Mediclaim Policy

The cost of healthcare is increasing in India. The yearly cost of universal medicine is expected to be around INR 1,713 per individual. Using branded healthcare supplies and pharmaceuticals can raise this cost by almost 24%. This makes it all more necessary to have a good mediclaim policy as a part of everyone's family health program. This article will go over everything you need to know about mediclaim health insurance plans in India.

What is mediclaim?

A mediclaim can be defined as a type of health insurance plan that reimburses the insured for medical expenditures incurred while treating their health problem. If you have mediclaim insurance, you can send your invoices for reimbursement to the insurance provider. You can also choose cashless care, which puts the insurance provider in a position to settle hospital and medical bills directly with the hospital administration.

Here are some of the most popular Mediclaim policies available:

1). National Mediclaim Policy

This is an indemnity health insurance policy which offers a sum insured ranging from INR 1 lakh to 10 lakhs on an individual basis.

• Sum insured: INR 1 lakh to INR 10 lakhs
• Policy type: Individual
• Policy term: 1 Year
• Entry Age: 18 years to 65 years

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Ayurveda and homoeopathy treatment
• Daycare treatments
• HIV / AIDS treatments
• Organ donor expenses
• Mental illness treatment
• Morbid obesity treatment
• Ambulance charges
• Refractive error correction

2). National Mediclaim Policy

This is an indemnity medical insurance policy divided into Plan A, B and C with the sum insured ranging from INR 2 lakhs to INR 5 lakhs on individual coverage basis.

• Sum insured: INR 2 lakhs to INR 50 lakhs
• Policy type: Individual
• Policy term: 1 Year
• Entry Age: 18 years to 65 years

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Daycare treatments
• Organ donor expenses
• Ayurveda and homoeopathy treatment
• Maternity cover
• Hospital cash benefit
• Air ambulance cover
• Road ambulance covers
• Medical emergency reunion
• Nursing care and doctor visit fees during post-hospitalisation
• Children's vaccination
• HIV / AIDS cover
• Modern treatment procedures
• Mental illness cover
• Refractive error correction
• Morbid obesity treatment
• Medical second opinion cover

3). National Parivar Mediclaim Policy Plus

This is a family floater indemnity health insurance plan with sum insurance ranging from INR 1 lakh to INR 10 lakhs

• Sum insured: INR 1 lakhs to INR 10 lakhs
• Policy type: Family floater
• Policy term: 1,2, or 3 years
• Entry Age: 18 years to 65 years

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Domiciliary hospitalisation
• Daycare treatments
• Organ donor expenses
• Ayurveda and homoeopathy treatment
• Hospital cash benefit
• Ambulance cover
• Anti-rabies vaccine covers
• Maternity cover
• Infertility treatment
• HIV/AIDS cover
• Modern treatment procedures
• Mental illness cover
• Morbid obesity treatment
• Medial second opinion
• Refractive error correction
• Pre-existing diseases cover including hypertension (available as an optional cover)
• Critical illness cover (available as an optional cover)
• Outpatient treatment (available as an optional cover)

4). New India Janata Mediclaim Plan

This is an indemnity 1-year health insurance plan for people on a tight budget with sum insured options being INR 50,000 and INR 75,000.

• Sum insured: INR 50,000 and INR 75,000
• Policy term: 1 Years

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• AYUSH treatment
• Ambulance cover
• Organ donor expenses

5). Senior Citizen Mediclaim Policy of New India

This is an indemnity medical insurance policy for people above the age of 60 years, offering sum insured options of INR 1 lakh and 1.5 lakhs.

• Sum insured: INR 1 lakh and 1.5 lakhs
• Policy type: Individual / Family floater
• Entry Age: 60 to 80 years

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Ambulance charges
• AYUSH treatment
• Ambulance cover
• Organ donor expenses

6). New India Floater Mediclaim Policy

This is an indemnity medical insurance policy which offers family floater-based sum insured options from INR 2 lakhs to 15 lakhs.

• Sum insured: INR 1 lakh and 15 lakhs
• Policy type: Individual / Family floater
• Entry Age: Adults: 18 years to 65 years
• Financially dependent children: 3 months to 25 years

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Cataract correction treatment
• Ayurveda, homoeopathy and unani treatment
• Hospital cash benefit
• Critical care benefit
• Ambulance cover
• Congenital internal disease cover
• No proportionate deduction (available as an optional cover)
• Maternity cover (available as an optional cover)
• Cataract limit revision (available as an optional cover)

7). PNB Oriental Royal Mediclaim Policy

This is an indemnity health insurance policy made for the current accountholders of Punjab National Banka as well as other associated banks.

• Sum insured: INR 2 lakhs to INR 10 lakhs
• Policy type: Individual / Family floater
• Policy tenure: 1 Year
• Entry Age: Adults: Adults: 18 years to 79 years Financially dependent children: 91 days

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Daycare treatments
• Organ donor expenses
• Domiciliary hospitalisation
• AYUSH treatment

8). Oriental Bank Mediclaim Policy

This is an indemnity family floater health insurance policy made for the current accountholders of Oriental Banks.

