What is the Difference between Mediclaim Insurance and Health Insurance?

Before you  plan to buy any health policy from a health insurance company  you must know the difference between Mediclaim Insurance and Health Insurance. First lets see what is mediclaim insurance and what Health Insurance is , then we can learn more about the difference between Mediclaim Insurance and Health Insurance.

What is Mediclaim Insurance?

Mediclaim insurance offers only a specified financial protection against health-related expenses. This surely  is a budget-friendly way to reduce any health-related emergency. However, the coverage is limited to hospitalization and other expenses have to be taken by the insured himself.

What is Health Insurance?

Medical and surgical expenses incurred by the insured are covered under the health insurance. The insured either has to pay such expenses out-of-pocket which are later subsequently reimbursed or the insurance company settles the bill directly with the hospital.It all depends on the terms and conditions of the insurance policy. All the benefit and features provided, are subject to the terms and conditions of the insurance policy.

Difference between Mediclaim Insurance and Health Insurance

Health Insurance vs Mediclaim

S.NO.  Mediclaim Health Insurance
1 A mediclaim plan can provides

a) coverage only for hospitalization,

b) accident-related treatment

c) pre-decided diseases for a pre-specified limit.

A health insurance plan offers

a) comprehensive coverage against hospitalization charges,

b) pre-hospitalization charges,

c) post-hospitalization charges, ambulance expenses.
Also health insurance offers compensation in case of loss of income as a result of an accident.

2 Can not offer any add-on coverage. In order to enhance the insurance coverage, it offers critical illness coverage, personal accident coverage, accidental disability coverage, maternity coverage etc.
3 When it comes to coverage, it offers no flexibility. Health insurance plans often provide  the much-needed flexibility. Insurance buyers, after a specified period, can reduce their health insurance premium amount; they can also change their policy duration. 
4 Features of a mediclaim plan vary from one  insurance provider to another. However the different mediclaim insurance companies offer different mediclaim insurance coverage. However over most of the insurance providers, the benefits and features of a health insurance plan of a specific sum insured is almost similar. 
5 Here in mediclaim , sum assured for a medical insurance plan doesn’t exceed 5 Lakh Rupees . Here in health insurance , sum assured for a health insurance plan doesn’t exceed 6 crore Rupees per year. 
6 Here a policyholder can file claims until the total amount assured is exhausted.  Here, when claims related to critical illness/ accidental disability coverage arise, the assured sum is paid as aggregate total.

Other than that, an insured can file claims as long as his sum insured isn’t exhausted.


7 It is necessary that the insured gets hospitalized in order to avail mediclaim benefits. It is not necessary that an insured gets hospitalized in order to avail benefit from health insurance. Without getting hospitalized, benefits like daycare treatment can be covered.


Always  analyze your insurance expectations before you buy a health insurance plan and you must compare various insurance plans that fulfill your  expectations.