Health Insurance vs Mediclaim

Health Insurance vs Mediclaim: Which is Best in 2024?

Health Insurance vs Mediclaim which health insurance is best? Read the whole article to know the important differences for your best plan.

Many people mistake assuming health insurance and mediclaim as the same thing. However, each of them works differently and has various benefits. This article will get to know the difference between health insurance and mediclaim. You will also find out how an individual plan will work out in your favor.

So, what are health insurance and mediclaim?

Health Insurance vs. Mediclaim:

Health Insurance

Health insurance provides an individual with coverage for medical and surgical expenses. The insurance company settles the bill with the hospital directly with this insurance policy. However, with some insurance companies, you have to pay the costs from your pocket that the company will later reimburse.

Now, let’s find out the features of a health insurance plan –


A typical health insurance plan safeguards you against any medical expenses. It also offers an add-on of critical illness of more than 30 diseases.

Renewal Discounts

A health insurance plan provides you a “No Claim Bonus” benefit at the end of a claim-free year.


Some health insurance plan comes with a co-payment. The primary purpose of co-payment is to lessen the insurance premium. This is because health insurance companies bear a certain percentage of medical expenses. The remaining amount has to be paid by you.

Tax Benefits

Any health insurance plan will offer you tax benefits under Section 80D of the Income Tax Act in India.


Mediclaim insurance offers you financial coverage for any health-related issues. It is comparatively cheaper insurance that bears your expenses for medical emergencies. Nevertheless, mediclaim insurance will only provide you with limited coverage for hospitalization. The policyholder should pay the other costs.

So, how does medical insurance work?


Mediclaim insurance covers your hospitalization expenses, treatment expenses because of an accident, and some particular diseases.

Sum Assured

A typical mediclaim insurance comes with a sum assured that is pre-determined.

Premium Factors

The premium of a mediclaim insurance plan depends on the following factors –

  • Sum insured
  • Policyholder’s age
  • Gender
  • Geographical location
  • Duration of the plan

Claim Settlement

Insurance companies process the claims for mediclaim insurance through reimbursement or cashless treatment.

Tax Benefit

Mediclaim offers tax benefits under Section 80D of the Income Tax Act in India.

Are you still confused between health insurance and mediclaim? Look at the table below to see what makes them apart.

Core Differences between Health Insurance and Mediclaim:

FactorsHealth InsuranceMediclaim
CoverageA health insurance plan provides coverage against hospitalization, pre and post-hospitalization, and ambulance expenses. Moreover, it compensates if an individual loses his job due to an accident.To some extent, mediclaim offers coverage for hospitalization expenses, treatment expenses due to accidents, and pre-existing diseases.
Add-onsIt offers some add-on coverage, such as coverage for critical illness, personal accident, accidental disability, maternity, and much more.It offers no add-on coverage.
FlexibilityA health insurance plan allows you to reduce the premium after a certain period. You can also change the policy duration as per your need.Medicalim insurance plans do not offer any flexibility in terms of coverage.
FeaturesThe benefits and features of a health insurance plan are the same for almost all insurance companies.Different insurance companies offer various mediclaim benefits, and the features vary.
Critical Illness CoverIt offers critical illness cover as an add-on for more than 30 diseases, including cancer, stroke, cardiac conditions, etc.It does not have any option for critical illness coverage.
Sum AssuredA health insurance plan provides extensive coverage with no more than Rs.6 Crores per annum.Mediclaim insurance plans come with a pre-assured sum of Rs.5 Lakhs.
ClaimsIn case of critical illness or accidental disability, you can file a claim only once during the policy duration. For other issues, you can file claims as long as your sum insured is not finished.With a mediclaim insurance plan, you can file claims till your assured amount is drained.
HospitalizationAn individual does not need hospitalization to get the benefits of health insurance. You can get benefits like daycare procedures without hospitalization.Individual needs to be hospitalized to get the benefits of mediclaim insurance.


These are all the sectors that make the difference between health insurance and mediclaim. By now, you should be able to understand what health insurance and mediclaim are and how each of them can benefit you. Hence, you can make a wise decision to choose between the two.

Frequently Asked Questions

  • What are the top 3 Mediclaim insurance policies in India?

Here are the top 3 Mediclaim insurance policies in India:

  1. Aditya Birla Mediclaim Policy – sum insured of Rs.10-30 lakhs
  2. Bajaj Allianz Mediclaim Policy – sum insured of Rs.1.5-50 lakhs
  3. Bharti AXA Mediclaim Policy – sum insured of Rs.3, 4, 5 lakhs
  • Which is better, mediclaim and health insurance?

Mediclaim and health insurance have their unique benefits and features. A health insurance plan offers coverage for all hospitalization expenses, pre and post-hospitalization expenses, and ambulance fees. Whereas a mediclaim plan provides a limited range to only hospitalization expenses.

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