What is the difference between health insurance and medical insurance?

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If you are one of those people who sees health insurance and medical insurance as one, then wait. You are wrong. These terms can be used interchangeably, but there is a slight difference between the two. People often confuse medicare with medicare and vice versa. Here in this article, we have differentiated these terms in a very simple way so that you can never get confused between the two again.

What is health insurance?

Health insurance not only covers all hospital costs, but also covers all costs such as pre-hospitalization and post-hospitalization, which includes ambulance costs and related expenses. We can say that it is an all risks insurance policy.

Advantages of a health insurance contract:

  1. It is well known that every health insurance policy includes a collection of hospitals. This means that if a person is admitted to one of these hospitals covered by their health insurance plan, they do not have to pay any fees. The simple police number of the admitted person will help in cashless treatment in the hospital.
  2. A comprehensive health insurance policy also covers pre-hospital and post-hospitalization costs (ranging from a period of 30 days to 60 days) depending on the type of insurance policy you have purchased. It means you don’t have to bear the freight cost.
  3. If, in the event that you do not claim your health insurance for a year, you will either benefit from an increase or a reduction in the sum insured. In addition to this, many mutuals offer their clients a free medical examination.
  4. In India, if you do fall under the tax, purchasing a premium health insurance policy will allow you to get a tax refund under Indian Income Tax Law. A relationship tax of Rs. 25,000 for the 18-50 age group and Rs. 30,000 for the elderly will be provided under Section 80D of the Income Tax Act, provided that you are a citizen of the Republic of India.
  5. A comprehensive health insurance policy also gives you a co-payment option. This means that in the event of treatment, the insurance company will bear part of the costs while the remaining costs will be paid by the insured person.

Different types of health insurance policies available in India:

There are different types of health insurance policies available in India. These policies cover all expenses for any type of medical emergency. They are as follows:

1- Individual Health Insurance Policy: The individual health insurance policy provides coverage to the insured person against different types of illnesses. It also covers the other benefits mentioned above.

2- Floating family health insurance policy: The whole family is insured under this insurance policy. The floating family plan offers individual members of a family a fixed amount of health insurance. This type of plain can be used either for the treatment of an individual or a total sum for the treatment of an individual family member.

3- Pre-existing health insurance policy- As part of this plan, the policyholder will get coverage for all the illnesses he had before purchasing the health insurance plan.

4- Surgical plan and serious illnesses: This plan provides coverage against serious illnesses such as cancer, heart attacks, etc.

5- Seniors’ health insurance policy: All health problems related to old age are covered by this policy.

6- Preventive Health Policy: This policy covers medical examinations and related expenses such as consultation fees, concessions in testing fees, etc.

What is medical insurance?

Medical insurance provides coverage limited to hospitalization and treatment costs for pre-specified illnesses and accidents. Medical insurance does not offer any additional cover like health insurance. It is based on the sum insured and cannot exceed 5 Lakhs INR.

There are two claims under the medical insurance policy:

1- Cashless

2- Refund

In cashless claim, the insured is treated in the hospital which is covered by the insurance company. The insurance company will cover all hospital costs and the insured person will not have to pay any amount.

In the event of a reimbursement request, the insured must inform the insurance company of the hospitalization either in advance or at the time of admission. In addition to this, all original documents should be kept in a safe place such as invoices, discharge card, etc. They will be required at the time of the refund request.

Different types of medical insurance policies available in India:

1- 1- Individual Medical Insurance Policy: The individual health insurance policy provides coverage for a specified amount to the insured person.

2- Floating family medical insurance policy: Under this policy, if an insured person in a family reaches a certain age or dies, that person’s policy will be closed and family members will not be allowed to renew the policy.

3- Pre-existing health insurance policy- As part of this plan, the policyholder will get coverage for any illnesses he had before purchasing the health insurance plan. It also covers all illnesses that may result from the pre-existing illness.

4- Renewal age: All policies provide coverage for one year only. Therefore, the policy should be taken out at an early age to get better low premium coverage and other added benefits.

Difference between health insurance and medical insurance:

Before purchasing any health insurance or medical insurance plan, analyze the fine line between the two.

1- Medical insurance will cover you only for hospitalization, pre-specified ailments and accidents also for a pre-specified amount while health insurance will provide you with full coverage against hospitalization costs, health costs. pre-hospitalization and post-hospitalization and ambulance costs.

2- Medical insurance will not provide you with any additional coverage, while health insurance offers additional coverage such as serious illness, accidental disability, etc.

3- Health insurance does not offer any flexibility in terms of coverage, while health insurance policyholders can reduce the duration of their contract, the amount of the health insurance premium after a certain period, etc.

4- Medical insurance does not provide critical illness coverage to the insured while health insurance provides critical illness coverage to the insured for illnesses like cancer, heart attacks, etc.

5- In medical insurance the pre-insured sum cannot exceed 5 Lakhs INR while in health insurance the limit is 6 Crores INR.

These are some of the differences between medical insurance and health insurance policies. Different insurance companies have different benefits and the individual should make a wise decision before purchasing a policy. The two policies mentioned above are also beneficial for health issues and the thin line between said policies should be well understood by the individual before making the decision.


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