A Complete Guide on Types of Mediclaim Policy and its Working
A medical insurance is a specific plan that provides coverage for all the hospital expenditures caused due to an unexpected hospitalisation. A proper medical insurance policy provides a reimbursement of a pre-specified percentage of expenditures including consultation fees of the doctors, X-rays, pathological tests, hospitalisation, medicine, operation theatre, follow-ups, etc.
The need for mediclaim policies
With the increasing cost of medical expenses, it has become inevitable to get a prudent mediclaim policy that will help in covering the costs instantaneously. You can avail a medical insurance plan on individual and family (group) basis. The specific facility is extended to workers of a company as well.
For more information on cashless mediclaim policy, you can contact a reputed insurance provider company.
Types of Medical Insurance
Health insurance is also known as medical insurance or in a simple term- mediclaim. It covers an individual’s surgical as well as medical expenses. To avail the health coverage, a person needs to pay a pre-specified sum (which is known as a premium), each year.
There are three types of mediclaim policy or health insurance policy available in India. They are:
The particular plan will offer reimbursement for the hospitalisation as well as medical costs involved during the hospital stay. The amount reimbursed will depend on the sum insured. That is why such plans are also called indemnity plans (total protection to cover costs of medical treatment).
You can fix the sum assured:
- For a single family member if you choose to get individual mediclaim or
- For an entire family if, you want to go for a family floater mediclaim policy
As an example, if there are three members in a family involved with an individual coverage of Rs. 1 lakh each, each of the members can claim for the reimbursement of maximum Rs. 1 lakh because these are all independent policies.
If a family enrols in a family floater policy with a coverage of Rs. 3 lakhs, then any member of that family can claim his/her medical benefit for the amount over Rs. 1 lakh up to the period within which it is limited to Rs. 3 lakhs (complete sum assured).
Hospital Daily Cash Benefit Plans
Hospital daily cash benefit plan is a defined benefit policy. It pays out a pre-specified amount of money for hospitalisation on a regular basis irrespective of the actual cost. As an instance, the hospitalisation expenses for a day might be Rs. 2,000/day and the pre-defined daily policy limit may be Rs 1,500/day, in this scenario, the insured gets the latter. In case of Rs. 1,000/day of hospitalisation cost, the insured will still receive Rs. 1,500/day.
Critical Illness Plans
These plans are benefit-based mediclaim plans that reimburse a lump sum amount on the diagnosis of pre-specified medical procedures and critical illnesses. The illnesses are described at the beginning. It is a fact that critical illnesses are involved with the nature of low frequency and high severity. In this case, the treatment cost is higher, as compared to normal medical problems, such as stroke, heart attack among others.
You should not forget to compare mediclaim policy before choosing the best one for you or your family.