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Best Mediclaim Policy in India: Compare & Buy the Right Health Plans

Medical bills in India are rising 2x faster than the average income. If you want to find the top Mediclaim policy in India, start with the benefits that matter: comprehensive coverage, a vast network of cashless hospitals, affordability, and easy claims support. Explore Care Health Insurance mediclaim policies and stay covered throughout.

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Ritika Malik
Written by:
Ritika Malik
Ritika Malik
Ritika Malik

Insurance Expert at Care Health Insurance

A highly skilled Insurance Specialist with a strong background in writing and research across various sectors, including medical and insurance fields. Expert at creating clear, engaging content that simplifies complex terminology while adhering to industry standards. Specialises in producing informative articles, blog posts, and marketing materials that effectively connect with the intended audience.

check_circleReviewed by:
Munmi Sharma
Munmi Sharma
Munmi Sharma

Sr. Health Insurance Expert at Care Health Insurance

Munmi is an insurance expert with a passion for storytelling and keen eye for detail. With 10+years of experience in the digital marketing industry, her expertise in the insurance domain combines with experience and perfection in refining written content. When not crafting and editing a piece of content, she also loves to paint the canvas, explore new places and people, binge watching, cooking and playing badminton.

What is a Mediclaim Policy?

A medical policy is a health insurance plan that covers costs related to illness, surgery, or accidents. It provides financial protection by covering hospital stays, treatments, and other medical services up to the insured amount. Mediclaim policies typically cover room charges, doctors' fees, diagnostic tests, pre- and post-hospitalisation expenses, and ambulance charges, subject to the policy's terms and conditions.

Policyholders can access these benefits either through cashless treatment, where the insurance company pays the hospital directly, or through reimbursement, where they pay the bills upfront and later claim the expenses from the insurer.

Why Choose Care Health Insurance Mediclaim Policy?

Choosing the right Mediclaim policy is essential for protecting your health and finances during medical emergencies. Below are the benefits of purchasing a Mediclaim policy from Care Health Insurance:

how insurance works

Key Benefits of Buying a Mediclaim Policy

A mediclaim insurance policy provides quality healthcare without financial stress. Here are the key benefits of the mediclaim policies:

  • Sum Insured (in ₹): The maximum coverage your policy provides ranges from 10 Lakh to 2 Crore.
  • Coverage: Expenses for hospitalisation, day care treatments, home treatments, AYUSH treatment, organ donor expenses, and more.
  • Cashless Treatment: Access treatments at over 21,700 network hospitals across Pan India.
  • Tax Benefits: Up to Rs 50,000 under Section 80D (depending on the polices)
  • Affordable Premiums: Higher SI coverage available at lower premiums.
  • Family Floater Coverage: All family members are included in a single policy.

Select from Our Best Mediclaim Insurance Plans in India

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Look for best health plan that suits your need!
Preffered Product Image
Critical Illness Insurance

Health Insurance Coverage for 32 Critical Illnesses

  • Chemotherapy & Radiotherapy Cover
  • AYUSH Coverage
KNOW MORE
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Health Insurance for Cancer

Cover for Treatment of Cancer at all Stages

  • Chemotherapy and Radiotherapy Cover
  • OPD Expenses Coverage
KNOW MORE
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Operation Insurance

Coverage for wide array of defined surgeries

  • In-Patient Care
  • Day Care Treatment
KNOW MORE
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Heart Mediclaim

Health Insurance Covering 16 Major Health Aliments

  • Cashless & Reimbursement Facility
  • Annual Cardiac health check-up
KNOW MORE

Types of Mediclaim Policies in India 

Mediclaim policy in India has various types to meet the diverse needs of individuals, families, and organisations. Here's a breakdown of the main types of mediclaim policies:

  • Individual Mediclaim Policy: Covers only one individual; the sum insured applies only to that individual, and is fit for people with specific health needs.
  • Family Floater Mediclaim Policy: Covers the entire family under a single sum insured: members usually include self, spouse, and dependent children (sometimes parents), and is cost-effective compared to individual policies.
  • Senior Citizen Mediclaim Policy: Designed especially for people aged 60 years and above. It includes benefits like domiciliary hospitalisation and higher coverage for pre-existing diseases. However, it may come with higher premiums due to increased risk.
  • Top-up: Additional coverage for  a single hospitalisation above the deductible limit.
  • Super Top-up: Covers cumulative hospitalisation expenses in a year above the deductible limit.
  • Critical Illness Insurance: It involves a lump sum payment upon diagnosis of specified critical illnesses, such as cancer, heart attack, or stroke. It helps cover non-hospitalisation costs like loss of income.

