Difference between Health Insurance and Mediclaim

Still confused whether to buy a health insurance policy or a mediclaim policy? Aren’t they one and the same? Let’s outbreak the myth today and know both Health insurance policy and mediclaim in detail!

I certainly didn’t know that Mediclaim and Health insurance policies are two different terms!

Until Health insurance came into existence in India, Indians were only aware of Mediclaim policies. However I still know people, who use both these words interchangeably. I recently walked in to a bank where they sold health insurance policies and the bank representative addressed it as mediclaim. I kept wondering, as the pamphlet stated Health insurance policy and not mediclaim policy.

Curiosity kills me! So I thought of bursting the myth myself and this is what I found.

“Health is wealth”- Undoubtedly it is! And these policies are saviors, who lessen your burden and not burn your pockets at the same time.

Difference between health insurance policy and Mediclaim policy

Health insurance policies

  • Health insurance policies are more of a comprehensive type of policies. Which means it not only covers your hospitalization charges but also look after the pre and post hospitalization expenses.
  • They provide critical illness cover for more than 30+ diseases. Diseases like Cancer, Kidney Failure, stroke etc. are covered.


  • Critical illness is a rider or an-add on, which means it is not included in the policy.
  • The diseases covered in critical illness completely depends on the discretion of the insurance company.
  • Discounts can be availed on premium on renewal.

Mediclaim policies

  • Mediclaim only covers hospitalization expenses and treatment towards an accident or any specific illness.
  • It does not cover critical illness and other hospitalization charges like a health insurance policy.

The Obvious difference between a Health Insurance policy and a Mediclaim policy are as below:

Health Insurance policy Mediclaim policy
Other Expenses A health insurance policy not only covers pre and post hospitalization expenses, but also other expenses like ambulance, compensation for the lost income, etc. All these are provided at the discretion of the insurance company and depending on the benefits provided by them. It does not take care of the other expenses, except the hospitalization charges.
Sum Assured The sum assured of a health insurance policy does not exceed Rs. 6 Crore. The sum assured does not exceed more than Rs. 5 lakh.
Claims In a health insurance policy, with critical illness or accidental disability cover, the sum assured is paid in one shot. Hence claim can only be made once. With mediclaim you can keep making claims until the entire amount is exhausted.

Since the myth is now broken. It proves that there is not much of a difference between a Health insurance policy and a mediclaim policy. However it would be advisable to buy a health insurance policy since it not only takes care of hospitalization but also other expenses related to it.

Source : www.coverfox.com


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