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Mediclaim Policy

A mediclaim policy or medical insurance is a health cover offering protection against standard hospitalisation expenses, including COVID-19 treatment, OPD, diagnosis, and more. Learn more about the benefits of mediclaim policy in this guide.

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What is the Mediclaim Policy?

Health mediclaim is a classification of health insurance that helps us mitigate the monetary risk whenever we need financial assistance during sickness or urgent medical attention. Mediclaim policy covers your hospitalisation expenses and any specific ailments and treatments you incur. Mediclaim policies ensure financial protection against your sickness or accident up to the sum insured. So, to combat such a medical crisis, we offer mediclaim insurance plans that cover your risks and provide you with financial support whenever you need it.

You cannot predict health uncertainties, but you can stay prepared. But India's best mediclaim policy helps you stand strong during a medical emergency. A health insurance plan covers your medical expenses up to the sum insured and helps to avail the best possible treatment for yourself or your loved ones. Under this policy, you can cover yourself, your spouse, children, and dependent parents and opt for a cashless hospitalisation facility or reimbursement to settle the claim. It is the best mediclaim policy in India for investment that offers you class healthcare services without worrying about money. So, your farsighted approach, pragmatic planning, and mediclaim health insurance cover help you to stay in the pinkest of your health without financial stress.

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Features & Benefits of Mediclaim Policy in India

It is a comprehensive mediclaim in India that provides financial assistance during hospitalisation. With the best mediclaim policy in India, you do not need to arrange cash for your treatment. We settle your medical bills so that you can focus on your recovery if you have best mediclaim policy in India in place. Let's take a close look at key features and benefits of mediclaim:

  • Cover for in-patient hospitalisation
  • Coverage for medical expenses during pre and post-hospitalisation
  • Claim settlement either by a cashless facility or by reimbursement up to the sum insured
  • Minimum 24 hours hospitalisation is required to get the claim
  • It also has a list of specific exclusions
  • Lifelong renewability is easily available
  • No upper age limit for enrolment
  • In a family mediclaim, you can pay a lump sum premium instead of paying for individual policies.

Above mentioned features and benefits clearly communicates how Care mediclaim can be your saviour when need help the most.

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Why is a Mediclaim Insurance Policy Important?

It is a saviour whenever you or your family face a medical emergency. It supports you without depletion of your savings. Read below the vital benefits of having the best medical policy for the family:

  • It provides a cashless hospitalisation facility during a medical emergency.
  • It will cover various out-of-pocket medical expenditures.
  • It has additional add-ons, such as an international second opinion you can select according to your healthcare needs for complete protection.
  • It offers coverage for your pre and post-hospitalisation medical expenses such as OPD expenses, diagnosis, doctor's fee, medication, therapies, etc.
  • One has the lifelong renewability option with additional benefits, such as coverage for alternative treatments, day care procedures, annual health check-ups, etc.
  • You can choose the advanced treatment facility on a cashless basis at any in-network hospitals in nearby locations.
  • Avail tax benefits under Section 80D of the Income Tax Act up to Rs.1,00,000 for the premium paid for a family floater policy, depending on the age of the proposer & insured.

Understanding the importance of the best mediclaim insurance policy and the benefits of mediclaim for individuals and the family.

What is Covered under a Mediclaim Policy?

Due to the uncertainties of life and the constant rise in health care costs, mediclaim nowadays is essential for families and individuals. Knowing the best mediclaim policy in India is always safe before you decide to buy a medical claim policy. Read below what mediclaim covers.

 

In-Patient hospitalisation

We cover your hospitalisation expenses if the in-patient hospitalisation lasts more than 24 hours. These include room charges, nursing expenses, ICU, surgeon's fee, doctor's fee, blood, oxygen, and OT (operation theatre changers).

 

Day Care Treatments

If you have to undergo procedure requiring a day's hospitalisation, we bear your daycare treatment expenses up to the sum insured. We cover 540 daycare treatments, the highest in the industry.

 

Pre and post-hospitalisation

It covers your pre and post-hospitalisation expenses that include diagnosis, treatment, and medicine expenses, along with doctor's fees.

 

ICU Charges

We value every life and know the importance of the right healthcare services. If you are admitted to ICU, we will cover the charges.

