Mediclaim Policy

What is Mediclaim Policy?

India is grappling with several health problems. It has turned into the diabetes capital of the world. Around one million new cancer patients register, every year and the rising rate of non-communicable diseases (NCDs) causes 61% of deaths in the country. No doubt, medical advancement bringing new hopes to the health care sector. But, at the same time, it is giving rise to medical inflation. Diagnosis, medication, treatment, and hospitalization costs are burning holes in the pockets and become unaffordable for the common mass. Either one has to sell the assets or lend money whenever there is a medical emergency. It results in financial distress for the entire family. So, to combat such a medical crisis, we offer mediclaim insurance that covers your risks and provides you with financial support whenever you need it.

You cannot predict health uncertainties, but you can stay prepared. But, the best mediclaim policy in India helps you to stand strong during a medical emergency. A medical insurance plan covers your medical expenses up to the sum insured and helps to avail the best possible treatment for yourself or your loved ones. Under this policy, you can cover self, spouse, children, and dependent parents and opt for either a cashless hospitalization facility or reimbursement to settle the claim. It is the best mediclaim policy for investment that offers you class healthcare services without worrying about money. So, your farsighted approach, pragmatic planning, and mediclaim health insurance cover help you to stay in the pinkest of your health without financial stress.

Key Features of Mediclaim Plan

It is a comprehensive policy that provides financial assistance during hospitalization. With mediclaim, you do not need to arrange cash for your treatment. We settle your medical bills so that you can focus on your recovery. Let's take a close look at its key features:

• Cover for in-patient hospitalization
• Coverage for medical expenses during pre and post hospitalization
• Claim settlement either by a cashless facility or by reimbursement up to the sum insured
• Minimum 24 hours hospitalization is required to get the claim
• It also has a list of specific exclusions
• Lifelong renewability is easily available
• No upper age limit for enrolment
• In a family mediclaim, you can pay a lump sum premium instead of paying for individual policies.

Calculate your Mediclaim Premium now!

Benefits of Mediclaim Insurance

It acts as a saviour whenever you or your family faces a medical emergency. It supports you without depletion of your savings. Read below the vital benefits of having the best medical policy for the family:

• It provides a cashless hospitalization facility during a medical emergency.
• It will cover various out-of-pocket medical expenditures.
• It has additional add-ons such as an international second opinion you can select according to your healthcare needs for complete protection.
• It offers coverage for your pre and post hospitalization medical expenses such as OPD expenses, diagnosis, doctor's fee, medication, therapies, etc.
• One has the lifelong renewability option with additional benefits, such as coverage for alternative treatments, day care procedures, annual health check-ups, etc.
• You can choose the advanced treatment facility on a cashless basis at any in-network hospitals in nearby locations.
• Avail tax benefits under Section 80D of the Income Tax Act up to Rs.1,00,000 for the premium paid for a family floater policy, depending on the age of proposer & insured.

How Many Types of Mediclaim Policies are Available in India?

Several types of mediclaim policies are available in India. At Care Health Insurance, we offer comprehensive and customised mediclaim insurance policies that cater to your unique health care needs and help you access the best treatment. Let us understand the different mediclaim policies:

• Individual Mediclaim: An individual mediclaim plan covers only one individual for the specified sum insured. The policy benefits and the entire sum insured are available to the policyholder for the premium applicable. 
• Family Floater Mediclaim Cover: In a family floater mediclaim insurance policy, the coverage and benefits are available to all the insured family members, including spouse, children, and parents. The policy has a floater sum insured that either one individual or the entire family can utilize for any hospitalization or medical treatment.
• Senior Citizen Mediclaim Policy: It is a type of mediclaim designed to provide coverage and benefits, including hospitalization cover, for elderly individuals aged above 60 years. 
• Critical Illness Mediclaim: Critical illnesses require long-term medical treatment that may lead to astronomically high medical bills. Critical illness mediclaim policies are designed to cover severe ailments, such as stroke, cancer, heart disease, etc. We offer coverage for 32 critical illnesses.
• Cancer Mediclaim: Cancer mediclaim plans provide lifelong protection and comprehensive coverage for various cancer treatments along with chemotherapy and radiotherapy cover. It's wise to invest in this policy early as people already diagnosed with cancer cannot get it.
• Heart Mediclaim: Heart mediclaim insurance plans provide comprehensive hospitalization and medical treatment coverage for various heart-related ailments, thus saving a person from facing any financial stress. At CHI, our heart care mediclaim covers 16 major heart ailments.

