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Learn more about Mediclaim policy a form of health insurance policy on Coverfox.com
Mediclaim Policy is a form of health insurance that helps you to manage expenses arising out of medical treatment. The expenses made by you towards the treatment of an illness, overcoming a medical emergency, or hospitalization expenses as a result of an accident are reimbursed up to the sum insured bought by you. In short, for the premium payment made by you to the insurance company, you get to enjoy a financial shield that protects you from medical expenses up to the sum insured for a period of one year.
The most economical manner of being prepared for medical emergencies and protecting your savings is through a mediclaim insurance policy. It looks after clinical prices following hospitalisation on illness or accident or even for any surgery required. The payments are taken care of through either a cashless treatment facility or repayment mode offered by means of the insurance company.
Mediclaim insurance plans reimburse your costs on submission of applicable proofs like clinical bills. Alternatively, it may make you eligible for a wholly cashless hospitalization in which your insurer acts as the intermediary between your insurance provider and the concerned hospital.
*Here is the list of active Mediclaim Plans available in the market:*
Government/Public Health Insurance Companies and It's Mediclaim Policies
|Mediclaim Policy||Entry Age||Sum Insured||Renewability||Network Hospitals|
|National Mediclaim Plus Policy||18 to 65 years||2 to 50 Lakh||Lifelong Renewal||6000+|
|New India Assurance Mediclaim Policy||18 to 65 years||1 to 15 Lakh||Lifelong Renewal||3000+|
|Oriental Individual Mediclaim Policy||18 to 65 years||1 to 10 Lakh||Lifelong Renewal||4300+|
Private Health Insurance Companies and It's Mediclaim Policies
|Mediclaim Policy||Entry Age||Sum Insured||Renewability||Network Hospitals|
|Star Medi classic Insurance Policy||5 months to 65 years||1.5 to 25 lakh||Lifelong Renewal||9900+|
|Future Generali Health Total Mediclaim Insurance||Day 1 up to any age||3 lakh to 1 Cr||Lifelong Renewal||5100+|
Mediclaim policy comes to your rescue in case you are hospitalized due to an accident or any ailment. It covers you for nursing, lodging and treatment costs up to the coverage amount that you choose while buying health insurance policy. Most mediclaim policies also cover the treatment sought before and after hospitalization, related to the reason or ailment you were hospitalized for. This time frame depends on the insurers and typically ranges from 30 to 60 days before hospitalization and between 60 and 120 days after hospitalization.
The rapidly increasing cost of medical and healthcare, one of the reasons being rising inflation rates, emphasises on the importance of a mediclaim policy. Another reason that is making healthcare increasingly expensive is the growing rate of lifestyle-driven health issues.
Sudden health emergencies are sure to leave a hole in your pocket, unless you prepare for it well in advance. A mediclaim policy offers a lump sum health cover, which is the sum insured, when you need it the most. Mediclaim policies in India are available for a specific tenure as offered by insurance companies. These policies can be renewed to avail continued benefits.
In simple terms, mediclaim policy comes to your rescue in case you are hospitalized due to an accident or any ailment. It covers you for nursing, lodging and treatment costs up to the coverage amount you choose while buying the policy. Most mediclaim policies also cover the treatment sought before and after hospitalization related to the reason/ailment you were hospitalized for. This time frame depends on the insurers and typically ranges between 30 days before and 60-120 days after hospitalization.
Sum Insured, Features And Benefits
The three important factors which determine mediclaim policy eligibility are:
The sky-rocketing hospitalization and related healthcare costs might burn a hole in your pockets. It proves to be even more challenging when the expenses arise from unforeseen circumstances like hospitalization due to accidents and critical illnesses. Mediclaim policies serve as financial security, enabling individuals to be prepared for all eventualities.
Considering the extensive range of benefits that you reap on these policies as compared to the reasonable premium payments, mediclaim policies are a smart investment option. Along with the financial cushion that it guarantees, the peace of mind that it offers makes it totally worth it. Well, the answer is simple. Anyone who cannot possibly afford those sky rocketing hospitalization and related healthcare costs should definitely invest in a good mediclaim insurance. Considering the premiums you pay each year, the benefits you reap are much valuable. Along with a financial cushion to reckon, the peace of mind it offers makes it totally worth.
