- Mediclaim insurance policy is a health policy that takes care of your medical expenses up to the sum insured in case of any health emergency. In this, the insurance company bears the cost of inpatient cover, daycare treatment, etc. for hospitalization in case of accident or illness.
Mediclaim Policy Benefits and Other Features
Before taking a mediclaim insurance policy, it is important to know its benefits and other features. Also, in view of the increasing medical expenses, diseases, hospital expenses, etc., it is necessary to have a mediclaim policy for financial support. It can provide support in case of a medical emergency. It has other insurance benefits like:
Fair price
Mediclaim policy is a reasonably priced policy for availing medical facilities.
Cashless treatment
In case of medical emergency, you can get treatment in a network hospital at no cost.
Reduces financial stress: Mediclaim reduces the financial pressure on the policyholder and his/her family.
Individual and Family Floater: Both individual and family floater are available in mediclaim policy.
Pre and post-hospitalization expenses: Mediclaim policy covers 3060 days pre-hospitalization and 60120 post-hospitalization expenses. It also helps with ambulance and emergency evacuation facilities.
Daycare hospitalization
Expenses that do not require 24 hours hospitalization.
Lifetime Renewal Cover: As per the insurance company, the Mediclaim policy gives lifelong renewal cover.
Additional Benefits: ICU, separate treatment, annual check-up expenses are also covered.
Benefits of Tax Exemption: You can also avail of tax benefits on Mediclaim premium payment under Section 80D of the Income Tax Act 1961.
Types of Mediclaim Policy
There are many types of medical policies available. You can be sure of getting a policy according to your needs. Let’s have a look at some of the medical plans:
Individual Mediclaim Policy
Individual mediclaim policy covers only the holder. Only one person can take medical insurance benefits on payment of premium. There are many health insurance companies in India that offer individual mediclaim policies.
Senior Citizen Mediclaim Policy
Senior citizen mediclaim policies cover hospital outflow expenses for people who are above 60 years of age.
Critical illness mediclaim
The cost of serious illness is very high. Chronic illness insurance covers life-threatening diseases like kidney failure, cardiovascular disease, etc.
Comparison of Mediclaim Policy and Health Insurance
Mediclaim policy
- It pays for your medical expenses.
- It covers more than time illness like hospitalization expenses due to accidents.
- This is a policy to save on hospitalization expenses.
Health insurance
- It gives you a lump sum amount in addition to medical expenses on the diagnosis of any chronic disease.
- It only covers diseases like heart attack, kidney failure, paralysis.
- It only covers critical illness expenses and It also compensates for financial loss due to illness.
There are two types of claims in a mediclaim policy:
Cashless Process:
In the cashless process, the insurance company either settles the entire claim or part of it with the hospital for treatment in a network hospital. This means that the holder does not have to pay a single rupee to the hospital. You need to follow the following steps for an easy claim process.
First of all, all the hospitals have an insurance desk. The policyholder will have to take the pre-authorization form from that desk in which all the information will have to be filled, otherwise, the claim will be received late. This form has to be sent by fax to the insurance company or to a third-party administrator (TPA) after getting stamped from the hospital. After checking the complete form, the insurance company will accept some amount and fax it again to the hospital stating that they have accepted the amount ‘A’ for the treatment.
Payoff:
Reimbursement The insurance company has to be informed about the hospitalization that has taken place or any future hospitalization. You can tell me this by email or by phone. For payment, you will have to submit all payment receipts, bills for medicines taken from outside. You also need to make sure that the original discharge letter, final bill, and payment receipts are in one place where you can give and collect payment to the insurance company.
Mediclaim Policy Coverage
Hospital recruitment expenses
It covers all hospitalization expenses such as OT charges, diagnostic procedures, blood oxygen, medicines, chemotherapy, X-rays, radiotherapy, donor expenses, pacemakers, etc.
Daycare charge
Covers the cost of technical work that does not require a hospital stay for more than 24 hours like cataract surgery etc.
Pre and post hospitalization expenses~ 30 days before and after hospitalization expenses up to 60 days, ambulance expenses are paid.