How Important is Mediclaim Insurance for Your Family?

Do you know a single-time hospitalization can push your financial planning back? Why take a risk? If you have a family to take care of, opt for a mediclaim plan now. Read below how it is crucial:

• Increasing Lifestyle Diseases: The incidences of lifestyle and critical diseases are rising in India. A medical emergency can come as an uninvited guest. So, better to stay protected with the best mediclaim policy in India that covers your expenses during a medical emergency.
• Cashless Hospitalization: You do not need to worry about cash for the treatment. Under the mediclaim plan, we will directly settle your hospital bills. Go for cashless hospitalization without worries.
• Lifelong Coverage: You do not need to buy medical insurance again and again. Once you get it, you and your family enjoy lifelong coverage on break-free renewals.
• Preventive Care:  Preventive health check-ups can cost you extra and burden your pocket. Opt for mediclaim policy in India that offers annual health check-ups for all the insured members.
• EMI Option:  The great relief to your pocket. You can opt for the EMI option and pay a mediclaim premium monthly or quarterly that reduces your financial burden.
• Quick Recovery Counseling:  At times, you need counseling to recover from health problems. You can get advice from a psychologist through face-to-face consultation up to the amount per session fixed.
• No Claim Bonus: Now, get no claim bonus as a reward for your good health. It is a seamless feature that helps you to double your sum insured. 
• Tax Exemption: Under section 80D of the Income Tax Act 1961, the premium paid for the policy for self, dependent parents, children, and spouses qualify for tax deductions. So, save more and stay healthy with the best mediclaim policy in India.

Factors You Should Consider while Finalising a Mediclaim Plan

Mediclaim will protect you at any time to face a medical emergency or any planned medical treatment for you or your loved ones. Choose a policy wisely so that you can avail the maximum benefits.

You may find options for mediclaim online, but finalising what is best can be challenging, especially if you are getting it for the first time. We list some vital factors that you should consider when choosing or comparing mediclaim policies online:

• Type of Coverage: A mediclaim policy in India is classified broadly into individual and family floater mediclaim plan. Choose family floater plans as they are affordable and cover the entire family for a single premium. An individual plan may be suitable if there are elderly family members.  
• Sum Insured: Carefully select the coverage amount after thoroughly assessing your estimated medical expenses and considering aspects like medical inflation rate and cost of surgeries and treatments. Also, the treatment costs in metro cities are relatively higher. Moreover, if you choose to cover your entire family, then going for a higher sum insured is advisable. 
• Benefits: Opt for a plan that gives maximum coverage, including hospitalization, ambulance cover, daycare treatment, medication, and pre and post-hospitalization medical expenses. Know the additional benefits you can get, such as international second opinion, OPD cover, and more to enhance the policy coverage.
• Premium: The coverage you would get should not make you spend on high premium costs. Check and compare the premium using the online mediclaim premium calculator available on our official website to pick the most affordable policy.
• Discounts: Discounts help you save money while getting affordable health coverage. At CHI, you can get a discount of up to 10% if you opt for a 3-year policy term. 
• Lifelong Renewability: Always check the eligibility criteria and pick a plan with lifelong renewability. Health risks increase as we become older; at the same time, it becomes more difficult to get medical insurance cover as we age. So, it is essential to ensure that you get a lifelong renewability feature to continue coverage under the same policy.
• Exclusions: The best mediclaim in India covers various health risks. However, there are specific scenarios and expenses for which the policyholder cannot get a claim. They include self-inflicted injuries, consumption/abuse of alcohol or drugs, etc. Check the permanent and temporary exclusions mentioned in the policy documents to avoid any hassle during claim settlement. 
• Waiting Period: Before you say yes to a mediclaim or a health insurance policy, check the policy document's waiting period clause. There is an initial waiting period, a waiting period for pre-existing diseases, and a waiting period for specified ailments/treatments. If you have a pre-existing illness before the policy issuance, check the waiting period clause and make sure you do not need to wait long to get the coverage. That is, opt for a policy with a minimum waiting period. 
• Network Hospitals:  Check out the list of network hospitals empanelled with us. Identify the network hospitals located in proximity where you will be comfortable getting the cashless medical treatment.
• Claim Settlement Ratio: If the claim settlement ratio is higher, it is one indicator of how easily you will get a claim. Consider this factor and make an informed decision. CHI has a claim settlement ratio of 95.22% in FY 2019-20.

