Last month, my neighbour had to sell his car to pay for his father’s heart surgery. The hospital bill came to almost 8 lakh rupees. He had no insurance. This happens to so many families in India.
When I talk to people about insurance, they always ask me the same question. Should I get mediclaim or health insurance? Honestly, even I was confused about this a few years ago.
Let me share what I’ve learned. It might help you avoid the mistakes many people make.
What Exactly is a Mediclaim Policy?
Think of mediclaim as your emergency fund for hospital visits. You give the company some money every year. When you end up in a hospital, they pay your bills.
It’s pretty straightforward. Here’s what happens:
- You stay admitted to a hospital
- The bills start piling up
- Your mediclaim policy takes care of these costs
- You don’t have to empty your bank account
But there’s a catch. Mediclaim mostly works only when you’re inside a hospital. Those doctor visits before getting admitted? Not covered. Follow-up appointments after discharge? Usually not included.
Now, What About Health Insurance?
Health insurance is like mediclaim’s bigger brother. It does everything mediclaim does, plus a whole lot more.
My friend Rajesh has a health insurance policy. Last year, his daughter needed surgery. The policy paid for:
- All the tests were done three weeks before the operation
- The surgery and hospital stay
- Medicines and doctor visits for two months after discharge
- Even the ambulance that brought her home
That’s the difference. The best health insurance policy doesn’t just look at your hospital stay. It covers the entire medical journey.
How Are They Actually Different?
I’ll be honest. Most insurance agents themselves mix these up. But knowing the difference can save you money and headaches.
What Gets Covered
Mediclaim sticks to hospital expenses. Health insurance spreads its wings wider. It pays for things that happen before and after you check into a hospital.
Those Extra Doctor Visits
Imagine you have stomach pain. You visit a doctor. He runs some tests. Two days later, you get admitted for appendix surgery. After surgery, you go back for check-ups.
A mediclaim policy might only pay for the surgery part. The best health insurance policy covers all three stages.
Your Yearly Health Check
Some health insurance plans give you a free health check-up every year. Your mediclaim policy won’t do this. It waits for you to fall sick first.
Adding Extra Protection
Want to add coverage for cancer or maternity? Health insurance lets you do that easily. Mediclaim policies are more rigid about such additions.
Finding the Best Mediclaim Policy
When you’re hunting for the best mediclaim policy, forget the fancy brochures. Look at real benefits instead.
Money Matters
Don’t go for anything less than 5 lakh coverage. Medical costs in cities are crazy expensive now. A simple surgery can cost 2-3 lakhs.
Cashless is King
I can’t stress this enough. Make sure you can get cashless treatment. Running around for money during an emergency is the last thing you want.
Growing Old Shouldn’t Be a Problem
Some policies kick you out after you turn 65. That’s exactly when you need insurance most. Pick one that renews for life.
Rewards for Staying Healthy
The best mediclaim policy gives you bonus coverage if you don’t make claims. It’s like getting rewarded for being healthy.
Also, check how fast they settle claims. Ask people who’ve actually used the policy. Google reviews help too.
What the Best Health Insurance Policy Brings to the Table
If you can stretch your budget a bit, health insurance gives you better sleep at night.
The Full Package
Good policies cover you from the moment you feel unwell till you’re completely recovered. That’s 30-60 days before hospitalisation and the same period after.
Same Day Treatments
Not all treatments require you to sleep in a hospital. Chemotherapy, dialysis, and cataract surgery. These happen in a day. Your policy should cover them.
Other Medicine Systems
Do you prefer Ayurvedic treatment? Some policies now cover that. Homoeopathy too. This wasn’t common a few years back.
For Women Planning Babies
Maternity coverage is expensive but necessary. Without it, delivery costs can shock you. Normal delivery itself costs around 50,000 these days.
Room Freedom
Some policies limit your room rent. If you pick a room above their limit, you pay extra for everything. The best health insurance policy doesn’t play these games.
So Which One Should You Actually Buy?
I get this question all the time. There’s no single answer that works for everyone.
Go for mediclaim if:
You’re in your twenties and rarely fall sick. Your budget is tight. You just want basic protection for emergencies. You keep some savings aside for small medical expenses.
Pick health insurance if:
You have kids or elderly parents at home. You want complete peace of mind. You’re okay with paying a bit more every year. You or your family members have ongoing health issues.
What About Buying Both?
Some smart people do this. They buy a basic mediclaim policy first. Then add a health insurance policy on top.
But remember one thing. You can’t claim the same bill twice. However, if your hospital bill crosses your mediclaim limit, the health insurance can cover the rest.
My Final Thoughts
The best mediclaim policy works great if you’re young and healthy. It’s affordable and covers emergencies well.
The best health insurance policy is what I’d recommend for families. Yes, it costs more. But it protects you better when things go wrong.
Whatever you choose, just get something. Medical emergencies don’t send advance warnings. They just show up and demand money.
Talk to your family this weekend. Figure out what works for your situation. Then take action. Your future self will thank you for it.
