Mediclaim Policy Mediclaim policy is a kind of health insurance policy that covers your medical expenses in case of any health emergency up to the sum insured. The Insurer pays for the treatment cost be it an accident or illness that led to hospitalization including in-patient cover, day-care treatment etc. Your mediclaim or health insurance policy will also cover the COVID 19(Ncov) treatment cost up to the sum insured. However, most of the mediclaim policies do not cover the cost of consumable items that are required for Coronavirus treatment such as PPE kits, masks, gloves, oximeters, ventilators, etc. As per the IRDAI recommendations, all the health and general insurers have launched COVID mediclaim insurance policy. Most of the COVID-19 plans cover pre and post-hospitalization expenses provided the hospitalization is required for a minimum of 24 hours. A few mediclaim policies for COVID such as Corona Rakshak and Corona Kavach also pay for Ayush treatment, home treatment if suggested by an authorized medical practitioner. For more details policy wordings can be referred. In case you have group mediclaim policy from your employer, you can check for the scope of coverage for COVID 19 and get it customized as per your requirements. Or if you plan to buy a standalone COVID 19 mediclaim policy you will have to serve the waiting period. Go through the policy coverage benefits and limitations if it suits your insurance needs. While most of the mediclaim policies cover Coronavirus hospitalization expenses except for the consumable medical items, which can only be covered by a standalone coronavirus policy. Mediclaim policy premium paid can also be claimed for tax-exemption benefits under section 80D of the Income Tax Act of India, 1961.

Features and Benefits of a Mediclaim Policy Before buying a mediclaim policy it is important to know its features and benefits. Moreover, amid the increasing number of lifestyle diseases, hospitalization expenses, and healthcare expenses it is inevitable to buy a mediclaim policy that can offer financial support during hospitalization. It offers a cushion in case of a medical emergency. At the same time, it offers numerous other insurance benefits such as: Cost-Effective: A mediclaim policy is a cost-effective way of availing healthcare services

A mediclaim policy is a cost-effective way of availing healthcare services Cashless Treatment: Cashless hospitalization facility is available in-network hospitals, which eliminates out-of-pocket expenses in case of a medical emergency.

Cashless hospitalization facility is available in-network hospitals, which eliminates out-of-pocket expenses in case of a medical emergency. Eases Financial Stress: A mediclaim policy lowers the financial burden on the policyholder and his family.

A mediclaim policy lowers the financial burden on the policyholder and his family. Individual and Family Floater Cover: Both individual and family floater mediclaim policies are available.

Both individual and family floater mediclaim policies are available. Pre and Post-hospitalization Expenses : Mediclaim policies also cover pre and post hospitalization expenses for 30-60 days and 60-120 days after hospitalization. It can also include emergency assistance services for ambulance and emergency evacuation.

: Mediclaim policies also cover pre and post hospitalization expenses for 30-60 days and 60-120 days after hospitalization. It can also include emergency assistance services for ambulance and emergency evacuation. Day-care Hospitalization : Expenses towards treatments that do not require 24-hour hospitalization.

: Expenses towards treatments that do not require 24-hour hospitalization. Lifelong Renewability Cover : A mediclaim policy can also offer lifelong renewability cover option depending on the insure.

: A mediclaim policy can also offer lifelong renewability cover option depending on the insure. Additional Benefits : Expenditures towards ICUs, alternative treatments, annual check-ups are recompensed as well.

: Expenditures towards ICUs, alternative treatments, annual check-ups are recompensed as well. Tax Exemption Benefits: Tax benefits under section 80 D can be availed on the mediclaim policy premium that is paid every year.



