Health Insurance vs Mediclaim Insurance

 A lot of people are unaware of the different health insurance plans available in India and what exactly they offer. Due to the lack of knowledge, people end up making various health insurance-related mistakes. What we fail to understand is the fundamental difference between a health insurance plan and a Mediclaim insurance.

It is high time we put an end to this confusion. In this article, we have briefly explained the difference between health insurance and Mediclaim insurance. Here’s everything that you need to know.

What Is Mediclaim Insurance?

A Mediclaim policy is nothing but a type of health insurance plan that offers financial protection to you in case of a medical emergency or health-related expenses. It is a simple way to tackle any unforeseen medical expenses.

However, it is noteworthy that the coverage provided is limited to hospitalisation and other expenses incurred by the insurer themselves.

How Does A Mediclaim Insurance Plan Work In India?

Some of the salient features of Mediclaim insurance plan are as follows –

  • Coverage 

A health insurance policy will provide you with financial coverage against hospitalisation expenses, treatment expenses incurred due to accidents and other diseases.

  • Sum Insured

It usually comes with a pre-determined sum insured.

  • Premium Affecting Factors 

The insurance premium rates are calculated based on the sum insured, your age at the time of seeking insurance, gender, geographical location, and policy term.

  • Claim Settlement 

The claim will be settled in the form of reimbursement as well as cashless health insurance treatments

  • Plan Basis 

You can purchase Mediclaim insurance individually or as a group (for family members). When you buy family health insurance, it covers self, spouse, dependent children, and parents.

  • Tax Benefits 

The Mediclaim insurance plans have various tax benefits under Section 80D of the Income Tax Act, 1961.

Difference between Mediclaim Insurance and Health Insurance

The following table compares mediclaim insurance and health insurance.


Mediclaim Insurance

Health Insurance

Policy Coverage

It covers you for the cost incurred during hospitalisation. Mediclaim policy does not cover daycare treatments or pre- and post-hospitalisation expenses

Health insurance provides comprehensive coverage and covers hospitalisation costs, pre- and post-hospitalisation expenses, ambulance costs, daycare treatment expenses, etc. The policy also compensates the insured for the loss of income due to accidents

Add-on Benefits

Mediclaim does not provide any add-on covers to enhance the scope of the policy

You can enhance your health insurance with add-on benefits like critical illness coverage, personal accident coverage, accidental disability coverage, and maternity coverage

How to Avail the Benefits?

Hospitalisation is mandatory to use the benefits under mediclaim policy

Health insurance benefits can be availed without hospitalisation

Can you Increase the Sum Insured?

Mediclaim insurance does not provide any facility to increase the coverage amount

Health insurance offers reinstatement benefits to restore your sum insured amount if it nears exhaustion. Moreover, you can use top-up plans to enhance your overall health insurance coverage


No flexibility

It offers flexibility. You can reduce the insurance premium amounts after a time, change the policy terms, and can avail the maximum insurance benefits

Benefits of Mediclaim and Health Insurance

Irrespective of the differences that these policies have, both mediclaim and health insurance provide certain unique benefits. These include:

Mediclaim Benefits

  • The policy provides immediate coverage when you are hospitalised (sudden or planned).

  • It provides cashless claim settlements wherein the insurer settles your treatment and hospitalisation expenses directly with the hospital.

  • You can also opt for a reimbursement claim wherein the insurer will reimburse the incurred expenses after submitting legitimate bills and discharge papers from the hospital.

Health Insurance Benefits

  • Health insurance provides extensive coverage. Meaning, the policy will cover hospitalisation costs, pre- and post-hospitalisation expenses, daycare treatments, and more.

  • The policy offers numerous top-up benefits to enhance your coverage.

  • Depending on your needs, you can opt for Individual Health Insurance Plans or Family Health Insurance Plans.

  • The policy offers both cashless claim settlements and reimbursement claim settlement.   

What Is Health Insurance?

health insurance policy covers medical and surgical expenses incurred by an individual. You will either have to pay for the expenses incurred which later your insurance company will reimburse, or the insurance company settles the bills directly with the hospital.

