Millennial’s Guide to Understanding Mediclaim Policy

Medical insurance is popularly known as Mediclaim policy in India. A mediclaim policy covers you financially against medical treatments, accidents and other illnesses. It serves the purpose of taking care of healthcare expenses including medical bills, hospitalization, etc. up to the sum assured. Mediclaim policies are offered by health insurer as well as life insurers.

There are two major mediclaim policies in India.

  • Individual Mediclaim Policy – A single person is covered under the individual mediclaim policy. The premium for this policy is based on the age of the person opting for the policy. The insured person can claim the entire sum whenever he or she requires that.
  • Family Floater Mediclaim Policy – This policy provides coverage for the insurer, spouse, and dependent children. Some family floater plans cover dependent parents as well. The premium for this mediclaim policy depends upon the family member with highest age. The complete policy amount can be used by the entire family or even by a single member.

Advantages of having a mediclaim policy

  • It provides peace of mind, as you won’t have to stress upon the financial burden in case of unpredicted accident or sudden illness leading to hospitalisation.
  • With cashless hospitalisation facility, you won’t have to pay for medical expenses then and there. The insurance company will cover all your expenses at a network hospital.
  • It is a cost-effective way of getting premium healthcare, at immediate hour.
  • You can opt for tax deductions on premiums paid towards a mediclaim policy under Section 80D of the Income Tax Act, 1961.

Things to keep in mind before buying mediclaim policy

  • Coverage Provided – Before buying a policy, you need to determine the best mediclaim policy for you. Compare the kind of coverage offered by the provider. Look for multiple options and choose the policy that covers you the best.
  • Network Hospitals – Check whether the hospitals included within the network are reliable or not.
  • Maternity Cover – If you are planning to have a child, check if there is any mediclaim policy that provides cover for maternity and provides various maternity related benefits
  • Co-Payment – The co-payment refers to a clause where a policy holder agrees to pay certain amount of the medical expense out of their own pocket while the insurance company pays out the rest. This can subsequently reduce the overall insurance premium of your mediclaim policy. Check if your provider has a co-payment clause and determine what percentage of expense will you pay.

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