members must split or share the sum insured amount.

• Senior Citizen Mediclaim Policy

A Senior Citizen Mediclaim Policy is designed for individuals above the age of 60 years, looking after specific healthcare coverage needs. It typically provides coverage for age-related health concerns. The premiums of such policies tend to be higher as seniors’ health usually declines after a certain age.

• Critical Illness Mediclaim Policy

A Critical Illness Mediclaim Policy  provides coverage against specific severe illnesses. It helps you bear the costs associated with the treatment of long-term illnesses like cancer, heart diseases, kidney ailments, etc. Insurers pay the whole sum insured as a lumpsum to help you manage the high costs.

• Top-up Mediclaim Policy

A Top-Up Mediclaim Policy acts as an additional layer of financial protection, covering medical expenses beyond a policy’s base sum insured amount. It is a cost-effective way to enhance coverage, providing added security against unexpected healthcare costs without the need for a separate policy.

Features of Mediclaim Policies

Navigating the realm of Mediclaim policies involves understanding their distinctive features, designed to look after your different healthcare needs. Here’s a closer look at the key elements:

• Sum Insured:

This crucial feature signifies the maximum amount your insurer will pay in the event that you need to file a claim.

• Policy Period:

Mediclaim policies are typically valid for 1 year. You must renew the policy every year to enjoy continuous coverage.

• Cashless Hospitalization:

You can seek cashless medical treatment at any hospital in your insurer’s network. Their representative deals with the hospital and manages the payments.

• Pre and Post-Hospitalization Coverage:

Your insurer also incurs the costs associated with pre and post-hospitalization, such as diagnostic tests, post-surgery consultations, etc.

Understanding these features empowers you to make informed choices and find the best Mediclaim policy that matches your specific coverage needs based on your budget and affordability.

Mediclaim Policy Coverage – The Inclusions and Exclusions

Let’s assess what’s included and excluded under Mediclaim policy coverage with this helpful table:

Inclusions In Mediclaim	Exclusions In Mediclaim
Expenses like room rent, doctor’s fees, nursing charges, etc. are included in the cover.	Voluntary cosmetic procedures such as rhinoplasty, bariatric surgery, are not covered.
You can get coverage for procedures that do not require overnight hospitalization.	Costs associated with external devices such as contact lenses and hearing aid are not covered.
You can file both, cashless and reimbursement claims.	Coverage for certain specific illnesses, caused by bad lifestyle habits.

 

Who Should Buy Mediclaim?

Ideally, everyone should buy Mediclaim as it serves as a valuable for the financial safety net against medical emergencies. But if we had to categorize the ideal customers for Mediclaim policy coverage, the following would make the cut:

• Young Professionals:

As a newly employed professional earing a salary, you must set aside a small sum to invest in a Mediclaim policy. Insurers typically levy low Mediclaim policy premiums from young, healthy buyers.

• Heads of Families:

If you’re the head and only working member of the family, looking for an affordable policy that covers all your loved ones, you can go for a Family Floater Mediclaim policy.

• Senior Citizens:

If you are above the age of 60 years, you should get a specialized senior Citizen Mediclaim policy that addresses your unique healthcare needs and age-related health concerns.

• Entrepreneurs and Self-Employed Individuals:

If you are not covered under any family or group Health Insurance plans, you should invest in an individual Mediclaim policy.

Mediclaim is not a one-size-fits-all solution; it changes per different needs, making it an essential financial tool for individuals and families across different life stages and professional situations.

How to Choose the Right Mediclaim Policy?

Choosing the right Mediclaim policy is crucial for effective health coverage. Follow these simple steps:

a) Consider your health condition, lifestyle, and family medical history.

b) Compare policies from different insurers to find a balance between cost and coverage.

c) Ensure that the insurance provider has a network of hospitals in your vicinity.

d) Assess the inclusions and exclusions, waiting periods , renewal terms.

e) Check the claim settlement ratio and customer reviews before locking in on a policy.

Did you know? Your insurer’s Claim Settlement Ratio denotes the number of claims received versus the number of claims settled per year. You must choose an insurer with a high settlement ratio.

 

How To Buy a Mediclaim Policy Online?

You can buy Mediclaim policies online by following these steps:

a) Research the various insurance providers and policies they offer to understand your options.

b) Compare the premiums charged against the coverage offered to find the best plan.

c) Visit the official website of your chosen insurance company.

d) Fill the online application form truthfully and submit the asked documents for KYC compliance.

e) Pay the medical policy premium online choosing your preferred payment method.

 

In some cases, the insurer may ask you to undergo a medical test, after which they will create and mail the policy agreement to your email and registered address.

Prepare For the Unexpected With Manipal Cigna Health Insurance Plans

In a country like ours, where healthcare costs are rising, investing in a Mediclaim policy can prove to be a wise decision. Your search for the top-rated Mediclaim policies across varying budgets ends with Manipal Cigna Health Insurance. Whether you need family floater Health Insurance, cashless Mediclaim policy for family, or a medical insurance policy for parents, you can find them all on our website. What’s more we offer you all the benefits of an online Mediclaim policy, including the facility to buy your plan and file claims online. Visit our website today to find the best Mediclaim policy for yourself and your loved ones.

Invest in a Mediclaim plan from Manipal Cigna Health Insurance today protect your savings tomorrow!

FAQs

What are the criteria to be eligible for Mediclaim?

Almost everyone can buy a Mediclaim policy today. Your specific eligibility depends on factors like your age, health condition, pre-existing ailments, lifestyle habits, and so on.

What is the meaning of co-payment in Mediclaim Insurance? 

In Mediclaim insurance, co-payment is a clause under which you have to bear the costs of your medical expenses up to a fixed percentage, while the insurer pays the rest. If your policy includes a co-payment clauses, you may have to pay a lower premium.

What documents must I submit while filing an insurance claims?

Insurers typically ask you to provide documents such as a copy of your insurance policy, doctor’s prescriptions, medical tests, discharge summaries, etc. They also need you to provide all bills in original along with the duly-filed claim form.

Is it possible to purchase an online Mediclaim policy?

Yes, you can buy Mediclaim online easily. Most Insurance companies today offer this facility through their apps and websites, where you can fill the application form online and submit the necessary KYC compliance documents.

Is it possible for Mediclaim to be cashless?             

Yes, Mediclaim can be cashless. With a cashless mediclaim policy for family, you do not need to pay for medical expenses upfront at network hospitals. Instead, the insurer settles the bills directly with the hospital, making it a hassle-free process for you during times of illnesses or emergencies.

How many times can I use my Mediclaim?

The number of times you can file an insurance claim depends on the specific terms under your Mediclaim insurance policy. Most insurers let you file multiple claims in a year, without any specific limits. The only caveat is that you cannot file claims or get coverage beyond the sum insured limit.