Mediclaim‌ ‌Policy‌

A mediclaim policy is a type of health insurance that provides coverage for medical expenses incurred by the policyholder during the policy period. This can include hospitalization expenses, outpatient treatment, medical tests, and medication costs.





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What is a Mediclaim Policy?

Due to the rising medical costs and the emergence of new diseases now and then, health insurance is a foremost requirement for everyone. A Mediclaim policy can support you mainly in case of hospitalization.

Mediclaim‌ ‌is‌ ‌a‌ ‌health‌ ‌insurance‌ ‌policy‌ ‌that‌ ‌covers‌ ‌the‌ ‌cost‌ ‌of‌ ‌hospitalization‌ ‌in‌ ‌case‌ ‌of‌ ‌any‌ health‌ ‌issues.‌ ‌‌The‌ ‌coverage‌ ‌amount‌ ‌extends‌ ‌up‌ ‌to‌ ‌the‌ ‌sum‌ ‌assured‌ ‌opted‌ ‌by‌ ‌the‌ ‌insurer.‌
‌‌Due‌ to‌ ‌the‌ ‌frantic‌ ‌lifestyle,‌ ‌we‌ ‌are‌ ‌all‌ ‌prone‌ ‌to‌ ‌various‌ ‌kinds‌ ‌of‌ ‌illness‌ ‌and ‌accidents. Mediclaim‌ ‌policy‌ ‌enables‌ ‌you‌ ‌to‌ ‌get‌ ‌reimbursement‌ ‌for‌ ‌hospitalization‌ ‌charges,‌ ‌on‌ ‌occasions‌ ‌where‌ ‌you‌ ‌are‌ ‌admitted‌ ‌for‌ ‌24‌ ‌hours‌ ‌or‌ ‌more.‌ ‌While‌ ‌a‌ ‌health‌ ‌insurance‌ ‌plan‌ ‌like‌ ‌critical‌ ‌illness‌ ‌gives‌ ‌you‌ ‌lump‌ ‌sum‌ ‌coverage‌ ‌for‌ ‌the‌ ‌health‌ ‌issue‌ ‌you‌ ‌develop,‌ ‌a‌ Mediclaim‌ ‌policy‌ covers your‌ ‌hospitalization‌ expenses.‌

Benefits and Features of Mediclaim Policy

It‌ ‌is‌ ‌essential‌ ‌to‌ ‌know‌ ‌the‌ ‌features‌ ‌and‌ ‌benefits‌ ‌of‌ ‌Mediclaim‌ ‌policy‌ ‌before‌ ‌you‌ ‌proceed‌ ‌to‌ buy‌ ‌one.‌ ‌A‌ ‌Mediclaim‌ ‌policy‌ ‌acts‌ ‌as‌ ‌a‌ ‌cushion‌ ‌during‌ ‌times‌ of‌ ‌medical‌ ‌emergency.‌ Listed‌ below‌ ‌are‌ ‌a‌ ‌few‌ ‌features‌ ‌and‌ ‌advantages‌ ‌of‌ ‌Mediclaim‌ ‌Policy.‌

Hospitalization Expenses

 A Mediclaim policy provides financial cover to expenses arising out of hospitalization charges during medical emergencies. It also covers pre and medical post-hospitalization expenditures for 30-60 days and 60-120 days, respectively.

Premiums and Terms

Different insurance providers have different terms and norms for premiums. Premium calculated depends on policy term, the sum assured, and age of the insured.

Tax‌ ‌benefits

You‌ ‌are‌ ‌eligible‌ ‌for‌ ‌tax‌ ‌deductions‌ ‌under‌ ‌section‌ ‌80D‌ ‌of‌ ‌Income-tax‌ ‌act‌ ‌on‌ ‌the‌ ‌Mediclaim‌ ‌premium‌ ‌paid‌ ‌every‌ ‌year.‌

Provides Peace of Mind

It eliminates the need for borrowing money from anyone and relieves stress and gives you peace of mind.

Day Care

Some Mediclaim policies cover daycare expenses for treatments that do not require 24 hours’ hospitalization.

Family Cover

You have an option to avail Mediclaim for your family with Family Floater Policy.

Renewable for life

A Mediclaim policy offers lifelong renewability option.

Cashless Treatment

Cashless‌ ‌treatment‌ ‌option‌ ‌is‌ ‌available‌ ‌at‌ ‌network‌ ‌hospitals‌.‌


It is the most cost-efficient way of dealing with a medical emergency.

Mediclaim Policy Vs Health Insurance

Mediclaim Health Insurance
Reimbursement for your medical expenses. Provides Lump Sum coverage upon diagnosis of any critical illness.
It has a wider scope of coverage as it covers hospitalization expenses for all kinds of illness and accident. It covers only critical illness like heart attack, and many other life-threatening diseases.
Only Hospitalization expenses is covered. Aside from the hospitalization expenses for critical illness, you will also receive compensation for financial loss that you may endure due to it.


