Health Insurance, or Mediclaim, covers the medical and surgical expenses of an insured individual. Depending on the type of policy, either the insured pays for the expenses upfront and is reimbursed later, or the insurer directly pays the healthcare provider. The policy takes care of medical expenses incurred due to Hospitalisation or Domiciliary Hospitalisation in the following situations:
• Sudden illness
• Accidents
• Any surgery needed for a disease diagnosed during the policy period.
Key Features of Mediclaim:
• The policy either reimburses or pays directly to the hospital for expenses such as doctor and nursing fees, operating theatre costs, medications, blood, oxygen, diagnostic tests, chemotherapy, radiotherapy, pacemakers, and donor expenses for organ transplants, typically for up to 30 days. It does not provide any financial gain to the insured.
• Pre- and post-hospitalization expenses are covered to a certain extent. The policy may also cover emergency and local ambulance services, provided the hospitalization lasts at least 24 hours.
• Certain procedures, such as cataract surgery, may be covered even without hospitalization.
• Many insurers offer cashless Mediclaim, allowing the insured to receive treatment at specified hospitals without upfront payments.
• A Family Floater option extends the Mediclaim coverage to all family members under a single policy.
