Home Health Insurance Fixed Benefit Health Insurance Plan vs. Mediclaim – What Is the difference?

Fixed Benefit Health Insurance Plan vs. Mediclaim – What Is the difference?

written by Vidya Sury November 6, 2020
What is the difference between mediclaim and Fixed Benefit Health insurance Plans

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This post looks at the difference between Mediclaim and Fixed Benefit Health Insurance Plans.

There is a common saying ‘Health is Wealth’. However, in today’s fast-paced world many people tend to prioritize material things over health. One thing that all of us need to remember is that no one can predict the future and being healthy today does not necessarily mean a healthy tomorrow!

Investing in a good health insurance plan has become an absolute necessity since it offers significant benefits in case of medical emergencies.

Many people also have a Mediclaim policy and they assume that Mediclaim and health insurance plans offer the same benefits. The reality is that there is a world of difference between Mediclaim and health insurance plans.

Let us look at:

  • The vital benefits of these financial instruments
  • The difference between Mediclaim and fixed benefit health insurance plans.

What is the difference between mediclaim and Fixed Benefit Health insurance plan

What is Mediclaim Insurance?

Mediclaim is a type of insurance that offers financial protection during medical emergencies. Unlike health insurance, Mediclaim insurance covers expenses only when the insured person is hospitalized.

This means only the hospitalization charges are covered under Mediclaim insurance and other expenses such as doctor consultation charges, ambulance charges, etc. have to be borne by the insured person. Hence, Mediclaim insurance offers fewer benefits compared to a health insurance plan.

Main features of Mediclaim Insurance

Some vital features of Mediclaim insurance are:

  • Mediclaim health insurance offers hospitalization cover, along with cover for the treatment for specific illnesses. If the insured person meets with an accident, it is covered by Mediclaim insurance.
  • The premium paid under the Mediclaim insurance depends on the pre-decided sum insured, age, proposer’s health conditions, geographical location, etc.
  • It offers cashless treatment (at a select network of hospitals) as well as reimbursements against the submitted claims.

What is a Fixed Benefit Health Insurance Plan?

Like Mediclaim insurance, health insurance plans protect the insured person(s) during the time of a medical emergency. However, reimbursement for insured customers is not limited to hospitalization expenses. Health insurance plans also cover pre & post hospitalization charges, ambulance charges, doctor consultation charges, surgeries, hospitalization charges arising from injuries (or illnesses), and more.

However, Mediclaim insurance only offers a minor subset of the benefits offered by health insurance plans. Insurance companies like ICICI Prudential Life Insurance have a tie-up with a large number of hospitals across India where customers can avail of cashless treatment.

Main features of Health Insurance Plans

Here are some salient features of fixed benefit health insurance plans:

  • Health insurance policies cover the expenses incurred on hospitalization (i.e. before and after) up to specified limits.
  • Ambulance charges and doctor consultation charges are also covered under major health insurance plans.
  • Patients can avail of cashless treatment when the insured person is treated in the hospital that has a tie-up with the insurance company.
  • Most health insurance policies offer NCB (No Claim Bonus) if the person insured does not submit any claims for treatments in a particular year.
  • Other than tax-benefits, health insurance plans remind people to focus on their health through periodic health check-ups.
  • Health insurance plans can be topped-up with relevant add-ons such as personal accident coverage, illness coverage, and more.

Health risks are increasing with each passing day, making an investment in a good health insurance plan a must. Insurance companies like ICICI Prudential offer different kinds of health insurance plans – individual plans, senior-citizen plans, critical illness plans, family plans, and more. They also offer fixed benefit health insurance plans where a certain amount is paid in case of a particular illness/event that is covered under the policy.

The advantage of Fixed Benefit Health Insurance Plans is that there is no cap on the sub-limits in terms of hospitalization, room rent, etc. Unlike other health insurance plans, fixed benefit health insurance plans offer higher coverage at affordable premiums. Since the payout is done at the diagnosis stage itself, the patient has the leverage to get treated at any hospital in the world.

To summarize, there are numerous advantages offered by health insurance, particularly fixed health insurance plans that Mediclaim health insurance does not offer. Get yourself and your loved ones a good health insurance plan cover since it provides the much-needed financial backup when there is a medical emergency.

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