List of Best Mediclaim Policies in India Although there are many mediclaim policies offered by different insurance companies. Below are some of the best mediclaim policies in India that you can consider: Mediclaim Policy Sum Insured (Rs.) Network Hospitals Renewability Aditya Birla Mediclaim Policy 10-30 lakhs 5850+ Lifelong Bajaj Allianz Mediclaim Policy 1.5-50 lakhs 6500+ Lifelong Bharti AXA Mediclaim Policy 3,4,5 lakhs 4300+ Lifelong Care Health Insurance Mediclaim Policy (Formerly known as Religare Health Insurance Mediclaim Policy Rs. 3 Lakh to Rs. 60 Lakh 4987 Lifelong Cholamandalam Mediclaim Policy 2- 15 lakhs 6500+ Lifelong Digit Mediclaim Policy 2- 25 lakhs 5900+ Lifelong Edelweiss Mediclaim Policy 5 lakh- 1 Crore 2578+ Lifelong Future Generali Mediclaim Policy Vital: 3, 5,10 lakhsSuperior: 15, 20, 25 lakhsPremier: 50 lakhs- 1 Crore 5000+ Lifelong HDFC ERGO Health Mediclaim Policy (formerly known as Apollo Munich Mediclaim Policy) 3-50 lakhs 4721 Lifelong HDFC Ergo Mediclaim Policy 3-10 lakhs 10000+ Lifelong IFFCO Tokio Individual Medisheild Mediclaim Policy 50,000- 5lakhs 5000+ Lifelong Kotak Mahindra Mediclaim Policy 2-100 lakhs 4800+ - Liberty Mediclaim Policy up to 1 Crore 3000+ Lifelong Max Bupa Mediclaim Policy 3 lakhs-1 Cr. 4115+ Lifelong ManipalCigna Mediclaim Policy 2.5-50 lakhs 4000+ - NationalMediclaimPlus Policy 2-50 lacs. 6000+ Lifelong New IndiaAssuranceMediclaim Policy 1-15 lakhs 3000+ Lifelong Oriental Individual Mediclaim Plan 1-10 lakhs 4300+ Lifelong Royal Sundaram Mediclaim

Policy 2-150 lakhs 5000+ Lifelong Reliance HealthWise

Mediclaim

Policy 1-5 lakhs 4000+ Up to 75 years Raheja QuBE Mediclaim Policy 1-50 lakhs 2000+ Lifelong Star Health Mediclaim Policy 1-25 lakhs 8341+ Lifelong SBI Mediclaim Policy 1-3 lakhs 6000+ Lifelong Tata AIG Mediclaim Policy 2-10 lakhs 4000+ Lifelong United India Mediclaim Policy 1-10 lakhs 7000+ - Universal Sompo Mediclaim Policy Up to 5 lakhs 5000+ Lifelong See More Plans Disclaimer : *Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.



Types of Mediclaim Policies There are different types of mediclaim policies that are available. You can choose a mediclaim policy as per your needs and enjoy your peace of mind. Let’s have a look at the various types of mediclaim plans: Individual Mediclaim Policy An individual mediclaim policy offers health coverage to only the policyholder. Only one person can avail the medical insurance benefits against the premium paid. There are a number of An individual mediclaim policy offers health coverage to only the policyholder. Only one person can avail the medical insurance benefits against the premium paid. There are a number of health insurance companies that provide individual mediclaim plans in India. Family Floater Mediclaim Policy A family floater mediclaim policy provides coverage to an individual, which is extendible to other family members including parents, spouse, and children. Senior Citizen Mediclaim Policy Senior citizen health insurance plans are designed to cover hospitalization expenses incurred on the elderly people who have crossed the age of 60 years. Critical Illness Mediclaim Hospitalization expenses incurred on critical illnesses are quite exorbitant.

Comparison between Mediclaim Policy and Health Insurance Hospitalization expenses incurred on critical illnesses are quite exorbitant. Critical illness insurance policy covers life-threatening illnesses like kidney failure, cancer, cardiovascular diseases etc. A family floater mediclaim policy provides coverage to an individual, which is extendible to other family members including parents, spouse, and children.

Read in Detail: mediclaim insurance vs health insurance

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply.

