Mediclaim vs. Critical Illness cover: Which one or both?

This will pay for the cost of the treatment.

You will need to be hospitalized for you to get to claim.

This will provide a lump sum upon diagnosis of a serious illness.

You don’t need to be hospitalized. The diagnosis is enough for the insurance company to pay.

Mediclaim will pay for actual costs of your hospitalization and medication. You can go to accredited hospital for “free” or you can choose a provider and get reimbursement. There is also a maximum limit for a specific benefit.

You have the freedom to spend the lump sum however you want or need. You can use it for your treatment, for your family’s daily needs or to pay your mortgage or loans.

This will cover virtually any medical condition that requires you to be hospitalized.

There is only a list of covered illnesses and the condition must be considered critical before the claim is payable.

This is on a reimbursement basis, you need to file a claim attaching all the bills related to the hospitalization.

This will pay you outright. Once you are diagnosed and make a claim, the insurance company will make the payment.

Also, as long as the policy is within its effective date, it will continue providing you with cover.

Once a claim is paid, the cover will cease to be effective.

This will provide coverage for those until 75 to 80 years old.

Coverage is usually only up to 60 to 65 years old.

• The Sum Insured is paid out when the critical illness meets the policy definition. You don’t need to be hospitalised to be eligible for the claim. You don’t need to submit receipts of your hospitalization expenses.
• You get a tax-free lump sum.
• You are free to spend the insurance proceeds – whether for the treatment, for out-of-pocket expenses, household expenses and other needs.

• Provides reimbursement of covered medical expenses
• Covers most medical conditions for a more comprehensive cover
• Mediclaim benefits can be cashless with the proper authorization

• Provides payment for a limited list of serious illnesses only.
• The illness must meet the definitions provided in the policy.
• There is a survival period from the day the illness is diagnosed. You must survive for the benefit to be payable.

• Mediclaim is a reimbursement plan and benefit limits on each expense item apply.
• Mediclaim is limited to qualified medical treatments, most of which need that you be hospitalised. Although in some cases, pre-medical expenses and post medical expenses are also included.
• You need to submit receipts or records of expenses.