Key Features of a Comprehensive Mediclaim Policy in India

Care Super Mediclaim policy comes with four variants: Critical Illness, Cancer, Heart, and Operation Mediclaim. The key features of these mediclaim policies include:

Features Critical Illness Care Cancer Mediclaim Heart Mediclaim Operation Mediclaim
In-Patient Hospitalisation Up to Sum Insured
Day Care Treatment Up to Sum Insured
Room Rent Eligibility Single Pvt. Room (for 10 Lacs SI) & All Categories (for SI >= 25 Lakh)
ICU Charges No Limit
Pre-Hospitalisation 30 Days, Up to SI
Post-Hospitalisation 60 Days, Up to SI
Chemotherapy and Radiotherapy Cover Up to SI Not Available
Dialysis Cover Up to SI Not Available
Ambulance Cover Up to 3,000 per hospitalisation
Organ Donor Cover Up to Sum Insured or 15 Lakh, whichever is lower
AYUSH Treatment Up to Sum Insured
Second Opinion Once per Covered Condition per policy year
Annual Health Check-up Annually, from the 2nd Policy year on, continuous coverage
No Claim Bonus Up to 100% of SI
Quick Recovery Counselling Up to 1000/- per session; Maximum 8 sessions Post Hospitalisation
Doctor On Call Yes (Telephonic/Online)
Global Coverage Up to Sum Insured (for SI>=1 Crore)
OPD Expenses 1% of Sum Insured; Max. up to 25,000 Not Available
International Second Opinion* Once per Covered Condition per policy year (for SI>=50 Lakh)
Air Ambulance* Up to 5 Lakh for SI >=50 Lakh

Disclaimer: The information above is for reference only. Please read the T&C of the policy thoroughly. Also, the * marked benefits are optional.

What is Covered in a Mediclaim Insurance Policy?

A mediclaim insurance policy offers economic solace during clinical crises, including many other coverage options, such as:

  • Hospitalisation Costs: Incorporates hospitalisation charges such as room rent, ICU charges, health professional fees, and medications.
  • Pre & Post-Hospitalisation: Offer coverage for medical costs before and after hospitalisation. 
  • Daycare Procedures: Include surgeries and treatments that don't need hospitalisation for more than a day.
  • Accidental Injuries: Offer coverage for medical costs that occur due to
  • Domiciliary Hospitalisation: Covers treatment received at home under clinical supervision due to insufficient beds or when transferring the patient to a hospital is complicated.

What is Not Covered in a Mediclaim Insurance Policy?

Even though the mediclaim policy offers medical expenses or hospitalisation costs coverage, some exclusions are involved, such as:

  • Pre-existing diseases: These involve conditions like BP, thyroid, diabetes, etc., which are only covered after a waiting period.
  • Cosmetic & Dental Procedures: These are not medical treatments. Hence, the mediclaim insurance policy doesn't offer coverage for such procedures.
  • Maternity & Infertility Treatments: Most mediclaim insurance plans don't cover expenses related to maternity and infertility.
  • Self-Inflicted Injuries: Mediclaim doesn't cover injuries that occur due to self-inflicted injuries like suicide or substance use.
  • Alternative Treatments: Mediclaim insurance policy excludes alternative treatments like homoeopathic, ayurvedic, and naturopathy.

What is the Difference Between Mediclaim and Health Insurance Plan?

Mediclaim and health insurance appear similar, but they offer different types of medical coverage. Knowing the difference can help you choose the perfect plan for your healthcare needs.

