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What is Mediclaim

Mediclaim policy is a type of insurance plan that offers specified financial protection against health related expenses.

  • 06 Apr 2023
  • 2 min read

When it comes to safeguarding our well-being, we often seek refuge in things that give us comfort, be it our family or our hobbies. But what about the unexpected twists that life throws our way? Illnesses and accidents can often leave us stranded in the face of physical and financial uncertainty. During these times, we realise the true importance of having a safety net that can catch us when we fall. The concept of the Mediclaim policy kicks in here.

Mediclaim Meaning

A Mediclaim policy is a type of health insurance policy that provides coverage for medical expenses incurred due to illness or injury.

  • This policy typically covers hospitalisation costs, medical treatments, and other related expenses.
  • The policyholder pays the insurer a premium in exchange for this coverage.
  • The coverage and benefits offered by a Mediclaim policy can vary depending on the policy provider and plan chosen.
  • Mediclaim insurance plan offers both cashless and reimbursement claim options.

How does Mediclaim work?

When you buy a Mediclaim policy, you pay a premium to the insurance company. In exchange, the insurance company agrees to pay for all or a portion of your medical expenses up to the coverage limit specified in the policy.

  • In a medical emergency, you can seek treatment from an affiliated hospital to receive cashless treatment or if you want reimbursement for your treatment bills from another healthcare provider.
  • The third-party administrator (TPA) is responsible for assisting you with documentation issues and taking care of the rest of the procedures to ensure a smooth claim settlement for cashless hospitalisation.
  • In the event of a reimbursement claim, the insurer will first review all the bills you have provided and determine how much of the medical expenses are covered by the policy.
  • You must remember that Mediclaim policies do not cover a wide range of ailments and may include a waiting period for some or all of the covered diseases. As a result, before making any decisions, always read the policy wording.

Features of buying Mediclaim policy

• Financial protection:

The primary benefit of a Mediclaim policy is financial protection. It can help you pay for expensive medical treatments and hospitalisation costs, which can put a strain on your wallet.

• Cashless hospitalisation:

With a Mediclaim policy, you can get cashless hospitalisation at network hospitals. That means you can get treatment without having to pay cash upfront. The insurance company will settle the bills directly with the hospital.

• Tax benefits:

You can claim a tax deduction for the premium paid towards your Mediclaim policy under Section 80D of the Income Tax Act.

• Pre- and post-hospitalisation expenses:

Mediclaim policies also cover pre- and post-hospitalisation expenses, including doctor's consultation fees, medicines, and diagnostic tests.

• No-claim bonus:

Mediclaim policies offer a no-claim bonus if you do not make any claims in a policy year. This can be in the form of a higher sum insured or a reduction in premium.

• Critical illness coverage:

Many Mediclaim policies offer coverage for critical illnesses, such as cancer, heart attack, and stroke. 

Mediclaim policy is an essential part of financial planning. It provides financial protection against unexpected medical expenses and ensures that you and your family can access quality healthcare without worrying about the cost. Before purchasing a Mediclaim policy, ensure you compare the features and benefits of different policies and choose one that meets your specific requirements.

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