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Cases of various diseases are increasing continuously in India and, due to rising inflation, it has become almost impossible for the common man to bear the entire burden of hospital expenses. While technological advancements in the health sector can be life-saving at times, the expenditure attached to them may be unaffordable for many. In such situations, it becomes very important to have a mediclaim policy, with the help of which you can get expensive and modern medical treatment without going broke. Simply put, investing in a mediclaim policy is a good way to be prepared for any medical emergency in the future.

(Read more: Health insurance)

Whether you are thinking of buying a mediclaim policy or not, you should read this article as it attempts to give you as much information as possible about a mediclaim policy so that you can decide if it’ll be beneficial for you.

  1. What is a mediclaim policy
  2. Types of mediclaim policies
  3. Why a mediclaim policy is necessary
  4. Benefits of a mediclaim policy - Benefits of Mediclaim policy in Hindi
  5. What does a mediclaim policy cover
  6. What does a mediclaim policy not cover
  7. Things to consider before you buy a mediclaim policy

Mediclaim policy is a type of health claim insurance policy, which covers your hospitalization expenses in case of an accident, illness or surgery etc. In a mediclaim policy, the insurance company pays the expenses incurred during the treatment of the policyholder or his family members covered under the policy, including accidents, diseases and surgeries etc. Whether the treatment is for just one day or the patient has to be hospitalized for several days, all situations are covered under a mediclaim policy. Some mediclaim policies cover post-treatment medical expenses, such as medicines, tests and doctor's follow-up fees.

Simply put, a mediclaim policy saves you and your family from the financial burden of health protection and treatment, so that you can manage your expenses along with fighting diseases. In this case, myUpchar Bima Plus Health Insurance may emerge as the best option for you, as not only does it have a low premium, but it is a complete health insurance plan that covers hospitalization as well as pre and post hospitalization.

Mediclaim policies can also be of different types, depending on the different requirements. The following are a few such types of mediclaim policies:

  • Individual Mediclaim Policy: In this, only the medical expenses of the person in whose name the policy has been made are covered.
  • Family floater policy: In this, the person whose name is the policy and his family is also included in the plan of mediclaim policy. The family usually consists of the parents, spouse and children of the policyholder.
  • Group mediclaim policy: This policy is usually purchased by the owner of a company or organization for its employees and members. The group mediclaim policy plan bears the medical expenses of all the persons involved.
  • Senior citizen mediclaim policy: This is a medical policy plan designed for senior citizens, in which the medical expenses incurred due to certain health problems they suffer from are covered.
  • Critical illness mediclaim policy: This plan is designed to cover medical expenses due to critical illnesses. A critical illness policy usually covers the cost of treatment for cancer, kidney failure and heart diseases.
  • Overseas Mediclaim Policy: If you fall ill and are hospitalized in another country, an overseas mediclaim policy can cover all your medical expenses.
  • Low-cost mediclaim policy: Those who are looking for a lower sum insured can opt for a low-cost mediclaim policy. Also, a low-cost mediclaim policy provides coverage of medical expenses to those people who have a smaller budget.

(Read more: What does health insurance cover)

Nowadays, it has become necessary for everyone to take a mediclaim policy in view of the increasing cost of hospitals and medicines. Given below are some reasons it may be prudent to take a mediclaim policy:

  • Increasing incidence of lifestyle diseases: Cases of serious diseases and other lifestyle-related health problems are increasing continuously in India. These diseases can drain all your savings with enough time. Therefore, it is a good option to keep yourself safe from rising medical expenses by taking a mediclaim policy.
  • To save your savings: To remain financially stable, it is necessary to save a little money every day. But in case of a sudden illness or injury, years of savings can come to an end very quickly. A mediclaim policy can help protect your savings by taking care of your medical expenses.
  • Safety of yourself and your family: Nowadays, due to the increasing inflation rates, a common individual is unable to bear their own medical expenses, let alone their family’s. In such a situation, it becomes almost impossible to keep the family safe from diseases. However, you can make it possible by taking a mediclaim policy.

