Types of Mediclaim Policies Available in India

If you have visited a healthcare facility such as a hospital recently, you will know that even a simple test or procedure can burn a hole in your pocket. It may seem impossible for the common man to afford good medical treatment without exhausting his savings. This is where a Mediclaim policy can help. A Mediclaim policy in India has become a prerequisite to avail the best possible treatment during a health emergency, considering the skyrocketing healthcare costs. But the availability of various options under Mediclaim may be confusing for the insurance policy buyer. This article offers a quick rundown of the different types of Mediclaim policies in India and their unique benefits.

What is a Mediclaim Policy?

A Mediclaim policy or a health insurance policy is an insurance plan in which the insured is reimbursed for hospitalisation expenses that may have been incurred during the policy period. The insured can either submit the medical bills to get the reimbursement or avail cashless facility at network healthcare centers and hospitals. Mediclaim policies provide coverage for illnesses and hospitalization up to the specified sum insured. It is valid for a certain period (usually one year) after which it must be renewed to continue services. Depending upon the sum insured and the coverage period, a premium amount must be paid to keep the policy active.

Types of Mediclaim Policies in India

  1. Individual Health Insurance
    An individual Mediclaim policy can cover you, your spouse, children and parents as individuals, with respective sum insured amounts. This kind of policy covers your medical expenses for illnesses and injuries, such as surgery, hospitalization, daycare procedures, room rent, and other medical expenses. Each member covered under the policy can choose a distinct sum insured depending upon coverage required.
    The premium charged depends upon the insured’s age, medical history, coverages and sum insured. The claims on an individual’s Mediclaim policy does not affect the sum insured for other members.
  2. Family Floater Health Insurance
    In a family floater Mediclaim plan, the coverage is provided to all the family members including spouse, parents, children, and dependent members. The coverage is similar to an individual health plan, except that all family members are covered under a single sum insured.
    The premium under this plan usually depends upon the age of the oldest policyholder. This plan is ideally suited for a family that has younger members without serious health issues, so that the premium is more affordable and the sum insured amount is not exhausted quickly
  3. Group Health Insurance
    A Group Health Insurance Mediclaim policy is typically provided by an employer to its employees. A Group medical cover plan offers coverage for hospitalization due to illnesses or accidents, and for other optional coverages such as maternity. The coverage is usually for a limited sum insured, with benefits specified by the employer.  Sometimes policy coverage can be extended to other family members by paying extra premium. Group Mediclaim policy benefits terminate if you leave your organization.
  4. Senior Citizens Health Insurance
    The Senior Citizens Mediclaim policy is dedicated to individuals above 60 years of age who are more vulnerable to serious illnesses. Health insurance for senior citizens will offer coverage for hospitalization due to illness or accident, pre- and post-hospitalization and treatment for age-related conditions among others.
    The premium for this plan may be higher than others due to its extensive coverage, but a Senior Citizens plan is ideal to ensure the best medical coverage for seniors in their post-retirement years.  Many Senior Citizen plans bring premiums down by requiring a Co-Pay percent to be paid by the insured on their claims.
  5. Critical Illness Insurance
    As the name suggests, a critical illness plan covers expenses incurred to treat life-threatening diseases such as certain cancers, kidney failure, paralysis, stroke and so on. The cost of treatment of such ailments is very high, requiring multiple hospital visits and other expenses including doctor visits and tests.
    The illnesses covered are mentioned at the time of policy purchase, and depending on the type of policy the sum insured is paid as a reimbursement of expenses or in lump sum to cover all medical costs.
  6. Covid 19 Cover
    While Covid19 is covered under your medical insurance, there are Covid 19 specific plans which give you cover for medical expenses relating to Covid only. These are useful in the current pandemic as special covers.

SANA.Insure helps individuals and families choose the Mediclaim policy that is best suited to their needs. You can avail of optimal medical cover and unique benefits of the plan that can be conveniently renewed each year. Check out SANA.Insure for quick access to policy information, perform comparative analysis and choose the best health insurance for parents, individuals and families customized to your requirements.

Get in touch with us over WhatsApp chat on 8278271818. or call us on 1800 202 8118 to connect with a Health Insurance Expert at SANA.Insure.

Wish you a healthy and happy life!


Frequently Asked Questions

- How do I choose my mediclaim policy?

Choosing your Mediclaim policy depends upon your personal needs, health condition and future medical requirements, whether for an individual, family, elderly people, or a group health insurance plan for company employees. SANA.Insure can help you choose the best plan with a wide selection of plans in India, easy to understand information and personal assistance to guide you along the buying journey.

- What is the best cashless mediclaim policy in India?

The best cashless Mediclaim policy would depend upon the insurer and the number of network hospitals and healthcare facilities associated with that insurance company within your area of residence.

- How much mediclaim should I have?

The amount of Mediclaim to be taken would be a factor of your personal and/or family dynamics i.e. whether you need an individual plan, a family floater policy or a senior citizens plan, or if it is for the employees of your organization. Additionally, the past and ongoing health condition as well as future healthcare requirements would also determine the amount of sum insured to be taken in your health insurance policy.

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