 

Ambulance cover

This policy provides reimbursement against the expenses that you incur on an ambulance during a medical emergency, subjected to terms and conditions of the policy.

 

Annual Health Check-Ups

Under the mediclaim plan, you will get an annual health check-up facility at our empanelled healthcare services providers. It includes complete blood sugar, urine routine, kidney function, ECG check-ups, etc

 

Recharge of Sum Insured

If your coverage amount gets exhausted, there will be an automatic recharge of the sum insured. You can use this amount to treat for the treatment of any other insured family member or yourself.

 

Other Benefits

Exclusive benefits such as organ donor cover, second opinion, NCB, and alternative treatments can come to your rescue and save you from exhausting your finances.

Always aim to buy the best mediclaim in India such as Care mediclaim policy, so you don’t have to regret it later.

What is Not Covered under a Mediclaim Policy?

The medical conditions not admissible under a medical insurance plan are called exclusions. You can read below the exclusions under mediclaim.

  • Any diagnosis, treatment, or surgery for illnesses occurring within 30 days of the Policy Period Start date
  • Medical expenses related to the treatment of congenital disease
  • Medical expenses incurred due to IVF or infertility treatment
  • Treatment arising due to/ or traceable to pregnancy, childbirth, miscarriage, abortion, and its consequences
  • Hospitalisation due to war, riot, strike, or nuclear weapons
  • Medical expenses due to alcohol or drug abuse
  • Expenses arising due to self-inflicted injuries and suicide/suicide attempt
  • Pre-existing disease up to 36 months since the policy inception

Types of Mediclaim Policy

Several types of mediclaim policies are available in India. Care Health Insurance offers comprehensive and customised mediclaim insurance policies that cater to your unique healthcare needs and help you access the best treatment. Let us understand the different types of mediclaim policies:

  • Individual Mediclaim: An individual mediclaim plan covers only one individual for the specified sum insured. Mediclaim insurance policy benefits and the entire sum insured are available to the policyholder for the premium applicable. Once you buy best mediclaim policy for individual, you willbe at ease.
  • Family Floater Mediclaim Cover: In a family floater mediclaim insurance policy, the coverage and benefits are available to all the insured family members, including spouses, children, and parents. Mediclaim health insurance for family has a floater sum insured that either one individual or the entire family can utilize for any hospitalisation or medical treatment.
  • Senior Citizen Mediclaim Policy: Mediclaim for senior citizens is a type of mediclaim designed to provide coverage and benefits, including hospitalisation coverage, for elderly individuals above 60 years.
  • Critical Illness Mediclaim: Critical illnesses require long-term medical treatment that may lead to astronomically high medical bills. Critical illness mediclaim policies are designed to cover severe ailments, such as stroke, cancer, heart disease, etc. We offer coverage for 32 critical illnesses under mediclaim insurance.
  • Cancer Mediclaim: Cancer mediclaim plans provide lifelong protection, comprehensive coverage for various cancer treatments, and chemotherapy and radiotherapy coverage. Investing in best mediclaim policy early is wise, as people already diagnosed with cancer cannot get it.
  • Heart Mediclaim: Best mediclaim policy such as heart mediclaim insurance plans provide comprehensive hospitalisation and medical treatment coverage for various heart-related ailments, thus saving a person from financial stress. At Care health insurance, our heart care mediclaim covers 16 major heart ailments.

Care health insurance offers the most comprehensive mediclaim plans suiting your requirements. We also ensure that your mediclaim insurance premium is affordable so that it doesn’t burden your pocket and savings. Moreover, you can buy mediclaim online if you don’t want to experience hassle of communicating with agents.

How is Mediclaim Policy Helpful for You and Your Family?

