Mediclaim Insurance: A Complete Guide

Medical crises strike without warning, and if you don’t have health insurance, be prepared for a hefty medical expense due to hospitalisation and treatments. Despite escalating healthcare expenses, many overlook and fail to protect our families and ourselves with medical insurance. However, the cost of healthcare services has increased due to medical inflation. Your lifetime savings will be gone if you wind up being taken to the hospital due to a medical emergency. The easiest way to pay for expensive medical care without depleting your resources is to purchase mediclaim coverage. 

What is Mediclaim Insurance?

The cost of healthcare services has increased due to medical inflation. A Mediclaim insurance policy is a kind of medical insurance in which the insurance provider pays the insured’s out-of-pocket costs for treating a medical ailment. If you have mediclaim coverage, you can ask for compensation by giving the insurance provider your receipts.

Additionally, you should be okay with paying the bills if you choose a cashless treatment option. The insurance provider will pay the hospital immediately to settle the debt. However, you must have treatment at one of the insurer’s network hospitals to use the cashless facility.

Different Features of Mediclaim Insurance

People with sedentary lifestyles run a significant risk of contracting many ailments. Medical insurance coverage might enable you to access money when needed. Because of the following factors, a lot of individuals nowadays choose to get a Mediclaim policy:

1. Medical expense security is offered through mediclaim.

2. Cashless payment options are available at network hospitals.

3. Both individuals and their families can access medical insurance.

4. It provides tax advantages on the yearly premium.

Types of Mediclaim

Mediclaim insurance has different types of health insurance plans, depending on your specific requirements. One can choose from the below-mentioned mediclaim policies: 

1. Individual Mediclaim Policy:  

Individual mediclaim policies, as the name implies, take the sum insured for each covered person individually, and only the specified individuals are eligible for the benefits mentioned in the policy.

2. Senior Citizen Mediclaim Policy: 

It is a mediclaim policy that provides coverage to persons over 55.

3. Family Floater Mediclaim Policy: 

The coverage of a family floater plan in medical claim is split among all insured family members. It is also possible to say that coverage is provided to a single person, who can extend it to their entire family.

4. Critical Illness Mediclaim Policy: 

Hospital expenditures swiftly deplete your finances when combating life-threatening ailments such as cancer, renal failure, heart disease, and so on. Critical illness mediclaim coverage helps to reduce such costs by providing a lump sum payment upon sickness diagnosis.

5. Personal Accident Mediclaim Policy: 

This mediclaim coverage covers permanent complete disability, temporary total disability, accidental death, and permanent partial disability.


There are several benefits of mediclaim. Some of the benefits are:

1. Coverage for Medical Expenses

Mediclaim provides coverage for medical costs incurred by the policyholder. This includes hospitalisation, diagnostic tests, doctor consultation fees, and other related expenses.

2. Cashless Hospitalisation

Many medical insurance policies offer cashless hospitalisation. This means that the policyholder does not have to pay for the medical expenses upfront. Insurers settle hospital bills directly with hospitals.

3. Tax Benefits

Insurance premiums are eligible for tax benefits under Section 80D of the ITA (Income Tax Act).

4. No-claim Bonus

If the policyholder does not make any claim during the policy period, many insurance companies offer a no-claim bonus. This results in a discount on the premium for the next policy period.

5. Comprehensive Coverage

Mediclaim insurance policies cover a wide range of medical expenses. This includes pre and post-hospitalization expenses, ambulance charges, and alternative treatments such as Ayurveda, Homeopathy, and Unani.

Things to Consider Before Buying Mediclaim Insurance

A medical claim is a legal agreement between the insured and the insurer. People should thus be careful while selecting a plan and provider. Here are a few things that one needs to consider. 

1. Coverage

Make sure that the policy provides coverage for the medical expenses that are important to you. Check the list of diseases and treatments covered by the health insurance policy.

2. Premium

Compare the premium of different policies to find the one that fits your budget.

3. Network hospitals

One must check the list of network hospitals. This will help you in case of cashless hospitalisation.

4. Co-payment

Some policies have a co-payment clause. This means that the policyholder has to pay a certain percentage of the medical expenses incurred.

5. Sum insured

It is the maximum amount the insurance company will pay in case of a claim. Make sure that the sum insured is adequate to cover your medical expenses.

Mediclaim insurance is one of the finest strategies for coping with the financial stress that results from medical issues. Due to the rarity of expensive medical emergencies, many people opt not to get medical insurance coverage. Often, people put off purchasing it until the very last minute. But, it’s crucial to understand that the best mediclaim policy in India, purchased in advance and with the right preparation, may ensure a smooth passage through medical situations.

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