• Sum insured: INR 1 lakhs to INR 5 lakhs
• Policy type:Family floater
• Entry Age: Adults: Adults: 18 years to 79 years
• Financially dependent children: 3 months to 26 years

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Daily hospital cash benefit
• Ambulance cover
• Organ donor expenses

9). Raheja QBE Comprehensive Plan

This is an indemnity health insurance plan which offers a sum insured ranging from INR 3 lakhs to 50 lakhs.

• Sum insured: INR 3 lakhs to INR 50 lakhs
• Policy type:Individual/Family floater
• Entry Age: Adults: Adults: 18 years to 65 years Financially dependent children: 3 months to 25 years

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Ambulance cover
• Daily allowance benefits
• Organ donor expenses
• Recharge benefit
• Medical check-up benefit
• Increase in sum insured benefit
• Domiciliary hospitalisation
• Sub-limit waiver (available as an optional cover)
• 20% co-pay (available as an optional cover)

10). Reliance Critical illness Insurance

This is a fixed benefit health insurance plan which covers 10 critical illnesses and offers a sum insured from INR 5 lakhs to 10 lakhs.

• Sum insured: INR 5 lakhs to INR 10 lakhs
• Policy type:Individual
• Entry Age: Adults: 18 years to 65 years

Coverage:

• Aorta graft surgery
• Third-degree burns
• Multiple sclerosis
• Major organ transplant
• Cancer
• Regular dialysis due to end-stage renal disease
• Complete blindness
• Coma quadriplegia
• Specified severity coma
• Heart valve repair or replacement

11). Royal Sundaram Lifeline Supreme Health Plan

This is an indemnity health insurance policy which offers insured sum options ranging from INR 5 lakhs to INR 50 lakhs.

• Sum insured: INR 5 lakhs to INR 50 lakhs
• Policy type:Individual/Family floater
• Policy tenure:1,2 or 3 years
• Entry Age: Adults: 18 years

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Daycare treatments
• Ambulance cover
• Organ donor expenses
• Domiciliary hospitalisation
• Sum insured reload
• AYUSH treatment
• Animal bite vaccination
• Critical illness second opinion
• Emergency domestic evacuation
• Emergency worldwide hospitalisation
• International treatment cover for 11 critical illnesses
• Maternity cover
• OPD treatment
• Top-up cover (available as an optional cover)
• Hospital cash benefit (available as an optional cover)

12). SBI Arogya Premier Policy

This is an indemnity health insurance policy which offers a sum insured ranging from INR 10 lakh to INR 30 lakhs.

• Sum insured: INR 10 lakhs to INR 30 lakhs
• Policy tenure:1,2 or 3 years
• Entry Age: 3 months to 65 years

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Daycare treatments
• Ambulance cover
• Organ donor cover
• Alternative treatments
• Domiciliary hospitalisation
• Maternity cover
• Healthcare check-up
• Sum insured reinstatement
• Cumulative bonus
• Mental illness cover
• HIV / AIDS treatment
• Genetic disorders cover
• Advanced treatment procedures
• Internal congenital diseases

13). Star Family Health Optima Plan

This is an indemnity health insurance plan which offers a sum insured ranging from INR 3 lakhs to 25 lakhs on a family floater basis.

• Sum insured: INR 3 lakhs to INR 25 lakhs
• Policy type:Family floater
• Policy tenure:1,2 or 3 years
• Entry Age: Adults: 18 years to 65 years
• Dependent children: 16 days to 25 years

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Modern treatment procedures
• Daycare treatments
• Premium instalment facility
• Domiciliary hospitalisation
• Organ donor expenses
• Healthcare check-up
• Newborn baby cover
• Emergency domestic medical evacuation
• Compassionate travel
• Mortal remain repatriation
• Valuable service provider treatment
• Shared accommodation cover
• AYUSH treatment
• Second medical opinion
• Assisted reproduction treatment
• Extra sum insured cover for road traffic accident
• Sum insured automatic restoration
• Cataract surgery
• Recharge benefit
• Cumulative bonus
• Co-payment

14). TATA AIG MediCare Plan

This is an indemnity health insurance policy which offers health insurance coverage ranging from INR 3 lakhs to INR 20 lakhs.

• Sum insured: INR 3 lakhs to INR 20 lakhs
• Policy type:Individual/Family floater
• Policy tenure:1,2 or 3 years
• Entry Age: 91 days

• Sum insured: INR 3 lakhs to INR 20 lakhs
• Entry Age: 21 years to 65 years

Coverage:

• Permanent limb paralysis
• Permanent symptoms of motor neurone disease
• Multiple sclerosis
• Bone marrow or major organ transplant
• Permanent symptoms from stroke
• Kidney failure
• Specified severity coma
• Heart valve replacement
• Coronary artery surgery
• First heart attack of specified severity
• Specified severity cancer

16). Universal Sompo Complete Healthcare Plan

This is an indemnity health insurance policy which offers health insurance coverage ranging from INR 1 lakh to INR 50 lakhs.

