Difference Between Health and Medical Insurance
Health and Medical Insurance: Understanding the Differences
Considering the increasing health issues among citizens, health insurance policies have become the need of the hour in India. However, most individuals get confused about health and medical insurance when it comes to choosing a policy for their healthcare needs. They tend to think that both are the same and buy a policy that may not suit their requirements completely.
Though the primary purpose of these insurance plans is the same – to cover medical expenses, specific differences make them unique. Keep reading to explore the differences between health insurance and medical insurance and make better choices.
What is the Role of Health Insurance?
Buying a health insurance policy is necessary to avail coverage against various expenses associated with the insured’s medical treatments and surgeries. They may include pre- and post-hospitalization costs, daycare procedures, homecare treatments, ambulance charges and more.
The policyholder needs to bear the costs initially, but they can claim reimbursement for the expenses incurred. Some plans even offer cashless treatment facilities at network hospitals, eliminating the need for upfront costs.
Following are the salient features of health insurance plans:
●Various Types of Health Insurance Plans
Health insurance policies are available in various types - individual, family, and senior citizen plans. Furthermore, leading insurers like Star Health provide critical health insurance plans that cover diseases like cancer, cardiovascular diseases and more.
●Tax Benefits
As per section 80D of the Income Tax Act, policyholders can claim a maximum deduction of ₹25,000 annually against their health insurance premium payments. This tax benefit increases to ₹50,000 for senior citizens.
●No Claim Bonus
For each claim-free year within the policy period, individuals can avail of a No Claim Bonus. It can be in the form of premium discounts at the time of policy renewal or an increase in the coverage amount.
What is the Role of Medical Insurance?
Medical insurance, as the name suggests, offers coverage against medical expenses, just like health insurance. However, it does not provide comprehensive coverage like a health insurance plan. They target specific expenses related to the insured's medical issues.
Generally, medical insurance covers the hospitalization costs, domiciliary treatment, doctor's consultation fees, ICU expenses, etc., at the empanelled hospitals or clinics under the insurance company. Thus, medical insurance safeguards individuals against their necessary medical costs.
How Does Health Insurance Differ from Medical Insurance?
The table below represents the differences between a health insurance and a medical insurance policy:
| Features | Health Insurance | Medical Insurance |
| Advantages | Some health insurance plans may cover maternity, OPD (outpatient department) and other treatment expenses when you get them from network hospitals. | Medical insurance primarily focuses on paying the hospital bills directly to the healthcare institution or reimbursing the costs incurred in the treatment of those health issues that it covers. |
| Purpose | It provides wide coverage for multiple health-related expenses. | Thus, you are assured of overall safety. It provides financial coverage against specific medical requirements that mainly lead to hospitalization. |
| Flexibility | Policyholders can maximize their health insurance benefits by purchasing additional riders with their comprehensive health plan. | These policies mainly focus on covering your hospitalization costs and offering fixed benefits. |
| Premium | As health insurance policies offer comprehensive coverage, their premium amounts are generally high. | These insurance policies are focused on providing specific coverage, keeping the premium amount low. |
| Coverage Scope | Offers comprehensive health coverage that includes annual check-ups, pre- and post-hospitalization, critical illness, and other health-related costs of the insured. | Covers the expenses of hospitalization caused by accidents or illness. It mainly includes hospital room charges, medicine costs, and doctor's fees. |
| Riders or Add-on | Policyholders can customize their health insurance policies with suitable riders, including waiver of premium, accidental death coverage, etc. | Even the rider under medical insurance offers limited coverage. |
| Family Coverage | It also covers the health expenses of the individual's family under the family floater plan. | Mainly focused on the individual policyholder. |
Now that you know the difference between a health and medical insurance policy, you can decide on one based on your requirements. Individuals looking for comprehensive coverage can opt for health insurance, whereas those looking for an affordable option can buy medical insurance.
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This FAQ page contains information for general purpose only and has no medical or legal advice. For any personalized advice, do refer company's policy documents or consult a licensed health insurance agent. T & C apply.