What are some important aspects of a Mediclaim policy

Modern sedentary lifestyles and stressful routines have caused a majority of people to suffer from lifestyle diseases and other illnesses. The ever-increasing cost of medical care has created awareness among people to buy health insurance. However, there are several aspects of health insurance that people still need to know, to find the most suitable health insurance cover for themselves.

In this article, we will explain what a Mediclaim policy is and address some important aspects of mediclaim policies.

What is a Mediclaim Policy?

Mediclaim policies offer financial cover for an individual’s hospitalization, or expenses incurred for certain diseases treatment or surgery for a pre-specified sum.

Some of the important aspects of a Mediclaim policy are:

  • Indemnity Basis- A Mediclaim policy works on an indemnity basis. In simple terms, it means that if the policyholder incurs any hospitalization expenses, the insurance company will reimburse those expenses. 
  • Reimbursement -If an individual has a mediclaim policy, he can submit his medical bills to the insurer and request reimbursement.
  • Cashless Treatment -When the medical treatment is obtained by the insured persons from a network hospital of the insurance company, they need not worry about paying the bills. Instead, the insurer settles the bill with the hospital directly.
  • Diverse Range - Mediclaim policies are available to suit various insurance needs, like individual or family floater policies, group mediclaims, senior citizen policies. There are policies for critical illness, medical expenses due to personal accidents, and even vector-borne diseases.
  • Cost effective-These policies offer a cost-effective way to cover healthcare expenses in case of hospitalization.

Important Features of a Mediclaim Policy

Now that you have some clarity as to what a mediclaim policy is, let us look into some important features of such a policy. Coverage: Mediclaim policies cover hospitalization costs arising from accidents,  ailments and emergency surgeries.

  • Plan Basis: Mediclaim policies can be taken on an individual or a family floater basis to cover self, spouse and dependents.
  • Sum Insured: Mediclaim policies have a pre-decided sum insured range for hospitalization expenses to choose from. Comprehensive health insurance plans offer a wide range of sum insured as per the individual or family’s needs.
  • Hospital Stay – Expenses incurred for hospital stay for more than 24 hours, like bed charges in private rooms, general wards, or ICU, are also covered.
  • Hospital Charges-A mediclaim policy will generally cover hospital charges like blood, oxygen cylinder, Operation Theatre charges, room rent, medical tests, etc. Also, doctor’s fees and consultation charges are covered.
  • Day Care Treatment –This covers the treatment that requires hospitalization for less than 24 hours.
  • Premiums: Different insurers charge different premiums for Mediclaim policies based on the coverage, policy holder’s age, policy tenure, number of people covered, etc.
  • Tax benefits: These policies provide tax benefits to the insured for the payments made towards the premiums under Sec 80D of the Income Tax Act.

Selection of the right mediclaim policy may require prudence and analysis as hundreds of products are available in the market. An individual’s financial budget, insurance needs, coverage requirements and many other factors determine the type of policy he has to choose. One has to read the fine print in the policy terms and conditions document (typically called “Customer Information Sheet” or “Policy Wordings”) carefully to determine the scope of coverage, features, and benefits available under such policies.

SANA.Insure is a Health Insurance specialist that offers the right advice to help you select the best option. We provide quick, prompt and hassle-free service to make health insurance easy for you.

Log on to our portal to find customized health insurance plans and compare various plan options that suit your requirements. You can also 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!

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