• Sum insured:INR 1 lakhs to INR 50 lakhs
• Policy type:Individual/Family floater
• Policy tenure:1,2 or 3 years
• Entry Age:Adults: 18 years to 65 years Dependent children: 91 days to 25 years

Coverage:

• In-patient hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Daycare treatment
• Domiciliary treatment
• Organ donor expenses
• Ambulance cover
• Accidental dental treatment
• AYUSH treatment cover
• Daily cash benefit
• Vaccination cover
• Out-patient treatments
• Convalescence benefit
• Maternity cover with child care benefit
• Restore benefit
• Health check-ups
• Dail-a-doctor benefits
• Health educational library
• Second opinion
• Specialist consolation with follow-ups
• Personal accident cover (available as an optional cover)
• Critical illness cover (available as an optional cover)
• Hospital daily cash benefit (available as an optional cover)
• Tiered network treatment (available as an optional cover)
• Pre-hospitalisation expenses extension (available as an optional cover)
• Post-hospitalisation expenses extension (available as an optional cover)
• Modification of maternity cover and childcare benefit (available as an optional cover)
• Non-medical item cover (available as an optional cover)
• Restore benefit condition waiver (available as an optional cover)
• Pre-existing disease waiting term waiver (available as an optional cover)
• Modification of outpatient dental treatment (available as an optional cover)
• Emergency travel allowance (available as an optional cover)
• Weight control expenses extension (available as an optional cover)
• Infertility and sterility treatment extension (available as an optional cover)
• Organ donor expenses extension (available as an optional cover)
• Premium waiver (available as an optional cover)
• Global cover (available as an optional cover)
• Medically advised support devices cover (available as an optional cover)
• Co-payment option (available as an optional cover)
• Homecare treatments (available as an optional cover)
• Extra wellness benefits (available as an optional cover)

If you are on the lookout for the best health insurance in India, these mediclaim insurance policies are a great place to start. However, you should keep in mind that the best health insurance policy depends on your coverage requirements as well as your budget. So, you should compare health insurance online in order to get the best deal available. This helps you when you decide to buy health insurance plan.

You can raise claims in two ways when you have a mediclaim policy. The first one is a cashless claim & the second one is a reimbursement claim. Here's some quick info on the mediclaim policy claim's procedure.

Cashless Claim Procedure For Mediclaim Policy?

Cashless claims make sure that you receive cashless medical treatment at a network hospital as your mediclaim policy. You don't have to pay a single penny at the network hospital for medical treatment.

Steps for Cashless Claims

• Visit the network hospital listed in your mediclaim policy to avail treatment.
• Get the pre-authorization form available at the hospital's health insurance desk.
• Fill the form mentioning all your details with correct information.
• Get the hospital stamp on the form.
• The network hospital will send your stamped form to the respective TPA - Third Party Administrator or the mediclaim policy insurer
• for further approval.
• The company will carefully examine the form & then approve the medical treatment.
• After approval, it will send a fax back to your hospital mentioning the cover amount.
• You can then complete your treatment & provide your signatures on all documents during your discharge
• After this, your mediclaim policy company will pay your hospital bill amount.

Reimbursement Claim Procedure For Mediclaim Policy?

• For reimbursement claims, you need to inform your mediclaim policy company about your hospitalization.
• You can inform the company via email or by simply making a call to your insurance provider's customer care service number.
• After your treatment is over, gather all your hospital medical documents.
• Submit all your hospital bills, medicine bills, payment receipts to your mediclaim policy provider.
• Attach the claim form & the original discharge card along with the bunch of these bills. After this, the mediclaim policy company will review your claim.
• After approval, the company will pay your reimbursement amount.

• Save Up To Rs. 75,000 On The Overall Mediclaim Policy
  A Mediclaim policy offers tax benefits where you can save nearly up to Rs.75,000. This falls under the Section 80D of IT Act 1961.

• Save Up To Rs. 25,000 on Mediclaim Policy Premium
  Buying a Mediclaim policy can get you a deduction of up to Rs. 25,000 every budgetary year on your mediclaim policy premium.

• Save Extra Rs. 25,000 on Mediclaim Policy For Parents
  If you have a mediclaim policy for your parents, you can claim additional deduction of up to nearly Rs. 25,000/- each budgetary year.

• Save More Rs. 5,000/- Annually On Medical Check-Ups
  You can also get tax benefits through claims on your preventive medical health check-ups once in a year under the Section 80D of IT Act. This can be up to 5000/- annually.

*The above-mentioned list of benefits are according to the present tax laws in our country. You should reconfirm about these benefits from your mediclaim policy provider.

A good health insurance policy is the best thing that you can avail of and invest in if you want to enjoy financial stability. The fact that healthcare costs go on rising year by year has made it essential for everyone to obtain insurance coverage as soon as they are able. Having the right mediclaim policy gives you peace of mind and makes every household function smoothly, even in difficult times. So, if you haven’t already, you should get one of the best health insurance plans in India. The best health insurance plan in India will meet all your coverage requirements as well as offer multiple value-added benefits when you renew health insurance online.