The coverage and benefits provided are dependent on the terms and conditions of your policy. A health insurance plan is generally extensive, and the plans are relatively expensive than Mediclaim policy.

How Does A Health Insurance Plan Works In India?

Some of the salient features of health insurance plans are as follows 

  • Coverage 

The basic health insurance plan provides high coverage for a wide-range of illnesses. The plan is relatively sufficient to cover for an individual as well their family members

  • Renewal Discounts 

A basic health insurance plan comes with renewal benefits that can be availed after the end of a claim-free year. In insurance terms, it is known as the No Claim.

  • Co-Payment 

There are a few health insurance plans that come with co-payment options. With this option, a portion of the medical expense incurred is paid by you, and the insurance company covers the remaining.

  • Tax Benefits 

A health insurance policy offers tax benefits under Section 80D of the Income Tax Act, 1961.

Difference between Mediclaim Insurance and Health Insurance

The following table compares Mediclaim insurance and health insurance –


Mediclaim Insurance

Health Insurance


It covers the cost incurred by an individual during hospitalization. All the charges incured before and after hospitalization, is not considered under the cover.

It provides comprehensive coverage in case of hospitalisation, pre and post hospitalisation expenses, ambulance expenses. It also compensates in case of loss of income due to accidents.

Add-on Coverage

Does not offer any add-on coverage

You can enhance your insurance with add-on benefits like critical illness coverage, personal accident coverage, accidental disability coverage, and maternity coverage.


No flexibility is offered

It offers flexibility. You can reduce the insurance premium amounts after a time, change the policy term, and can avail maximum insurance benefits

Health Insurance Calculator

Calculating health insurance premium includes complex algorithms, and the entire process can be time-consuming. Hence, to make the task easier, insurance companies offer health insurance calculator tool on their websites.

With health insurance calculator tool, you can gain understanding regarding the health insurance premiums that you need to pay every month. Moreover, doing so will help you plan your finances and understand your health insurance a bit more.

A Final Thought

Before you purchase a Mediclaim or health insurance policy, understand your expectations. Also, it is advisable to compare different health insurance policies online and choose one with affordable premiums. If you ask us, in the debacle of Mediclaim vs Health Insurance, there is no winner or loser. Both of them helps mitigate health-related risks and expenses.

Get access to the best medical insurance with us on Finserv Markets. The health insurance plan at Finserv Markets offer plenty of insurance solutions, extensive coverage, and swift claim settlement. So, whether you need health insurance for self or your family members, we at Finserv Markets have a broad range of health insurance plans at affordable premium rates.

Apply for Health Insurance at Finserv MARKETS, today!

Best Health Insurance Plans Available at Finserv MARKETS


  • ✔️What is the difference between health insurance and mediclaim insurance?

    The primary difference between the two policies is that mediclaim only covers you during hospitalisation. However, health insurance provides comprehensive coverage irrespective of your hospitalisation.

  • ✔️Does mediclaim insurance offer cashless claim settlements?

    Yes. Mediclaim insurance has a cashless claim settlement facility. The expenses incurred during your hospitalisation are directly taken care of by the insurer.

  • ✔️Does health insurance offer cashless claim settlements?

    Yes. Health insurance, too, offers cashless claim settlements. The insurer will compensate the hospital directly for the incurred expenses.

  • ✔️Can I buy health insurance at Finserv MARKETS?

    Yes. You can buy health insurance plans with us at Finserv MARKETS online. Moreover, you can also use our health insurance app to buy a policy.

  • ✔️How to buy health insurance at Finserv MARKETS online?

     Follow the steps below to buy health insurance online on Finserv MARKETS.

    1. Go to the ‘Health Insurance’ section on the Finserv MARKETS website.

    2. Choose the type of health insurance plan you need: individual health insurance or family health insurance.

    3. Select your coverage amount.

    4. Fill in personal and lifestyle details as requested.

    5. Pay the premium amount online.

    6. The insurer will access your application and issue the policy in no time.

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