Do you know a single-time hospitalisation can push your financial planning back? Why take a risk? If you have a family to care for, opt for a mediclaim plan now. And mediclaim for senior citizens is even more important if you want your elders to be secure. Read below how it is crucial:

  • Increasing Lifestyle Diseases: The incidences of lifestyle and critical diseases are rising in India. A medical emergency can come as an uninvited guest. So, staying protected with the best mediclaim policy in India that covers your expenses during a medical emergency is better.
  • Cashless hospitalisation: You do not need to worry about cash for the treatment. Under the mediclaim plan, we will directly settle your hospital bills. Go for the best cashless mediclaim policy without worries.
  • Lifelong Coverage: You do not need to buy medical insurance repeatedly. Once you get it, you and your family enjoy lifelong coverage on break-free renewals.
  • Preventive Care: Preventive health check-ups can cost you extra and burden your pocket. Opt for a mediclaim policy in India that offers annual health check-ups for all insured members.
  • EMI Option: The great relief to your pocket. You can opt for the EMI option and pay a mediclaim premium monthly or quarterly that reduces your financial burden.
  • Quick Recovery Counseling: Sometimes, you need counselling to recover from health problems. You can get advice from a psychologist through face-to-face consultation up to the amount per session fixed.
  • No Claim Bonus: Get a no-claim bonus to reward your health. It is a seamless feature that helps you to double your sum insured.
  • Tax Exemption: Under section 80D of the Income Tax Act 1961, the premium paid for the policy for self, dependent parents, children, and spouses qualify for tax deductions. So, save more and stay healthy with the best mediclaim policy in India. Also, you can save more tax if you buy the best mediclaim policy for parents.

Now that you know how mediclaim works, you can decide and make an informed decision that would only help you during unforeseen medical emergencies. Buy mediclaim policy today and be stressfree for coming years of your life.

How to Select the Best Mediclaim Policy in India?

Selecting a Mediclaim policy is one of the most crucial tasks you have to do for yourself and your family. Knowing what you want in your policy is important and helps you in life. See the factors below to Consider while selecting a mediclaim policy in India-

 

Coverage

The higher the coverage you opt for, the better. There is a direct correlation between the premium you pay and the coverage you receive. Some providers offer to cover more than the basic hospitalisation and pre-and-post-hospitalisation expenses.

 

Flexibility

Care Health Insurance allows you to recharge the sum insured, up to 100% of the original SI, if the amount gets exhausted. Look for such options that build useful flexibility into your plan.

 

Maximum Age to Renew

Care Health Insurance mediclaim policy ensures to stand by you even when you turn old. While looking for a healthcare policy, find one that offers you lifelong renewal. This option will keep you at ease in your elderly years.

 

Simple Claim Process

This factor is relevant, regardless of your age. Ensure you understand how the claim process works in advance so you save time and effort following up on a claim.

 

Day-care Procedures

Opting for a policy that also covers daycare procedures is wiser. We cover medical expenses if you undergo a daycare treatment which might not require you to stay hospitalized for 24 hours or more, and we cover over 540+ daycare procedures.

 

How to Buy Mediclaim Policy Online?

Mediclaim policy is absolutely simple to buy mediclaim online with us. Follow these simple steps to get mediclaim policy online hassle-free:

  • Visit our official website
  • Enter the required details, including contact number and email id
  • Click on Get Quote
  • Fill in the Proposer details, including mobile number, email ID, name, and Pincode
  • Click on Next and enter the insured person's details, such as gender and age
  • Click on the Next button and fill in the details for pre-existing conditions if any
  • Select the sum insured and policy tenure
  • At the top, you can see the premium, including GST and EMI options too
  • Click on Buy Now, and the 'quick pay' page will open where you need to confirm proposer details, then click on the Next button
  • Please select any of our secure payment modes such as net banking, debit or credit cards, or payment wallets
  • You will receive the policy documents, including the policy number and e-card, on your registered email-id

Factors You Should Consider While Buying a Mediclaim Plan

Mediclaim will protect you at any time when you face a medical emergency or any planned medical treatment for you or your loved ones. Choose a policy wisely so that you can avail the maximum benefits. You may find options to buy mediclaim online, but finalising what is best can be challenging, especially if you get a mediclaim policy for the first time. We list some vital factors you should consider when choosing or comparing mediclaim policies online:

