Critical Illness vs. Hospitalization and Surgical plan: What are the differences?

To help fund treatments for the critical illness.

To help pay for the hospitalization and surgical expenses of the Insured.

Lump sum when the insured is diagnosed with a serious illness.

Reimbursement (when the Insured pays for the treatments) or direct payment to hospital.

Lump sum equivalent to the face amount.

What is actually spent during the hospitalization and surgery, up to specified limits and up to a limited number of days. The policy will usually have a schedule of benefits that outline what the insurance will pay.

Diagnosis of a covered serious illness. There are only a number of specific illnesses that are covered in the policy. This will not pay if the illness does not qualify under the definitions of the policy.

Basically, hospitalization that is a result of any illness or injury due to accident. Self-inflicted injuries are usually excluded.

This is only for critical illnesses.

• Is limited only to hospitalization.
• Will only pay up to the limits. Anything over the limit will be shouldered by the Insured.
• Depending on the type of plan, direct payments by the Insurance company to the hospital or medical provider are limited only to accredited hospitals.

Once a claim is paid, the insurance policy terminates.

Is usually renewable yearly. The cover will continue even after a claim as long as the policy is effective.

This will provide a lump sum that a critically ill person can use to pay for medical treatments (including out-of-pocket expenses) or to supplement the family income when one is no longer able to work.

This pays for the hospitalization expenses so that the family is not financially crippled with hospital bills.

• The lump sum can be used not just for hospital expenses but also other out-of-pocket expenses that entail a hospital stay.
• The lump sum enables you to have the freedom to choose the kind of treatment you want, as well as the hospital (whether local or abroad).
• Provides a longer length of cover.

• Covers hospitalization costs such as room and board, doctor’s fees, surgeon’s fees, diagnostic tests and a long list of other benefits.
• Provides a more comprehensive cover for illnesses, covering most hospital and surgical care needed.
• Plans can also cover dental and diagnostic costs, depending on the plan you choose.
• Provides hospitalization expenses not just for illness but also for accidents

• The cover is limited only to a specific list of critical illnesses.
• You need to meet the definition of the critical illness for the claim to be payable.

• You are limited to the treatment options listed in the benefit schedule.
• Hospitalization payments have a maximum limit per treatment or benefit and per illness.
• You will need to cover out-of-pocket expenses.
• There may be co-payments or deductions, meaning you will also pay a certain portion of the hospital expenses. The health insurance plan will kick in to pay the rest.