Your mediclaim or health insurance policy covers the cost of COVID treatment as much as the sum insured. However, most mediclaim policies do not cover the cost of items used in coronavirus such as PPE kits, masks, gloves, oximeters, ventilators, etc. All mediclaim policies have started covid mediclaim insurance policy as per the instructions of IRDI.
Most of the COVID-19 plans cover pre and post hospitalization expenses as long as the minimum hospitalization is 24 hours. Kovid policies like Corona Rakshak and Corona Kavach also cover home treatment or AYUSH treatment if prescribed by a doctor. For more details read the policy.
If you have a Mediclaim policy given by your employer, then you can see the COVID coverage in it and get it abolished as per your wish. If you want to take a Kovid 19 Medicare policy then you have to complete the waiting period. Take a look at the benefits and exclusions of the policy to see if it works for you or not. As far as it is, all the policies cover the treatment of Coronavirus but for useful items you have to take a separate policy.
You can also avail tax benefits on Mediclaim premium payment under Section 80D of the Income Tax Act of India 1961.
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Mediclaim Policy Benefits and Other Features
Before taking a mediclaim policy, it is important to know its benefits and other features. Also, in view of increasing medical expenses, diseases, hospital expenses etc., it is necessary to have a mediclaim policy for financial support. It can provide support in case of a medical emergency. It has other insurance benefits like:
Reasonable Cost: A mediclaim policy is a reasonably priced policy for availing medical facilities.
Cashless treatment: In case of decal emergency, you can get treatment at network hospital at no cost.
Reduces financial stress: Mediclaim reduces the financial pressure on the policy holder and his/her family.
Individual and Family Floater: Both individual and family floater is available in mediclaim policy.
Pre and Post Hospitalization Expenses: Mediclaim policy covers 30-60 days pre and post hospitalization expenses for 60-120 days. It also helps with ambulance and emergency evacuation facilities.
Day Care Hospitalization: Expenses that do not require 24-hour hospitalization.
Lifelong renewal cover: Mediclaim policy offers lifetime renewal cover as per the insurance company.
Additional benefits: Expenses like ICU, separate treatment, annual check up are also covered.
Benefits of Tax Exemption: You can also avail tax benefits on Mediclaim premium payment under Section 80D of the Income Tax Act 1961.
List of Best Mediclaim Policy in India
However, many companies offer different mediclaim policies. Below you can see the list of best mediclaim policies in India:
Mediclaim Policy Bima Dhan Network Hospital Renewability
Aditya Birla Mediclaim Policy
10 lakh -30 lakh
Bajaj Allianz Mediclaim Policy
1.5 lakh -50 lakh
Bharat Aksa Mediclaim Policy
3 lakh,4 lakh,5 lakh
Care Health Insurance Mediclaim Policy
3 lakh-60 lakh
Cholamandalam Mediclaim Policy
2 lakh -15 lakh
Digit Mediclaim Policy
2 lakh -25 lakh
Edelweiss Mediclaim Policy
5 lakh-1 crore
Future Generali Mediclaim Policy
Vital: 3 Lakh, 5 Lakh, 10 Lakh
Superior-15 Lakh,20 Lakh,25 Lakh
Premier-50 Lakh-1 Crore
IFFCO Tokie Individual Medicaid Mediclaim Policy
Kotak Mahindra Mediclaim Policy
2 lakh -100 lakh
Liberty Mediclaim Policy
up to 1 lakh
Max Bupa Mediclaim Policy
3 lakh-1 crore
Manpal Cigna Mediclaim Policy
2.5 lac -50 lac
National Mediclaim + Policy
2 lakh -50 lakh
New India Assurance Mediclaim Policy
1 lakh -15 lakh
Oriental Individual Mediclaim Plan
1 lakh -10 lakh
Royal Sundaram Mediclaim Policy
2 lakh -150 lakh
Reliance Healthwise Mediclaim Policy
1 lakh -5 lakh
up to 75 years
Raheja QBE Mediclaim Policy
1 lakh -50 lakh
star health mediclaim policy
1 lakh -25 lakh
SBI Mediclaim Policy
1 lakh -3 lakh
Tata AIG Mediclaim Policy
2 lakh -10 lakh
United India Mediclaim Policy
1 lakh-10 lakh
Universal Sompo Mediclaim Policy
up to 5 lakhs
Submission: “Policy Bazaar does not endorse, recommend and evaluate any insurance company, any plan.”
Types of Mediclaim Policy
There are many different types of mediclaim policies available. You can be sure of getting a policy according to your needs. Let’s have a look at some of the mediclaim plans:
Individual Mediclaim Policy
Individual mediclaim policy covers only the holder. Only one person can take medical insurance benefit on payment of premium. There are many health insurance companies in India that offer individual mediclaim policies.