Documents Required to Buy a Mediclaim Policy
The key features of a mediclaim policy are:
Benefits covered by a mediclaim may vary depending on the insurance company. These are the common benefits covered by mediclaim policies:
Types of mediclaim policies can be broadly classified under two categories:
Note: The coverage offered, applicable age limits, sum insured and premium vary across policies and insurers. The information mentioned below is of a basic plan common across insurers.
|Best Mediclaim Plans||Coverage||Age||Sum Insured||Premium|
|Individual Mediclaim Plan||Individual, can range from Rs. 1 lakh to 50 lakhs||Rs. 1 lakh to 50 lakhs or more|
|Family Floater Mediclaim Plan||Family Floater Basis, can range from Rs. 2 lakhs to Rs. 1 crore|
|Senior Citizen Mediclaim Plan||Senior citizens, Some plans offer the option to cover both lives (you and your spouse) up to 90 years of age or lifetime||60 years to 80 years|
Insurance companies consider a lot of factors while determining the premiums for the mediclaim policy. Age, sum insured, geographical location, any pre-existing medical condition, number of members to be insured, the extent of coverage, etc. are some of them. While the guidelines are set by IRDAI, health insurance companies take the final decision regarding premium calculation on the basis of your needs and requirements. The more comprehensive your requirements are, the higher will be the premiums to be shelled out.
How is mediclaim premium calculated?
Insurance companies have their own unique list of parameters that they consider while calculating premium. Here are some parameters that are generally considered by all insurance companies.
Premium is the amount that the policyholder pays towards the insurance policy to become eligible for its benefits, as per the policy document.
Below are some of the best mediclaim policies in India:
• Religare Care NCB Super Premium
• Royal Sundaram Lifeline Supreme
Investing in mediclaim is a great decision. Consider all the factors involved and accordingly choose the right policy. Below are some of the aspects you need to keep an eye on before purchasing the policy:
The claim process of a mediclaim policy has become increasingly more streamlined and quick, owing to the integration of advanced technology. The settlement process follows either of these two methods – cash reimbursement or cashless claims.
If you opt for the reimbursement option during claim settlement, this is the process that is usually followed:
To initiate this process, you have to fill up the Preauthorization Request Form and submit it to your insurance company through the network hospital.
|Make a Claim||Death Claim||Medical Natural Death||Accidental Unnatural Death|
|Claim Form/Pre-authorization Request Form||Original policy documents||Attending physician's statement (Form 'C')||Copy of the First Information Report (FIR) or Panchanama/Police complaint|
|Attending physician's statement||Original/attested copy of death certificate issued by local municipal authority||Medical records (admission notes, discharge/death summary, test reports, etc.)||Copy of Post Mortem report (PMR)/Autopsy and Viscera report|
|Attested copies of all medical records||Death claim application form (Form A)||Copy of the Final Police Investigation report (FPIR)/Charge sheet|
|NEFT mandate form||NEFT mandate form attested by bank authorities along with a cancelled cheque or bank account passbook|
|Nominee's photo identity proof such as copy of Passport, PAN card, Voter identity card, Aadhar (UID) card, etc.|
You need to keep the following parameters in mind while selecting a suitable mediclaim policy:
While choosing a health insurance policy there are a few things which you should be ready with are:
Some mediclaim policies that cover pregnancy in India are:
Yes you can cancel a policy after you buy it. A free look period of 15 days is provided to you after buying a policy to understand the terms and conditions. In case there is any objectionable clause, you can cancel the policy and get a refund. Stamp duty, expenses on medical check-up and proportionate risk premium (the number of days that the insurance company was at a risk of bearing your health expenses) would be calculated while the premium amount is refunded. Refer the policy termination or policy cancellation section in your policy wording to know the amount that would be refunded.
Group mediclaim policies are specifically designed for employers, who can opt for it for their employees on the payment of pre-determined premiums. This policy enables employers to cover their employees on specific hospitalization and other related expenses, as defined in the policy document of the insurance company. Employees can also avail tax benefits under such policies.
The following are the two types of cashless claims in mediclaim:
Here’s how Coverfox simplifies the process of selecting a suitable mediclaim policy.