Aspect Mediclaim Policy Health Insurance Policy
Definition Covers clinical expenses, including hospitalisation and surgery. Provides comprehensive healthcare coverage, including hospitalisation, preventive care, OPD visits, wellness benefits, and more.
Sum Insured Provides a fixed sum insured, typically less than needed, that may not cover medical expenses. Higher sum-insured options are available for comprehensive coverage.
Premium Compared to health insurance, premiums are lower. Premiums are higher due to comprehensive coverage.
Pre-existing diseases It involves a waiting period before covering medical expenses for pre-existing diseases. It also includes waiting periods; however, it offers add-ons to reduce them for early coverage.
Who Should Buy Suitable for individuals seeking basic hospitalisation cover for particular chronic conditions. Ideal for individuals and families seeking complete health protection.
Renewability Renewable for a lifetime with a restricted increase in coverage. Lifelong renewal with various options to enhance health insurance coverage and benefits.

How to Choose the Best Mediclaim Policy?

Choosing the best mediclaim policy can be complex due to the several options available. Here are the steps one must follow:

  • Evaluate Your Needs: Identify your needs and understand which type you require, such as an individual, family floater, or senior citizen policy.
  • Comparing Plans: You can use online platforms to purchase mediclaim plans and view their benefits, including exclusions.
  • Examine Policy Terms: Don't forget to review the policy terms involving inclusions, exclusions, sub-limits, etc.
  • Understand Add-Ons: Most mediclaim policies in India don't cover add-ons; however, if you discover a plan that does, buy it.
  • Customer Feedback: Reviewing customer service and claims processes helps quickly choose the policy.

How to Buy a Mediclaim Policy Online?

Purchasing a mediclaim policy with us is a simple process. Follow these simple steps to get our mediclaim policy online hassle-free:

  • On the quote page, review the sum insured and coverage options, then click the Buy Now button.
  • On the newly opened page, enter the proposer's details, then click the “Next” button when finished.
  • On the following pages, complete the insured member’s details and, if applicable, provide their medical history.
  • Complete your purchase by paying. The policy documents will be sent to your registered email address and phone numbers.

Documents Required for Buying a Mediclaim Policy

Purchasing a mediclaim policy online can be a smooth process if you know what is required. Here’s a list of documents you may need when buying mediclaim insurance online.

Proof Eligible Documents
ID Proof Aadhaar card, voter ID, driving license, or passport
Address Proof Aadhaar card, passport, driving license, voter ID, etc.
Financial Statement Bank statement or other proof of income
Medical Reports Required for Senior Citizens or those with pre-existing conditions.

How to File a Claim?

Policyholders can file a claim for a mediclaim policy in two ways: cashless and reimbursement. Here is how one can file a claim:
Claim Type Process Types
Cashless Getting admission to a network hospital
  • Inform the insurance service provider and submit a pre-authorisation form
  • The insurer will approve the claim with the network hospital directly
  • Lastly, the insurer will settle the bill, and the policyholder needs to pay for expenses that are not covered
Reimbursement
  • Get admitted to the hospital and take the treatment.
  • The policyholder has to pay the bill initially
  • Submit all the essential documents, such as medical reports and invoices
  • The insurer will authenticate the claim
  • After approval, the policyholder gets the final amount for incurred medical expenses.

Why Choose a Mediclaim Policy from Care Health Insurance?

Care Health Insurance offers comprehensive mediclaim policies to ensure your health is well-protected when you need it. It provides flexible, reasonable plans tailored to your healthcare needs. Here's why Care health insurance is the best option for a Mediclaim policy:

  • Access to a vast network of hospitals for cashless treatment across India.
  • It provides hospitalisation, surgery, daycare treatments, and more.
  • Flexible premium payment options to suit your budget.
  • Quick and hassle-free claim settlement with 24/7 support.
  • Health coverage for the entire family under a single policy.
  • Coverage for medical expenses before and after hospitalisation.
  • Regular health check-ups to monitor your well-being.

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FAQ on Mediclaim Policy

Q. How to take Mediclaim policy? Can I also buy online mediclaim policy?

You can buy a mediclaim policy either online or offline. You will have to choose a company first. Your chosen company should be based on premium, cashless network and other benefits. One can also buy a Mediclaim policy by visiting the nearest branch of the chosen insurance provider.

Q. How to Port a Mediclaim Policy in India?

You can port the mediclaim insurance only at the stage of policy renewal. Intimation for porting is required 45 days before renewal. Inform your last insurer in writing for a porting, mentioning the name of the new insurer. Fill up our portability form with existing insurance details, submit the relevant documents, and make payment for mediclaim health insurance.

