Mediclaim

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How is Mediclaim Different from Health Insurance?

Insurance companies offer health insurance products under two broad categories – indemnity policies and benefit policies:

  • Benefit policies are mostly traditional health insurance policies which pay out a pre-determined “sum insured” amount on the occurrence of an accident, or diagnosis of any of the illnesses, diseases, conditions, etc. that have been insured against. Traditional insurance policies work this way, offering you a financial benefit up-front and not necessarily requiring you to submit hospital bills, etc.

  • Indemnity policies compensate or reimburse you for the expenses incurred during your hospitalization or domiciliary care, on the submission of necessary proofs, up to the limiting amount mentioned in the policy. Mediclaim is an example of such a product. Although with recent advancements, mediclaim enables cashless hospitalization facilities wherein the insurer pays the hospital directly.

How is Mediclaim Different from Health Insurance?

Insurance companies offer health insurance products under two broad categories – indemnity policies and benefit policies:

  • Premiums – that are payable on Mediclaim policies differ between insurers but are based on certain criteria like age of the proposer, geographical area of treatment, sum insured, term of plan, etc.
  • Age – of insured persons can range from 5 years to 80 years, although age criteria and range insurable varies between companies.
  • Family cover – You can provide Mediclaim cover for your entire family with the payment of one master premium. This may also make you eligible for discounts on your premium, depending on your provider.
  • Claims – are administered largely through Third Party Administrators (TPAs) these days, but a few insurers deal with claims in-house.
  • Types – Mediclaim policies are available in a range of types, depending on the need and the category of those to be insured. You can get individual policies, group policies, senior citizen policies, critical illness policies and special maternity policies.
  • Tax benefits– under Section 80D are available up to Rs.15,000 on mediclaim premiums for yourself, spouse and dependent children. An additional Rs.15,000 of tax exemption is available if you insure your parents, and the amount goes up to Rs.20,000 if they are senior citizens.

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