Health Insurance 493 views June 18, 2021

Difference Between Mediclaim and Health Insurance

Nobody wants to ruin their finances in case of a medical emergency. People choose mediclaim and health insurance policies to prevent their hard-earned savings from going towards treatment expenses in case of an illness or an accident. However, when doing the same, people often like to believe that mediclaim and health insurance are alike, which is not true. Most people don’t know the difference between both of them.

Considering the same, it is important to understand the difference between mediclaim and health insurance so that you can purchase accordingly. On this page, we will discuss the same. But first, we will talk about what exactly is mediclaim and health insurance. Let’s start!

Health Insurance

Please fill the details below and our policy experts will call you to help figure out the correct health insurance policy for your needs


What Exactly is Mediclaim and Health Insurance?

A mediclaim policy provides coverage against treatment expenses incurred by an insured person during hospitalization due to an illness, surgery or an accident. It will not cover expenses incurred on critical illness or any other charges during your treatment apart from hospitalization. With the mediclaim policy, you can get claims on cashless or reimbursement basis.

On the other hand, health insurance provides comprehensive cover against different expenses such as in-patient hospitalization, day care treatment, OPD treatment, critical illness cover, pre & post-hospitalization, etc. Same as a mediclaim policy, you can get claims via cashless or reimbursement basis under a health insurance plan.

Key Differences between Mediclaim and Health Insurance

We are showing crucial points with which you can understand the difference between mediclaim and health insurance better. Please check!

Basic Coverage

As you can see from the basic definition, a mediclaim policy only covers hospitalization expenses incurred due to an accident, illness, or surgery whereas, you get comprehensive coverage with a health insurance plan for different expenses on an ambulance, OPD, dental treatment, maternity expenses, newborn child, diagnostic tests, etc.

Add-on Covers

Mediclaim policy does not offer any add-on covers with which you can enhance your overall protection. On the other hand, a health insurance policy offers several add-on or rider options that can help you get comprehensive coverage. You can check them below.

  1. Hospital Daily Cash Rider
  2. Room Rent Waiver
  3. Critical Illness Rider
  4. Personal Accident Cover
  5. Maternity Coverage
  6. Accidental Disability Cover

Sum Insured

With a mediclaim policy, the sum insured will most likely be up to INR 5 lakh, while a health insurance policy provides higher coverage compared to a mediclaim policy. The sum insured in a health insurance policy depends on several factors such as the age of the insured person, pre-existing illnesses, location of the insured person, number of members in a plan, etc.

Coverage for Critical Illness

Policyholders cannot get coverage against critical illness treatment expenses with a mediclaim policy. In contrast, health insurance covers up to a specified critical illness (stroke, heart attack, kidney failure, etc.) as per the terms and conditions of the policy. So, you should check before choosing a health insurance plan.


Mediclaim policy does not offer any flexibility to customize your plan according to your needs. However, if you choose health insurance, you can customize the premium amount, plan option, sum insured option, policy term, rider options, etc. according to your convenience.

The Bottom Line

From the points mentioned above, you would have understood the difference between mediclaim and health insurance. Also, it would be better for you to choose a health insurance policy over a mediclaim policy to get comprehensive coverage. Considering the same, we are showing some top health insurance plans below so that you can make a better decision. Have a look!

People Also Read