Mediclaim FAQ: Your Questions Answered About Health Insurance
Mediclaim policies, also known as health insurance plans, are essential for managing healthcare costs. If you’re new to Mediclaim or looking for specific information, this guide answers the most frequently asked questions to help you make an informed decision.
1. What is a Mediclaim policy?
A Mediclaim policy is a type of health insurance that covers hospitalization expenses due to illness, injury, or surgery. It includes costs like:
Room rent
Doctor’s fees
Diagnostic tests
Medicine and surgery costs
2. How is Mediclaim different from health insurance?
While both offer financial protection for medical expenses:
Mediclaim: Focuses on hospitalization expenses and offers cashless or reimbursement coverage.
Health Insurance: Offers broader coverage, including critical illness benefits, OPD costs, and preventive care.
3. Who should buy Mediclaim insurance?
Everyone should have a Mediclaim policy to avoid financial stress during medical emergencies. It is especially beneficial for:
Families seeking affordable coverage for hospitalization.
Senior citizens to cover age-related health issues.
Individuals with pre-existing conditions (after the waiting period).
4. What are the key benefits of a Mediclaim policy?
Cashless Treatment: Available at network hospitals.
Tax Savings: Premiums qualify for deductions under Section 80D.
Affordable Premiums: Offers financial protection at a reasonable cost.
Covers Pre and Post-Hospitalization: Many policies cover expenses before and after treatment.
5. What is the claim process for Mediclaim?
There are two types of claims:
Cashless Claims:
Avail treatment at a network hospital.
Submit the pre-authorization form at the hospital.
Insurer directly settles the bill with the hospital.
Reimbursement Claims:
Pay hospital bills upfront.
Submit the bills and claim form to the insurer.
Receive reimbursement after claim approval.
6. Are pre-existing conditions covered under Mediclaim?
Yes, but most policies have a waiting period (usually 2-4 years) before pre-existing diseases are covered. Always check the policy terms for details.
7. Can I cover my family under one Mediclaim policy?
Yes, you can opt for a family floater Mediclaim policy, which covers all family members under a single sum insured.
8. What documents are required for a Mediclaim claim?
For a successful claim, you’ll need:
Policy document or Mediclaim card
Hospital bills and receipts
Discharge summary
Doctor’s prescriptions
Diagnostic test reports
Claim form (completed and signed)
9. How does the cashless facility work?
The cashless facility allows you to receive treatment without paying upfront. Steps include:
Visit a network hospital.
Submit your insurance card or policy details.
Fill out and submit the pre-authorization form.
The insurer settles the bill directly with the hospital.
10. What is a no-claim bonus (NCB) in Mediclaim?
If you don’t make a claim during a policy year, insurers reward you with a no-claim bonus, which can be:
A discount on your next premium.
An increase in the sum insured without extra cost.
11. Is maternity covered under Mediclaim?
Many policies offer maternity coverage, but it typically comes with:
A waiting period (2-4 years).
Caps on expenses for delivery and newborn care.
12. Can I buy Mediclaim online?
Yes, purchasing Mediclaim online is quick and convenient. Platforms like GetMediclaim.help allow you to compare and buy policies easily.
13. What is not covered under Mediclaim?
Most policies exclude:
Cosmetic surgeries
Dental treatments (unless accidental)
Non-allopathic treatments
Pre-existing diseases during the waiting period
Self-inflicted injuries
14. How much coverage do I need?
The ideal coverage depends on:
Your age and health condition.
Family size and medical history.
Hospitalization costs in your area.
A general rule is to have coverage of at least 50% of your annual income.
15. Can I port my Mediclaim policy to another insurer?
Yes, as per IRDAI guidelines, you can port your policy to another insurer without losing benefits like waiting periods or no-claim bonuses.
How GetMediclaim.help Simplifies Mediclaim Insurance
Expert Guidance: Personalized advice on the best Mediclaim policies.
Compare Plans: Compare premiums, benefits, and coverage from top insurers.
Claim Support: Assistance with cashless and reimbursement claims.
Trusted Partners: Partnered with India’s leading insurance providers.
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Header Tags:
H1: Mediclaim FAQ: Your Questions Answered About Health Insurance
H2: What is a Mediclaim policy?
H2: How is Mediclaim different from health insurance?
H2: Who should buy Mediclaim insurance?
H2: What are the key benefits of a Mediclaim policy?
H2: What is the claim process for Mediclaim?
H2: Are pre-existing conditions covered under Mediclaim?
H2: Can I cover my family under one Mediclaim policy?
H2: How does the cashless facility work?
H2: What is a no-claim bonus (NCB) in Mediclaim?
H2: Is maternity covered under Mediclaim?
H2: Can I buy Mediclaim online?
H2: What is not covered under Mediclaim?
H2: How much coverage do I need?
H2: Can I port my Mediclaim policy to another insurer?
