Know Everything About Mediclaim Policies

In the event of a medical emergency, a mediclaim policy is an indemnity-based plan that provides financial assistance and protection to the insured individual. The insured individual pays for their medical treatment, and the insurance company reimburses them until the policy's top limit of coverage is reached. After the insured individual presents their medical costs to the insurance company, they will be reimbursed.
Most mediclaim plans are only available to people between the ages of 18 and 65, and premiums are calculated similarly, taking into consideration age, sum assured, policy length, existing health problems, and other criteria. Mediclaim and regular health insurance policies are frequently used interchangeably, which is incorrect because the policies are quite distinct. To know more about mediclaim policies, read on.

What Are The Key Features Of Mediclaim Policies?

Terms of the policy - Mediclaim insurance is only valid for a certain amount of time, which varies depending on the policy. If the insured individual desires, the term can be renewed at the conclusion of the period. To begin with, there are no lifetime Mediclaim plans, which is why it is usually less expensive than a standard health insurance policy.

Cashless facility - Although reimbursement for medical expenditures is a part of Mediclaim plans, many also provide a cashless option in which you can obtain medical care and the insurance company will pay the hospital directly. However, the covered person can only obtain cashless care at a hospital in the insurance company's network.

Sum assured is fixed - Depending on the insured person's option, a Mediclaim policy might cover an individual or a family. The sum guaranteed is a defined amount (usually between INR 5 lakh and INR 10 lakh, depending on the policy), and the insurance company will not pay out more than that amount, regardless of the number of people insured.

The coverage is limited - Most Mediclaim insurance only cover hospitalisation and pre-hospitalization (usually up to 30 days) and post-hospitalization (typically up to 60 days) expenditures, which might include everything from medications to x-rays. These conditions vary per insurance, with some coverage covering medical expenditures spent for fewer than 24 hours of hospitalisation. Pre-existing diseases, dentistry or cosmetic surgery, and pregnancy expenditures are often not covered by Mediclaims insurance.

Tax Rebates - Under Section 80D of the Income Tax Act of 1961, money paid forward towards a Mediclaim policy could be claimed as tax deductions. You can claim up to INR 25,000 or INR 35,000 for elderly people, with policyholders eligible for an extra INR 25000 if they are paying their parents' premiums.

Waiting period - When filing a claim, most insurance companies impose a waiting period during which the policyholder is unable to claim any medical expenditures. Most insurance companies have a waiting time for pre-existing illnesses, as well as other ailments, if they are covered. The only claim that may be filed during this time is for hospitalisation due to an accident. It is crucial to verify the length of the waiting period for certain ailments, as well as what may be claimed during that time. This not only protects you from harm, but it also assists you in making your decision.

Endnotes

With healthcare prices growing at a rate of between 9% and 15% per year, depending on the expenditure, insurance can no longer be considered an afterthought or a luxury. While a comprehensive health insurance plan with nearly total coverage should be the ultimate objective, mediclaim plans are typically a solid pick as well, especially now that payments may be split into monthly instalments. They're cost-effective and assist in reducing the cost of medical crises, as hospitalisation fees are among the most expensive medical costs. Examining the policy's essential features before purchasing can help you guarantee that you're getting the most bang for your buck and that you're protected when you need it most.

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Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.