(Read more: Health insurance plans for family)

Before taking a mediclaim policy, it is also important to know about what benefits you get from it. In this era of new diseases and epidemics, it has become almost impossible for the common person to bear the medical expenses of themselves and their family. In such a situation, a mediclaim policy can save a life by providing timely financial help. Apart from this, there are some other benefits of mediclaim policies, some of which are as follows:

  • No stress of payment in the hospital: You do not need to worry about cash during the treatment, as your hospital bill will be paid by the mediclaim policy.
  • Lifetime coverage: If you have taken a mediclaim policy, then you do not need to take medical insurance again and again. Once the policy is taken, you and your family can renew it for life and reap its benefits.
  • Preventive care: A regular health checkup is essential for your health, but can be detrimental to your budget. In such a situation, with the help of the mediclaim policy, you can get a health check-up done from time to time without increasing the burden on your pocket.
  • Pre and post hospitalization expenses: After taking a mediclaim policy, you do not need to worry about pre-hospitalization expenses like getting tests done, doctor's consultation, etc. Apart from this, whatever medical expenses you incur after being discharged from the hospital are also covered under the mediclaim policy. Usually, 30 days pre-hospitalization and 60 days post-hospitalization expenses can be claimed.
  • EMI option: Mediclaim policies also provide you with the facility of easy instalments. In such cases, you can pay mediclaim premiums on a monthly or quarterly basis, so that your budget does not get disturbed.

(Read more: Which is the cheapest health insurance)

Before choosing a mediclaim policy or health insurance, it is important to know what is being covered in the plan. The following are generally covered in a mediclaim policy:

  • In-patient hospitalization: If the patient is kept in the hospital for more than 24 hours during or after the treatment, he is called inpatient. Mediclaim policy covers inpatient expenses, which include room, ICU, blood, oxygen, operation theatre and other expenses. Additionally, the fees of doctors and other staff are also included in this.
  • Day-care treatment: If you have undergone any such treatment or operation, in which only one day (less than 24 hours) is kept in the hospital, the expenses of the room, machines, doctor and medical staff are still covered by the mediclaim policy. However, every mediclaim policy plan has its own terms and conditions.

(Read more: What does health insurance not cover)

There are certain things that are not covered in a mediclaim policy, which are called exclusions. It is important to know of these before choosing a mediclaim policy. Some of them may include:

  • Any medical expenses incurred within one month of taking the mediclaim policy (For example, within a month, there is a diagnosis, surgery, etc. that is needed. However, accident cover will be available.)
  • Medical expenses on congenital diseases
  • Infertility or IVF treatment cost
  • Expenses related to pregnancy, childbirth, miscarriage or abortion
  • Medical expenses of injuries sustained in fights, riots and beatings
  • Medical expenses for suicide or self-harm
  • Any chronic illness occurring 48 months prior to taking the medical policy

While taking a mediclaim policy, it is very important for you to keep some things in mind, so that whenever you have a medical emergency, you can better deal with the situation. Although you can read about mediclaim policy and its types on the internet, if you are taking a policy for the first time, then the terms and conditions can be quite confusing for you. It’s best to keep the following points in mind before buying a mediclaim policy:

  • Types of coverage: Mediclaim policies in India can be of many different types depending on the individual or family. You may wish to opt for a family floater plan, as it covers the medical expenses of your entire family. If there is an elderly person at home, then an individual plan may also be right for him.
  • Insurance coverage: To decide the sum insured, you should get an idea of ​​all your medical expenses. It is also important to note that medical expenses are high in metro cities. If you are planning to take a mediclaim policy for the whole family, it is advisable to take a higher sum insured.
  • Benefits: Choose a mediclaim policy that offers maximum coverage. For example, hospitalization, day-care treatment, ambulance, medicines and pre and post hospitalization expenses, etc. should all be covered.
  • Premium: Make sure that you are not paying more premium than the coverage that you are getting from the mediclaim policy. Before taking a mediclaim policy, check it thoroughly.
  • Discount: When you are taking a mediclaim policy, do a one-time discount check. This is why many times with the help of good discount offers, you can get a good plan for less money.
  • Inclusions and exclusions: This point is the most important one to keep in mind while buying a mediclaim policy. Before buying a plan, you should be fully aware of what is included and what is not included in the plan you take. These details will help you determine and buy the right mediclaim policy for you and your family.
  • Waiting period: Before taking a mediclaim policy, read all the documents, including the waiting period point. Check what is the initial waiting period after taking a mediclaim policy and what is the waiting period for pre-existing diseases. If you or someone in the family already has a disease, then it is even more important to know about the waiting period before buying the mediclaim policy. You are advised to take a mediclaim policy with a minimum waiting period.
  • Network hospitals: Find out which hospitals are covered under the network of the mediclaim policy you are taking. If there is a hospital near you that is in the network of the mediclaim policy, then you can buy the plan.
  • Check CSR: It is also necessary to check the claim settlement ratio before taking a mediclaim policy. If the CSR is high, you can easily make a claim if required.

(Read more: Which is the cheapest health insurance)

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