Mediclaim vs critical illness
Inclusions and Exclusions

Critical Illness vs. Mediclaim Policy

When it comes to health insurance, there are various types of policies available in the market. Two such policies are critical illness insurance and mediclaim policy. Both policies provide financial support to policyholders in case of a medical emergency. However, there are some key differences between these two policies when it comes to their inclusions and exclusions. In this blog, we will discuss critical illness vs. mediclaim policy inclusions and exclusions in detail.

What is Included in a Mediclaim Policy?

A mediclaim policy provides coverage for various medical expenses such as doctor’s consultation fees, diagnostic tests, medicines, hospital room rent, etc. The policy provides coverage for hospitalization expenses arising from illnesses or injuries. The following are the inclusions of a mediclaim policy:

  • Hospitalization Expenses: A mediclaim policy covers hospitalization expenses arising from illnesses or injuries. The policy provides coverage for room rent, ICU charges, doctor’s consultation fees, diagnostic tests, medicines, etc.
  • Pre and Post Hospitalization Expenses: A mediclaim policy also covers pre and post-hospitalization expenses. This includes expenses incurred for diagnosis, consultation, and medication before and after hospitalization.
  • Day-care Procedures: A mediclaim policy covers the cost of day-care procedures that do not require hospitalization for more than 24 hours.
What is Included in a Critical Illness Policy?

A critical illness policy provides coverage for life-threatening illnesses such as cancer, heart attack, stroke, kidney failure, etc. The policy pays a lump sum amount to the policyholder in case of a medical emergency. The following are the inclusions of a critical illness policy:

  • Life-threatening Illnesses: A critical illness policy provides coverage for life-threatening illnesses such as cancer, heart attack, stroke, kidney failure, etc.
  • Lump Sum Payment: If the policyholder is diagnosed with a covered illness, the policy pays a lump sum amount to the policyholder. The policyholder can use this amount for medical treatment or any other expenses related to the illness.
  • Multiple Claims: A critical illness policy allows multiple claims in case the policyholder is diagnosed with multiple illnesses.
What is Excluded in a Mediclaim Policy?

While a mediclaim policy provides coverage for various medical expenses, there are some exclusions. The following are the common exclusions of a mediclaim policy:

  • Pre-existing Illnesses: A mediclaim policy does not cover pre-existing illnesses for a specific period, usually 2-4 years, from the date of policy purchase.
  • Waiting Period: There is a waiting period of 30 days from the date of policy purchase for any illness or injury, except in case of accidental injuries.
  • Non-medical Expenses: A mediclaim policy does not cover non-medical expenses such as cosmetic surgery, dental treatment, etc.
What is Excluded in a Critical Illness Policy?

While a critical illness policy provides coverage for life-threatening illnesses, there are some exclusions. The following are the common exclusions of a critical illness policy:

  • Non-life-threatening Illnesses: A critical illness policy does not cover non-life-threatening illnesses.
  • Pre-existing Illnesses: A critical illness policy does not cover pre-existing illnesses.
  • Waiting Period: There is a waiting period of 90 days from the date of policy purchase for any illness or diagnosis of a critical illness.
Which Policy Should You Choose?

Choosing the right health insurance policy depends on your specific requirements and financial situation. If you are looking for coverage for various medical expenses, a mediclaim policy may be the right choice for you. However, if you want coverage for life-threatening illnesses specifically, then a critical illness policy may be a better option.

It’s important to note that both policies have their own set of inclusions and exclusions. Therefore, it’s crucial to read the policy document carefully and understand the terms and conditions before purchasing a policy.

Additionally, some insurance companies offer a combination of both policies as a rider or add-on to their base policy. This can provide comprehensive coverage for both medical expenses and critical illnesses.

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