  • Type of Coverage: A mediclaim policy in India is classified broadly into individual and family floater mediclaim plans. Choose family floater plans as they are affordable and cover the entire family for a single premium. An individual health insurance plan may be suitable if there are elderly family members.
  • Sum Insured: Carefully select the coverage amount after thoroughly assessing your estimated medical expenses and considering aspects like medical inflation rate and cost of surgeries and treatments. Also, the treatment costs in metro cities are relatively higher. Moreover, a higher sum insured is advisable if you cover your entire family.
  • Benefits: Opt for a plan that gives maximum coverage, including hospitalisation, ambulance cover, daycare treatment, medication, and pre and post-hospitalisation medical expenses. Know the additional benefits you can get, such as international second opinion, OPD cover, and more to enhance the policy coverage.
  • Premium: The coverage you would get should not make you spend on high premium costs. Check and compare the premium using the online mediclaim premium calculator on our official website to pick the most affordable policy.
  • Discounts: Discounts help you save money while getting affordable health coverage. You can get a discount of up to 10% at Care health insurance if you opt for a 3-year policy term.
  • Lifelong Renewability: Always check the eligibility criteria and pick a plan with lifelong renewability. Health risks increase as we become older; at the same time, it becomes more difficult to get medical insurance coverage as we age. So, it is essential to ensure that you get a lifelong renewability feature to continue coverage under the same mediclaim plan.
  • Exclusions: The best mediclaim in India covers various health risks. However, there are specific scenarios and expenses for which the policyholder cannot get a claim. They include self-inflicted injuries, consumption/abuse of alcohol or drugs, etc. Check the permanent and temporary exclusions mentioned in the policy documents to avoid any hassle during claim settlement.
  • Waiting Period: Before saying yes to a mediclaim or health insurance policy, check the document's waiting period clause. There is an initial waiting period, a waiting period for pre-existing diseases, and a waiting period for specified ailments/treatments. If you have a pre-existing illness before the policy issuance, check the waiting period clause and ensure you do not need to wait long to get the coverage. That is, opt for a policy with a minimum waiting period.
  • Network Hospitals: Check out the network hospitals empanelled with us. Identify the network hospitals in proximity where you will be comfortable getting the cashless medical treatment.
  • Claim Settlement Ratio: If the claim settlement ratio is higher, it indicates how easily you will get a claim. Consider this factor and make an informed decision while buying a mediclaim plan.

Be careful when you buy mediclaim online, as there could be hidden terms and conditions to the plan you choose. Getting an online mediclaim policy and first-hand information regarding the plan you want to opt for is always convenient.

How to Claim Mediclaim Policy?

With us, claim under the mediclaim policy is quick and easy. You must inform our customer support team within 24 hours of hospitalisation during an emergency. For planned hospitalisation, you need to inform before 48 hours of hospitalisation. You can file the claim in two ways:

Cashless Claim Process Reimbursement Claim Process
Step 1: Go to a listed in-network hospital. Step 1: Submit your claim form along with other required documents.
Step 2: Fill out the proper forms at the insurance desk. Step 2: You'll get an approval letter when your claim is verified.
Step 3: Send the completed form to our claim management team. Step 3: Respond to queries raised by the claim management team.
Step 4: You'll get an approval letter when your claim is verified. Step 4: Get approval from the claim management team.
Step 5: Respond to queries from the claim management team. You will receive communication about whether your cashless claim is approved or rejected within the standard TAT. Step 5: Our claims team will contact you if there are specific reasons for rejecting your claim.

Double-checking the mediclaim policy details before buying is necessary to avoid so that you don’t face any issues while getting a claim. Also make sure you read through your online mediclaim policy as well.

Disclaimer: Procedure can vary as per mediclaim health insurance product opted.

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FAQ on Mediclaim Policy

Q. How to take Mediclaim policy? Can I also buy online mediclaim policy?

You can buy a mediclaim policy either online or offline. You will have to choose a company first. Your chosen company should be based on premium, cashless network and other benefits. One can also buy a Mediclaim policy by visiting the nearest branch of the chosen insurance provider.

Q. How to Port a Mediclaim Policy in India?

You can port the mediclaim health insurance only at the stage of policy renewal. Intimation for porting is required 45 days before renewal. Inform your last insurer in writing for a porting, mentioning the name of the new insurer. Fill up our portability form with existing insurance details, submit the relevant documents, and make payment for mediclaim health insurance.

Note: NCB will not reduce if the claim amount exceeds 25% of SI under the add-on Care Shield. For details, refer to policy T&C.

