Mediclaim Insurance: Meaning, Benefits, Types & Coverage Explained
The medical inflation rate in India is 13-14%, whereas the general inflation rate has been close to 2-4% in the past few years. This simply implies that an individual is always at risk of losing all their savings due to a single hospitalisation or treatment of a critical illness. For individuals with multiple dependents, it is essential to understand that the risk of default or bankruptcy is significantly higher due to the ever-increasing costs of medical care.
In such a case, health insurance is one of the most effective financial planning tools available. The premium-benefit ratio of a health insurance plan is quite high. Hence, you pay a few thousand per year, and your family's health is covered; your insurance company pays all hospitalisation costs up to a given level. A Health Insurance policy ensures that you enjoy complete peace of mind and your family gets only the best and state-of-the-art treatment when needed.
In this blog, we explain the meaning of Health Insurance, its benefits, types, and how to choose the right plan for your needs.
What is Mediclaim Insurance?
Mediclaim Insurance is a category of health insurance that provides financial coverage for hospitalisation expenses, which can range from a few thousand to tens of lakhs. Suppose you or someone from your family meets with an accident. In that case, if you suffer an illness or require surgery that necessitates hospitalisation, a Health Insurance policy ensures that the insurance company covers your expenses.
Based on the terms and conditions of your insurance policy, you can get cashless treatment or get a reimbursement of the bill paid. It is designed to cover essential medical needs, ensuring policyholders don't have to dip into their savings during emergencies.
How Does Mediclaim Insurance Work?
When you purchase a Mediclaim Insurance policy, the insurer provider gives you a list of network hospitals where your hospitalisation is covered on a cashless basis. Hence, if you or anyone from your family is admitted for treatment in the network hospitals, you do not need to pay anything upfront, and your out-of-pocket costs are quite low (except for a few consumables and mandatory expenses).
However, in the event of an emergency, you may not have time to find a network hospital. If you have to choose the nearest best healthcare centre for treatment, you might not get a cashless advantage, but your bills will be reimbursed later by your insurance company.
Mediclaim Insurance Vs Health Insurance
The two terms are often used interchangeably. However, the two concepts (Health Insurance and Mediclaim Insurance) are quite different from each other in context and scope. Mediclaim Insurance primarily takes care of hospitalisation and related expenses, whereas a health insurance policy provides a broader coverage that includes preventive, critical illness, maternity cover, and wellness care for the policyholder and family members.
- Mediclaim Insurance = Basic hospitalisation cover
- Health Insurance = Comprehensive coverage, with add-ons and preventive benefits
For individuals seeking low-cost financial protection, Health Insurance is a suitable option; for comprehensive health coverage, health insurance is a better choice.
The Different Types of Health Insurance Policies
Individual Health Insurance Policy
It refers to a policy that covers only one person (the policyholder) for hospitalisation expenses up to the sum insured.
Family Floater Mediclaim Policy
This type of Health Insurance policy provides coverage for the entire family, making it highly cost-effective. You do not need to purchase separate policies when you have a family floater plan.
Senior Citizen Mediclaim Policy
This Health Insurance's terms and conditions are designed to cater to the unique needs of senior citizens.
Critical Illness Mediclaim Policy
Offers a lump sum benefit on diagnosis of major illnesses like cancer, kidney failure, or heart disease.
Top-up Mediclaim Policy
Acts as a supplementary cover once your base Health Insurance policy limit is exhausted.
Benefits of Mediclaim
Cashless Hospitalisation
You get complete peace of mind, as the need for upfront payments during hospitalisation is no longer required.
Affordable Premiums
Compared to the health insurance plans, Health Insurance policies have lower and affordable premiums.
Tax Benefits under Section 80D
Premiums paid towards Health Insurance qualify for tax deductions under Section 80D of the Income Tax Act, offering dual benefits of savings and protection.
Wide Network Hospitals
There are insurance companies, such as ManipalCigna, that provide access to thousands of empanelled hospitals, ensuring nationwide reach for high-quality treatment.
Pre & Post Hospitalisation Cover
Health Insurance doesn't just cover hospital bills, but also expenses such as diagnostic tests, medicines, and follow-up visits within a specified period.
Mediclaim Policy Coverage -- The Inclusions and Exclusions
Inclusions generally cover hospitalisation due to illness, accidents, surgeries, daycare treatments, and ambulance charges. Exclusions include cosmetic procedures, self-inflicted injuries, pre-existing illnesses during waiting periods, and non-allopathic treatments. Always read the policy wording carefully before purchase.
Who Should Buy Health Insurance?
Young Professionals
Health Insurance offers affordable protection at the start of your career, when savings are limited.
Heads of Families
Family floater policies make it convenient to cover all family members under one plan.
Senior Citizens
Tailored plans provide cover for age-related health issues and higher hospitalisation risks.
Entrepreneurs and Self-Employed Individuals
Health Insurance provides a safety net when there is no employer-provided health coverage.
How To Buy a Mediclaim Policy Online?
- Compare policies online for benefits and premiums.
- Select the sum insured based on your needs.
- Fill in the proposal form with accurate details.
- Pay the premium and receive the policy instantly in your inbox.
Buying online ensures transparency, quick comparisons, and faster issuance.
ManipalCigna Comprehensive Health Insurance Plans
ManipalCigna offers a range of Health Insurance plans that combine affordability with comprehensive benefits. With a wide hospital network, cashless claim settlement, and strong customer support, ManipalCigna policies are designed to provide peace of mind during medical emergencies.
Summing up
Health Insurance is a must-have financial tool that safeguards you against rising hospitalisation costs. It provides affordable premiums, tax benefits, and wide coverage, making it suitable for all age groups and professions. Explore ManipalCigna Health Insurance plans today to stay financially secure and health-ready.
FAQs
Does Health Insurance cover pre-existing conditions?
Health Insurance policies usually cover pre-existing conditions after a waiting period, which may range from 2 to 4 years, depending on the insurer. Coverage begins only once this period is completed without any policy breaks.
How to file a Health Insurance reimbursement?
To file a reimbursement claim, submit the hospital bills, discharge summary, prescriptions, and claim form to the insurer after discharge. The insurer verifies the documents and reimburses eligible expenses directly to your bank account.