Mediclaim policies can be bought only by the users within a specified age group. Usually, the insurance companies have an entry age of 18 years and an exit age of 65 years. But these days, coverage is provided from the age of 5 and goes up to 80 years. The age factors vary with the company, so it’s better to check with the company before applying for a policy.

Types of Mediclaim Policy

According to the terms of the policy, only the policyholder receives the coverage. It means that the medical expenses are covered only for the policyholder. Multiple companies provide Individual Mediclaim Plans in India. Each provider has its own set of features and benefits. The buyer must ensure he reads and understands each feature before proceeding to buy.
A Critical illness that you may develop may ruin your finances. Hence, having proper Critical illness coverage would give you financial leverage to make up for the expenses. It covers life-threatening medical conditions like Heart Attack, Kidney Failure, Cancer and other critical illnesses.
As the name suggests, this policy is for the elderly. Senior Citizen Mediclaim Policy covers hospitalization expenses for people who are over 60 years old.
A Family Floater Mediclaim Policy provides coverage to the policyholder and his dependents (spouse, children, and parents).

Mediclaim Policy Claim Procedure

Cashless Reimbursement

● If you are planning for a medical admission, inform the insurance provider a day or two before it. On occasions of sudden admission, tell the insurance company that moment you get admitted. Provide your health card at the time of entry. You or your guardian will have to fill the preauthorization form.

● The hospital will intimate the company to obtain approval for cashless treatment. This process takes typically 1-3 hours depending upon the hospital.

● After discharge, the bills are sent to the insurance company which the company settles with the hospital.

● If you are planning to go for reimbursement claims, it is imperative to inform the company as soon as you are hospitalized.

● Keep all the bills, medical reports, and discharge summary.

● Submit the duly filled claim form to your insurance company along with the documents.

● The insurance provider shall verify the claim and send you a verification email or SMS.

● Generally, for the approved cases, you will receive the insurance amount within 30 days after filing.


Factors to Consider while choosing a Mediclaim Policy

If you are planning to buy a Mediclaim Policy, it is highly recommended to take note of a few factors before buying one. Having a look at these checkpoints will ensure you buy the most appropriate policy suited to your requirements.

  • Sum Assured: Sum assured, or the coverage amount is the most critical checkpoint that you have to consider before buying a policy. It would help if you took into account factors such as inflation, hospitalization charges, and your financial capability. These factors could help you select a plan that meets your requirements. Also, the area you live in could make a difference. For example, the hospitalization expenses in urban areas may be significantly higher than the rural areas. Take these factors into consideration and choose the most appropriate policy.
  • Network Hospitals: One of the most significant advantages of Mediclaim policy is the option for cashless treatment in-network hospitals. Therefore, you must choose the plan which has network hospitals near to your residence.
  • Renewability: Almost all the Mediclaim policies provide coverage for one year only. It is essential to keep renewing your policy as you age. If you fail to renew the policy, you may land up on occasions where acquiring a new one is difficult because of your age.
  • Co-Payment: Several insurance plans come with a co-payment clause. It means that you have to pay a specific part of the sum while raising the claim before the insurance company settles the rest. Usually, co-payments range between 10%-30% of the expenses.
  • Pre-existing illness: Most companies have a clause which states that you can avail cover to pre-existing diseases only after a certain number of years. Choose the one which covers pre-existing conditions in a limited time.
  • Exclusions: Beware of the exclusions in the policy that you select to avoid confusions later.

Documents Required for Claim

  • Duly Filled Claim Form
  • Bills
  • Medical Reports, X Rays, Scans, etc
  • Original Policy documents
  • ID Proof
  • Death Certificate
  • FIR Copy (Unnatural death)

Exclusions in a Mediclaim Policy

  • Regular Dental and cosmetic Procedures
  • Childbirth, pregnancy
  • Treatment for Alcohol/drug abuse
  • Sexually transmitted diseases
  • Intentional Self-harm
  • Non-allopathic treatments like Naturopathy
  • Plastic surgery
  • Contact lens and hearing aid
How to buy

How to buy Mediclaim Policy at Fincover?

Fincover is a one-stop destination to find the best Mediclaim policies. Your search for a good plan ends at FinCover.

  • Login to Fincover
  • Select Insurance -> Health Insurance -> Mediclaim
  • Enter your details such as name, annual income, age, DOB, and occupation, and submit
  • You will get to see free Mediclaim quotes from multiple insurance providers
  • Choose the one that fits you the most and purchase
  • You will receive your policy documents in your email which you can take a printout copy