Note: NCB will not reduce if the claim amount exceeds 25% of SI under the add-on Care Shield. For details, refer to policy T&C.

Q. Is it Possible to Modify the Sum Insured in the Mediclaim Policy?

Yes, you can modify the sum insured in the mediclaim policy; that shall be permissible only at the time of policy renewal. However, it can affect your premium amount. So, reading through the mediclaim policy details is important to understand better.

Q. Can I Add or Remove Family Members in My Current Mediclaim Policy for the Family?

No, you cannot add and remove family members in your current mediclaim policy for the family. You can do it only at the time of policy renewal.

Q. Can I Change the Date of Birth if it is Written Incorrectly in the Mediclaim Policy Document?

Accepting change in DOB is solely Care's discretion and may affect your premium. Therefore, providing the right birth date and other details when purchasing the mediclaim policy is advisable.

 

Q. What should I do if my mediclaim policy expires?

You can renew your mediclaim policy online and offline both, within the grace period of 30 days.

Q. What are the age criteria to buy a mediclaim policy?

The minimum entry age to buy a mediclaim policy is 91 days to 4 years (with at least one insured member of 18 years of age or above) and 5 years on an individual basis, and the maximum entry age has no age bar, with lifelong renewability.

Q. Do mediclaims cover accidents?

Yes, mediclaims cover accidents as well. However, you need to buy it as an optional benefit. Under this, you will get an additional sum insured for accidental hospitalisation.

Q. Which mediclaim policy covers dental treatment?

Our various mediclaim policies and operation mediclaim cover dental treatment subject to policy terms and conditions.

Q. Who should purchase mediclaim insurance plans?

Mediclaim insurance is recommended for everyone, especially in this age of rising medical inflation and increasing lifestyle diseases. It is a must for those who depend on their corporate health insurance and do not have a separate health cover. Anyone 18 years of age or above can purchase a mediclaim insurance policy for themselves or their loved ones.

Q. Can I buy mediclaim policy online?

Yes, you can buy mediclaim policy online while visiting our official website.

Q. Does mediclaim cover AYUSH?

Yes, you will get coverage for alternative treatments like AYUSH.

Q. Will Mediclaim Policy Cover Coronavirus Infections?

Our indemnity-based products offer hospitalisation coverage for COVID-19. Do refer to the terms and conditions for more details.

Q. What is Cashless Mediclaim Policy?

A Cashless Mediclaim is an advantage offered by most healthcare providers. Under a cashless Mediclaim, medical bills are directly settled by the insurance company, provided the total bill amount falls within the assured limit, and the hospital is a network hospital. Thus, it is always important to buy the best cashless mediclaim policy.

Q. What is Floater Mediclaim Insurance Policy?

The Floater mediclaim policy is a tailor-made plan for families. It is almost similar to individual health insurance, but the only difference is that mediclaim health insurance for families acts as an umbrella to cover your entire family.

Q. Can I Port my Mediclaim policy? If yes, What is the Process?

Yes, you can port your mediclaim policy. You must approach the insurance provider where you wish to port your existing health insurance policy. The company will hand you documents, including your portability and proposal forms.

Q. How is Mediclaim Different from Health Insurance?

Mediclaim is a type of insurance that covers only hospitalisation-related expenses up to the sum insured, whereas Health insurance is a type of insurance that provides comprehensive coverage for medical costs and surgical expenses beyond more than hospitalisation.

Q. When can you File a Claim After Buying Mediclaim Insurance?

In the mediclaim insurance claim process, the policyholder must avail of the coverage under a set of rules. At Care Health Insurance, we follow procedures to settle the claim. For a hassle-free claim settlement, you must inform our customer support team about your hospitalisation within 24 hours of emergency hospitalisation and 48 hours of planned hospitalisation.

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Disclaimer : Information above is just for reference. Kindly read T & C of policy thoroughly. Do refer IRDAI guidelines for tax exemption conditions.

~Tax benefit is subject to changes in tax laws. Standard T&C Apply

**Number of Claims Settled as of Dec'24

^^Number of Cashless Healthcare Providers till Feb 2025

^10% discount is applicable for a 3-year policy

*Premium calculated for an individual (Age 18) for sum insured 10 Lakhs