Q. Is it Possible to Modify the Sum Insured in the Mediclaim Policy?

Yes, you can modify the sum insured in the mediclaim policy; that shall be permissible only at the time of policy renewal. However, it can affect your premium amount. So, reading through the mediclaim policy details is important to understand better.

Q. Can I Add or Remove Family Members in My Current Mediclaim Policy for the Family?

No, you cannot add and remove family members in your current mediclaim policy for the family. You can do it only at the time of policy renewal.

Q. Can I Change the Date of Birth if it is Written Incorrectly in the Mediclaim Policy Document?

Accepting change in DOB is solely Care's discretion and may affect your premium. Therefore, providing the right birth date and other details when purchasing the mediclaim policy is advisable.

 

Q. What should I do if my mediclaim policy expires?

You can renew your mediclaim policy online and offline both, within the grace period of 30 days.

Q. What are the age criteria to buy a mediclaim policy?

The minimum entry age to buy a mediclaim policy is 91 days to 4 years (with at least one insured member of 18 years of age or above) and 5 years on an individual basis, and the maximum entry age has no age bar, with lifelong renewability.

Q. Do mediclaims cover accidents?

Yes, mediclaims cover accidents as well. However, you need to buy it as an optional benefit. Under this, you will get an additional sum insured for accidental hospitalisation.

Q. Which mediclaim policy covers dental treatment?

Our various mediclaim policies and operation mediclaim cover dental treatment subject to policy terms and conditions.

Q. Who should purchase mediclaim insurance plans?

Mediclaim insurance is recommended for everyone, especially in this age of rising medical inflation and increasing lifestyle diseases. It is a must for those who depend on their corporate health insurance and do not have a separate health cover. Anyone 18 years of age or above can purchase a mediclaim insurance policy for themselves or their loved ones.

Q. Can I buy mediclaim policy online?

Yes, you can buy mediclaim policy online while visiting our official website.

Q. Does mediclaim cover AYUSH?

Yes, you will get coverage for alternative treatments like AYUSH.

Q. Will Mediclaim Policy Cover Coronavirus Infections?

Our indemnity-based products offer hospitalisation coverage for COVID-19. Do refer to the terms and conditions for more details.

Q. What is Cashless Mediclaim Policy?

A Cashless Mediclaim is an advantage offered by most healthcare providers. Under a cashless Mediclaim, medical bills are directly settled by the insurance company, provided the total bill amount falls within the assured limit, and the hospital is a network hospital. Thus, it is always important to buy the best cashless mediclaim policy.

Q. What does the Overseas Mediclaim Policy Mean?

As the name suggests, mediclaim policies act as health insurance that covers the risk of hospitalisation expenses if you travel to a foreign country.

Q. What is Floater Mediclaim Insurance Policy?

The Floater mediclaim policy is a tailor-made plan for families. It is almost similar to individual health insurance, but the only difference is that mediclaim health insurance for families acts as an umbrella to cover your entire family.

Q. Can I Port my Mediclaim policy? If yes, What is the Process?

Yes, you can port your mediclaim policy. You must approach the insurance provider where you wish to port your existing health insurance policy. The company will hand you documents, including your portability and proposal forms.

Q. How is Mediclaim Different from Health Insurance?

Mediclaim is a type of insurance that covers only hospitalisation-related expenses up to the sum insured, whereas Health insurance is a type of insurance that provides comprehensive coverage for medical costs and surgical expenses beyond more than hospitalisation.

Q. When can you File a Claim After Buying Mediclaim Insurance?

In the mediclaim insurance claim process, the policyholder must avail of the coverage under a set of rules. At Care Health Insurance, we follow procedures to settle the claim. For a hassle-free claim settlement, you must inform our customer support team about your hospitalisation within 24 hours of emergency hospitalisation and 48 hours of planned hospitalisation.

Disclaimer : Information above is just for reference. Kindly read T & C of policy thoroughly. Do refer IRDAI guidelines for tax exemption conditions.

~Tax benefit is subject to changes in tax laws. Standard T&C Apply

**Number of Claims Settled as of 31st March 2024

^^Number of Cashless Healthcare Providers till 31st March 2024

^10% discount is applicable for a 3-year policy

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