Everything You Need to Know About Mediclaim Policy

A mediclaim policy is a type of health policy that covers the policyholder's medical expenses in case of illness, accident, or surgery. It provides financial protection by paying for hospital stays, treatments, and other medical services up to the insured amount. These plans typically cover room charges, doctor's fees, diagnostic tests, and ambulance costs.

This blog will explore mediclaim policies, their types, benefits, and tips for choosing a suitable one for your needs. Keep reading for more insight. 

What is a Mediclaim Policy? 

An understanding on the general information of what is mediclaim for a first-time health insurance buyer will help them purchase the best policies available in the market. A mediclaim policy helps pay for hospital expenses when sick or injured. It provides financial protection by repaying or directly paying for eligible medical costs like hospital room rent, doctor's fees, and diagnostic tests up to a specific limit. It is a way to manage the financial burden of unexpected medical emergencies.

What are the Types of Mediclaim Policy?

Mediclaim policies come in various types to cover different healthcare needs, age groups, and financial situations. Listed below are the main types of mediclaim policies:

1. Individual Health Policy

Individual health policy plans are designed to cover only one person. The policy provider pays for medical and hospital expenses up to the insured amount only for that person.

2. Family Floater Policy

A family floater health policy covers the whole family. This single policy covers all of the family's medical costs, and every member of the family shares this covered amount on a floater basis.

3. Senior Citizens Policy

This plan for senior citizens aims to pay for the medical bills of those over 60. It may not require a pre-medical screening before purchasing the policy and concentrates on the health needs of senior persons. 

However, senior citizens face higher health policy costs due to their increased susceptibility to age-related health issues.

4. Critical Illness Policy

Critical illness policy plans are designed to cover the treatment of severe conditions like cancer, heart attacks, strokes, liver failure, and more. When a covered illness is diagnosed, the insurer pays the full insured amount, no matter what the actual medical costs are.

5. Maternity Policy

A maternity policy covers the medical costs associated with pregnancy and childbirth. It covers pregnancy and postpartum costs, medical pregnancy termination, and the costs of treating and vaccinating a newborn. This policy can be chosen by women who are thinking about a pregnancy or who are already pregnant.

How Does a Mediclaim Policy Work?

Mediclaim policy is designed to provide financial support to policyholders during medical emergencies. Here is what you need to understand about mediclaim policies and how they work:

• Coverage: During the coverage period, mediclaim pays for hospital stays caused by critical illnesses, surgeries, or accidents.

• Premium Payments: Policyholders must regularly pay a premium to receive Mediclaim’s benefits.

• Renewal Terms: Mediclaim policies provide predefined coverage, and you must renew the policy at the end of each term to keep receiving benefits.

• Settlement Options: You can choose between cashless hospitalization and reimbursement settlement options.

What are the Benefits of Mediclaim Policies?

Here are some common benefits which are as follows:

• Cashless Settlement: Cashless Mediclaim reduces the policyholder's financial burden by letting the policy company pay the bills and hospital medical costs directly.

• Tax Benefits: Under Section 80D of the Income Tax Act, mediclaim plans provide tax advantages. Premiums paid for policies can be deducted from your income tax up to ₹25,000. And up to ₹50,000 in deductions are available to senior citizens.

• Various Policy Choices: Mediclaim offers a wide range of policy options. You can purchase plans for yourself, your spouse, children, or parents at affordable premiums. There are also specific policies for critical illnesses and senior citizens.

Unlike other mediclaim policies, we have the ABHA card that is managed under the Ayushman Bharat Digital Mission (ABDM), which offers hassle-free medical access to users.

What are the Tips for Choosing the Right Mediclaim Policy?

There are several things that you should consider before choosing a mediclaim policy. Some are as follows:

• Assess Your Needs: To find the policy you require, consider your age, family medical history, and potential health concerns. Make sure the coverage covers hospital stays, acute illnesses, and treatments relevant to your circumstances.

• Compare Coverage and Premiums: Compare different policies based on coverage, premiums, and benefits. Look for policies that offer comprehensive coverage at an affordable premium without compromising on essential benefits.

• Check Network Hospitals: Make sure the policy includes several hospitals, particularly respectable ones in your area. A broad network ensures you can easily access cashless treatment.

• Understand Policy Terms: Read the policy documentation carefully to understand waiting periods, exclusions, inclusions, and claim procedures. If you have any questions, ask the policy provider.

At Star Health, we go beyond basic insurance by offering customized health insurance solutions designed to meet your unique healthcare needs. 

Whether you are looking for individual coverage or a family health plan, we have the right insurance tailored to your needs. You can also use a health insurance premium calculator to help estimate the cost of the policies.