Hospital room rent The full cost of a regular ward and ICU is covered in cashless hospital treatment.
Medical practitioner’s fee Doctor, nurse, surgeon, anesthetist’s fee is also paid.
What is not covered in a mediclaim policy?
Mediclaim does not cover chronic illness.
Diagnosis of any disease not covered within 30 days from the date of commencement of the policy. You can read the policy document to know the plan in detail.
Not covered in the plan Some diseases have occurred.
Dental surgeries that require hospitalization.
Birth Control and Hormonal Treatment
Things to keep in mind before taking a mediclaim policy
If you want to buy a mediclaim policy then you should take care of the points given below. Keeping these points in mind, you can compare several plans in the market.
Sum Assured (Coverage Amount):
Before deciding the sum insured or coverage amount, take into account inflation, surgery cost etc. If you live in a city then your expenses will be more than the villager’s. Similarly, if you want to take a policy for your family members, then you should take more insurance money.
Limit of Renewability:
As such the policy gets renewal for one year but, it is between you and your insurance company. So your health insurance policy should cover you till one age as it is not easy to get insurance later. If at that age your policy does not cover you dt then there will be no peace by taking the policy.
Exclusion:
Every medical plan is made keeping in mind the medical risk of the policyholder. However, some exclusions are either missing or not in a plan. Any situation arising out of HIV infection, drug or drug addiction, suicide, congenital disease, etc. is not covered in medical. However, the waiting period is covered after hysterectomy, kidney stone, gall bladder surgery, maternity, etc.
Why buy from Policybazaar?
Affordable option
Policybazaar makes health insurance more affordable for you through various monthly payment options and discounts provided by its partners
30-minute claim support
Policybazaar experts will reach your hospital or home in 30 minutes to support your health Insurance claim
As per the insurance guidelines, you are allowed to cancel the policy within 15 days from the date of issue of the policy. For more details, please read the plan brochure carefully or talk to our consultant at the time of purchase. Purpose of giving reasonable assistance to the customer in pursuance of the claim. For more details, one can contact the 24×7 Claims Support Helpline at 18002585881. terms and Conditions apply*. Policybazaar endeavors to provide the best claim support services to its customers. It is the responsibility of the insurance company to settle the claim as per the terms and conditions of the insurance policy chosen by you. 30 Minutes claim support is not valid if our operations are affected due to system failure or force majeure or non-availability of Company officials which are beyond our control. These terms are subject to change without notice.
Platinum Insurance Partner
Policybazaar is the largest partner for most health insurers and platinum partners, which means your policy and claims will be treated on a priority basis
After how much time you can make a claim after buying the policy?
Most of the insurance companies do not accept any claim till 30 days after taking the policy. However, it covers accidental hospitalization that occurs within 30 days.
Does mediclaim cover accidents?
Accident cover is provided in a personal accident insurance plan. You can take personal accident cover as an add-on with your mediclaim policy.
What to do after hospitalization?
You must first inform the TPA about your policy name, hospital, and treatment. After that, you will have to fill out the claim form in which your policy number, hospital name, and treatment details will be required. After this, you will have to submit your documents to the TPA department of the hospital. The claim will be processed after giving the documents to the insurance company.
What is the age base for buying a mediclaim policy?
The age varies from one insurance company to another. It occurs for around 18 to 65 years and also for 91 days old newborns. Many plans also have lifetime renewal.
How can I get the benefits of my mediclaim policy?
There are two modes: repayment and cashless claim. You will need to inform the insurance company or TPA about your hospitalization for payment. With this, you will have to keep all the medical bills till the payment. All the details for the cashless claims have to be filled and given to the insurance company. And the insurance company will settle the claim (as much as the sum insured) directly with the hospital.
Will my mediclaim policy cover coronavirus?
All medical insurance companies will have to bear the cost of quarantine and hospitalization as per IRDI guidelines. Many companies are also offering coronavirus health insurance, and others are including it in their medical. However, after declaring corona a pandemic, you should ask your insurance company.