Family Floater Mediclaim Policy
Family floater mediclaim policy covers parents, spouse and children along with providing coverage to an individual.
Senior Citizen Mediclaim Policy
Senior Citizen Mediclaim Policy Above 60 Years of Age
They cover people’s hospital withdrawal expenses.
critical illness mediclaim
The cost of serious illness is very high. Chronic illness insurance covers life-threatening diseases like kidney failure, cardiovascular disease, etc.
Comparison of Mediclaim Policy and Health Insurance
It pays for your medical expenses.
It gives you a lump sum amount in addition to medical expenses on diagnosis of a chronic chronic disease.
This time covers more than illness like hospitalization expenses due to accident.
It only covers diseases like heart attack, kidney failure, paralysis.
This is a policy to save on hospitalization expenses.
It only compensates for the exorbitant illness expenses and also the financial loss caused by the illness.
Read more: Mediclaim Vs Health Insurance
Mediclaim Policy Claim Process
There are two types of claims in a mediclaim policy:
In the cashless process, the insurance company either settles the entire claim or part of it with the hospital for treatment in a network hospital. This means that the holder does not have to pay a single rupee to the hospital. You need to follow the following steps for easy claim process.
Firstly, all hospitals have an insurance desk. The policy holder will have to take the pre-authorization form from that desk in which all the information has to be filled otherwise the claim will be received late. This form has to be stamped from the hospital and sent by fax to the insurance company or to the third party administrator (TPA). After checking the complete form, the insurance company will accept some amount and fax it again to the hospital stating that they have accepted the amount ‘A’ for the treatment.
Let us understand this with an example: For example, if a hospital has mentioned the cost of 4 lakh treatment, then the TPA and the insurance company will agree to the amount of 3 lakh after talking to each other. After that, they will tell the hospital people that they will only accept up to 3 lakhs for cashless treatment and will see the extra cost of that later. After that the bill at the time of discharge is 3.60 lakhs, then the policy holder will have 2 options. First, he should send a copy of the bill to the beam company and wait for their reply. It might take a while. Second, the policy holder should pay the additional charges out of his pocket, 40,000 here and then take the payment by giving the original bill receipt to the insurance company.
Payment must be made to the insurance company about the hospitalization that has taken place or any future hospitalization. You can tell this by email or by phone. For payment, you will have to submit all payment receipts, bills for medicines taken from outside. You also need to make sure that the original discharge letter, final bills and payment receipts are in one place where you can give and collect payment to the insurance company.
mediclaim policy coverage
Although all policies are different, yet the following expenses are covered in all:
hospital recruitment expenses
It covers all hospitalization expenses such as OT charges, diagnostic procedures, blood oxygen, medicines, chemotherapy, X-rays, radiotherapy, donor expenses, pacemakers, etc.
day care charge
Covers the cost of technical work that does not require hospital stay for more than 24 hours like cataract surgery etc.
Pre and post hospitalization expenses
30 days before and after hospitalization expenses up to 60 days, ambulance expenses are paid.
hospital room rent
In cashless hospital treatment, the entire cost of regular ward and ICU is covered.
medical practitioner fees
Fees for doctors, nurses, surgeons, anesthetists are also paid.
What is not covered in a mediclaim policy?
All mediclaims have their limits. Your claim may be rejected in the following circumstances:
Mediclaim does not cover chronic illness.
Diagnosis of any disease that occurs within 30 days from the date of commencement of the policy is not covered. You can read the policy document to know the plan in detail.
Some diseases not covered in the plan.
Dental injuries that require hospitalization.
Birth Control and Hormonal Treatment
Birth complications and ectopic pregnancy
Things to keep in mind before taking a mediclaim policy
If you want to buy a mediclaim policy then you should take care of the points given below. Keeping these points in mind, you can compare several plans in the market.
Individual and family floaters:
In individual plan an individual and in family health insurance the entire family is covered for one sum insured. After the death of the holder in the family floater, the surviving family members cannot get the policy renewed. In individual plans, insurance is done on different bases. Wave insurance coverage will not affect other family members upon reaching one age.
Sum Assured (Coverage Amount)
Before deciding on the sum insured or coverage amount, keep in mind inflation, surgery cost, etc. If you live in a city then your expenses will be more than that of a villager. Similarly, if you want to take a policy for your family members, then you should take more sum insured.
Many mediclaim plans come with co-pays. Co-pay is a percentage that at the time of making a claim has to be paid by the insurance company to the holder before settling the claim. It varies from 10 to 30 percent according to the insurance company.
Keeping in mind the medical risk of each mediclaim plan policy holder