10 Differences Between mediclaim and health insurance

Mediclaim vs Health Insurance

Mediclaim vs Health Insurance

What is Mediclaim?

Mediclaim is a type of health insurance policy that covers hospitalization expenses, providing financial protection against medical emergencies. It focuses on reimbursement of medical expenses incurred during hospitalization due to illness, injury, or surgery. Mediclaim policies usually have a specified sum assured and policyholders can claim expenses up to that limit.

Examples of Mediclaim

  • Policy A covering hospitalization expenses up to $50,000.
  • Policy B providing coverage for specific critical illnesses.

What is Health Insurance?

Health insurance is a broader term that encompasses various types of coverage, including preventive care, outpatient treatments, hospitalization, maternity benefits, and more. It offers comprehensive protection by covering not only hospitalization expenses but also regular medical check-ups, doctor consultations, and other healthcare services. Health insurance policies have different types of plans catering to specific needs.

Examples of Health Insurance

  • Plan A providing coverage for hospitalization, outpatient treatments, and maternity benefits.
  • Plan B covering the entire family for preventive care and regular check-ups.

Differences between Mediclaim and Health Insurance:

Difference Area Mediclaim Health Insurance
Coverage Focuses mainly on hospitalization expenses. Comprehensive coverage including hospitalization, preventive care, and outpatient treatments.
Policy Limit Sum assured specifies the maximum reimbursement limit. Policy limits can vary based on the type of plan and insurer.
Scope Primarily covers expenses related to illness, injury, or surgery. Includes broader services like preventive care, regular check-ups, and maternity benefits.
Additional Benefits Usually lacks additional benefits like maternity coverage or critical illness cover. May include extra benefits such as dental coverage, maternity benefits, and critical illness cover.
Flexibility Less flexible in terms of policy customization and add-ons. Offers more flexibility to choose specific coverage options and add-ons.
Premium Premiums are generally lower compared to health insurance due to limited coverage. Premiums can be higher due to the broader scope of coverage.
Policy Types Commonly available as individual policies. Can have individual, family, or group policies.
Preventive Care Mediclaim policies do not cover preventive care expenses. Health insurance includes coverage for preventive care services like vaccinations and regular screenings.
Claim Process Claim process mainly involves reimbursement of hospitalization expenses. Claim process may involve reimbursement, cashless facilities, or direct settlement with the hospital.
Renewability Mediclaim policies can be renewed annually, subject to terms and conditions. Health insurance policies are generally renewable for a longer period, ensuring continuous coverage.


In summary, mediclaim and health insurance both provide financial protection against medical expenses, but they differ in terms of coverage, policy limit, scope, flexibility, and additional benefits. While mediclaim focuses mainly on hospitalization expenses, health insurance offers a broader range of services including preventive care and outpatient treatments.

People Also Ask:

  1. What is the main difference between mediclaim and health insurance?
    Mediclaim primarily covers hospitalization expenses, while health insurance offers comprehensive coverage including preventive care, outpatient treatments, and more.
  2. Can mediclaim policies cover critical illnesses?
    Mediclaim policies generally do not cover critical illnesses, but some health insurance plans offer specific coverage for critical illnesses.
  3. Can I switch from mediclaim to health insurance?
    Yes, you can switch from a mediclaim policy to a health insurance policy based on your requirements and preferences.
  4. Which type of policy is more suitable for a family?
    Health insurance is more suitable for a family as it provides coverage not only for individual members but also for preventive care, maternity benefits, and regular check-ups.
  5. Is there a waiting period for coverage in mediclaim and health insurance?
    Yes, both mediclaim and health insurance policies may have a waiting period for certain illnesses or specific benefits, which varies between insurers.

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