Difference between Health Insurance Plan & Mediclaim Policy | PNB MetLife Insurance

How is a health insurance plan different from a mediclaim policy?

PNB MetLife 12-09-2016 12:57:40 PM
How is a health insurance plan different from a mediclaim policy

Though the terms health insurance and mediclaim policy are used interchangeably, there are still some outlining differences between the two. A mediclaim is specific to hospitalization expenses, a health insurance is on the other hand more comprehensive and covers beyond hospitalization. Read More

The differences are given below;

  1. (a) A mediclaim only covers hospital related expenses.
    (b) A health insurance plan may also cover pre and post hospitalization charge, ambulance charges and compensation for all lost income. 
  2. (a) Mediclaim works on the principle of indemnity wherein the hospitalization expenses incurred by the insured are reimbursed to him.
    (b) A health insurance plan works on the principle of benefits according to which a lump sum is given to the insured in case of an eventuality.
  3. (a) In case of a Mediclaim the insured is allowed to make ‘n’ number of claims until the sum insured is exhausted.
    (b) Whereas in case of a health insurance plan, you can only make a claim once, since in case of an eventuality a lump sum is paid to the insured. Once claimed, there is no question of another claim.


To conclude, both the policies serve different purposes and play different roles, therefore it is advisable to have both. A mediclaim policy helps you to pay your bills, whereas a health insurance policy offers you a comprehensive health cover. In case of an eventuality, you can bank on your health insurance policy, whereas a mediclaim would reimburse you for your recurring health expenses.