What Does a Mediclaim Insurance Policy Cover?

Due to the uncertainties of life and the constant rise in health care costs, mediclaim nowadays is essential for families and individuals. Read below what mediclaim covers.

• In-Patient Hospitalization: If the in-patient hospitalization is for more than 24 hours, we cover your hospitalization expenses. These expenses include your room charges, nursing expenses, ICU, surgeon's fee, doctor's fee, blood, oxygen, and OT (operation theatre changers).
• Day Care Treatments: If you have to undergo any surgery or treatment or therapy that requires hospitalization for a day, then from room rent to medicine bills, we bear your daycare treatment expenses, up to the sum insured. We cover 540 daycare treatments, the highest in the industry.
• Pre and post hospitalization: It covers your pre and post hospitalization expenses that include diagnosis, treatment, and medicine expenses, along with doctor's fees.
• ICU Charges: We value every life and know the importance of the right healthcare services. If you are admitted to ICU, we will cover the charges.
• Ambulance cover: This policy provides reimbursement against the expenses that you incur on an ambulance during a medical emergency.
• Annual Health Check-Ups: Under the mediclaim plan, you will get an annual health check-up facility at our empanelled healthcare services providers. It includes complete blood sugar, urine routine, kidney function, ECG check-ups, etc.
• Recharge of Sum Insured: If your coverage amount gets exhausted, you get an automatic recharge of the sum insured. You can use this amount for the treatment of any other insured family member or yourself.
• Other Benefits: Organ donor cover, second opinion, NCB, and alternative treatments are other useful benefits.

What is Not Covered under a Mediclaim policy?

The medical conditions not admissible under a medical insurance plan are called exclusions. You can read below the *exclusions under mediclaim.

• Any diagnosis, treatment, or surgery for illnesses occurring within 30 days of the Policy Period Start date
• Medical expenses related to the treatment of congenital disease
• Medical expenses incurred due to IVF or infertility treatment
• Treatment arising due to/ or traceable to pregnancy, childbirth, miscarriage, abortion, and its consequences
• Hospitalization due to war, riot, strike, or nuclear weapons
• Medical expenses due to alcohol or drug abuse
• Expenses arising due to self-inflicted injuries and suicide/suicide attempt
• Pre-existing disease up to 48 months since the policy inception

How to Claim Mediclaim Policy?

With us, claim under mediclaim policy is quick and easy. During an emergency, you need to inform our customer support team within 24 hours of hospitalization. For planned hospitalization, you need to intimate before 48 hours of hospitalization. You can file the claim in two ways:

Cashless Claim

For cashless hospitalization, admission to any network hospital is mandatory. Below are the simple steps to file the claim:

• Submit the pre-authorization form and submit it to the hospital insurance desk.
• Our claim management team will send an approval letter
• If required, our claim management team may raise a query
• After the approval, we will settle your bills to the hospital
• In case of rejection, you may initiate the treatment and file for reimbursement

Reimbursement Claim

Under reimbursement, you have to pay the hospital bills at the time of discharge. Later, you can file for reimbursement by following the below steps:

• Submit the Health Insurance claim reimbursement form and attach all the required documents along with the form
• Our claim management team will send an approval letter
• Insured need to respond to the query raised by the claim management te
• We will communicate the reason in case of rejection

How to Buy Mediclaim Plans Online?

With us buying a mediclaim insurance policy is simple.  Follow these simple steps to get it online hassle-free: 

• Visit our official website
• Enter the required details, including contact number and email id
• Click on Get Quote.
• Fill in the Proposer details, including mobile number, email id, name, and Pincode
• Click on Next and enter the insured person details such as gender and age
• Click on the Next button and fill in the details for pre-existing conditions if any
• Select sum insured and policy tenure
• At the top, you can see the premium, including GST and EMI option too
• Click on Buy Now, 'quick pay' page will open where you need to confirm proposer details, then click on the Next button
• Please select any of our secure payment modes such as net banking, debit or credit cards, or payment wallets
• You will receive the policy documents, including the policy number and e-card, on your registered email-id.

How to Port a Mediclaim Policy in India?

You can port the policy 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 and submit the relevant documents and make payment.

Want to port your current health insurance?

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