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How Is Mediclaim Different From Health Insurance

Health Insurance


Paying for healthcare expenses in today’s times can be very challenging, so investing in insurance is recommended. People often get confused while purchasing health insurance.

One of the most frequent concerns is to assume that mediclaim is synonymous with health insurance. In truth, mediclaim and health insurance plans can be vastly distinct. Knowing this difference could be of great help in making an informed decision.

You should choose the one that suits your individual medical needs and financial limitations after understanding what each one covers and the premium you need to pay. You can use an online health insurance premium calculator to get a good idea of your premium amount.

What is health insurance?

It is a plan through which you can get compensated for your medical costs. Some essential cost insurance providers cover you for can be –

  • Hospitalisation
  • Ambulance
  • Pre and post hospitalisation
  • Critical illness
  • Diagnostic tests
  • Surgery
  • Medication
  • Consultation
  • Accidents
  • Room rent
  • Daycare

Depending on the policy terms, coverage for some of these costs might be part of the basic plan, and some might be needed to be bought as an add-on by paying extra. A critical illness insurance plan may have to be bought as a standalone policy. Many health insurance plans can offer comprehensive coverage with small premiums. They also offer a cumulative bonus if no claims are made during the policy period. * 

* Standard T&C Apply

What is Mediclaim?

Scope of coverage is the primary differentiator between Mediclaim and health insurance. Mediclaim is a form of health insurance that provides specific financial protection against health-related costs. It can be a cost-effective method for mitigating any health-related emergency. However, Mediclaim coverage could be restricted to hospitalisation; the insured may be responsible for additional medical expenses. *

* Standard T&C Apply

Health insurance Vs Mediclaim

The main difference between the two can be coverage. The below table highlights other differences in regards to health insurance vs mediclaim for a better understanding *:

Factor Health insurance Mediclaim
Coverage* A health insurance plan may provide full medical coverage for hospitalisation expenses, pre-hospitalisation costs, post-hospitalisation costs, ambulance expenditures, and other medical fees. In addition, it may include compensation for income loss resulting from an accident. *


A mediclaim plan may cover hospitalisation, accident-related care, and pre-existing conditions up to a predetermined maximum.
Extra covers It may include multiple add-on covers such as critical illness coverage, personal accident coverage, and maternity coverage. * It offers no additional coverage *
Flexibility Health insurance plans may allow for modifications in coverage, duration etc., in the near future. * Mediclaim plans can be rigid
Cover for Critical illness Depending on the type of policy, critical illnesses might be covered by a special critical illness plan that offers a lump sum. Mediclaim does not cover critical conditions
Value insured High. Can even beyond 60 lakhs a year Does not exceed five lakhs
Claims In health insurance, claims can be filed as long as the insured’s sum insured has not been depleted. A policyholder may submit several claims until the total amount insured is exhausted.
Hospitalisation The insured does not need to be hospitalised to obtain health insurance benefits. Benefits such as daycare procedure coverage can be obtained without hospitalisation. * In order to get medical insurance benefits, the insured must be hospitalised.

* Standard T&C Apply

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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