Mediclaim Policy Claim Procedure There are two types of claims available under Mediclaim policy- Cashless Procedure: Cashless is a mechanism wherein a patient is treated in a network hospital, then insurer settles either the part of the claim or the entire claim with the hospital. It means, a patient doesn’t need to pay a penny to the hospital for the treatment. There are certain procedures which you need to follow to ensure the smooth claim process.

At the first level, all empanelled hospitals will have an insurance desk in their premises. A policyholder has to obtain a pre-authorization form from this desk, which has to be dully filled with correct information because any missed detail will only delay the entire process. This filled form needs to be stamped by the hospital and the doctor and then it has to fax across Third Party Administrator (TPA) or the insurer. After carefully examining the form, the company will approve a certain sum and send a fax back to the hospital saying that ‘X’ amount has been sanctioned for the treatment.

Let us understand this procedure with an example. If the hospital has given a treatment cost of Rs 4 lakh, the insurer and TPA will rework and for instance, approve Rs 3 lakh for treatment. Now, they will inform the hospital that they will reimburse expenses up to Rs 3 lakh only under cashless and if the total cost would be more than this limit, they will look at it later. However, at the time of discharge, the total billing amount comes at Rs 3.60 lakh. In this case, the policyholder has two options. The first option is, he will send all discharge letters and final bill copy to the insurer and wait for the revert. No doubt, it will take time. The other option is, policyholder himself pays the remaining amount, which is Rs 40,000 in this case, and then he submits those original bill receipts to the policy provider to get reimbursement of Rs 40,000. Get More Info On Cashless Mediclaim Policy Reimbursement: In the case of reimbursement, it is pivotal to inform your insurance company that a hospitalization has been taken place or likely to take place in a near future. Either you could that by sending an email or by making a call. To get reimbursement, you need to submit all payment receipts, including bills of those medicines which you have bought from outside chemist. You need to make sure that original discharge card, final bills and payment receipts should be in one place, so that they can be submitted to the insurance company to get reimbursement.

Mediclaim Policy Coverage The coverage varies from one policy to another, but usually, the following expenses are covered: Hospitalization charges It covers all the all direct charges incurred during hospitalization such as OT charges, diagnostic procedures, blood, oxygen, medicines, chemotherapy, x-ray, radiotherapy, donor expenses, pacemakers etc.

It covers all the all direct charges incurred during hospitalization such as OT charges, diagnostic procedures, blood, oxygen, medicines, chemotherapy, x-ray, radiotherapy, donor expenses, pacemakers etc. Day-care Charges Expenses incurred on specified technically -advanced treatments like cataract surgery etc. that do not require hospitalization for more than 24 hours.

Expenses incurred on specified technically -advanced treatments like cataract surgery etc. that do not require hospitalization for more than 24 hours. Pre and post-hospitalization expenses Expenses incurred on hospitalization for a period of 30 days before admission and up to 60 days after discharge including ambulance cover are reimbursed.

Expenses incurred on hospitalization for a period of 30 days before admission and up to 60 days after discharge including ambulance cover are reimbursed. Hospital Room Charges Charges of regular wards or Intensive-Care-Unit are fully recompensed, or taken care of with cashless hospitalization in the network hospitals.

Charges of regular wards or Intensive-Care-Unit are fully recompensed, or taken care of with cashless hospitalization in the network hospitals. Fees Charged by Medical Professionals Compensation is provided for fees charged by the doctor, surgeon, nurse, anesthetist etc.



What is Not Covered in a Mediclaim Policy? Every mediclaim policy has some limitations. Mentioned below are the circumstances that can deny you claim- A mediclaim policy will not cover pre-existing ailments.

Any medical condition or critical illnesses that are diagnosed within 30 days of the policy commencement date are not covered. You can read the policy documents to know the details of the plan.

Specific ailments that are not covered in the plan

Expenses incurred on dental surgeries unless it requires hospitalization

Birth control and hormonal treatment

Complication during childbirth and ectopic pregnancies