Best Mediclaim Policy, Mediclaim Insurance Plans in India | Niva Bupa (2023)

As per the Insurance Regulatory Development Authority of India (IRDAI), it is mandatory for all insurance providers to cover the treatment cost and hospitalization expenses related to COVID-19. Some insurance companies have come up with a separate coronavirus health insurance policy while others have included it under their basic mediclaim policy.

There are two simple ways to claim the benefits of your mediclaim policy – reimbursement claim and cashless claim. If you opt for a reimbursement option, then you need to inform your insurance company in the event of hospitalization. Also, you need to keep your medical bills handy and make sure you fill up the claim form with accurate details in order to claim your medical reimbursement. For cashless claims, you just need to submit your claim form and medical expenses will be settled directly by the insurance company to the network hospital.

Every health insurance policy has a certain age criterion. For instance, some plans have the minimum entry age limit of 18 years and the maximum entry age limit of up to 65 years. Also, there are plans that have an entry age limit of 91 days. Hence, you must check the age limit criterion before buying a mediclaim policy as this would help you choose your plan accordingly.

A mediclaim policy does not cover accidents. However, it covers hospitalization expenses incurred due to accident-related injuries. Accidents are mostly covered under personal accident insurance. Such insurance policies are designed specially to cover the financial risks linked with accidents. Besides this, you can get a mediclaim policy with an accidental benefit rider. Buy the personal accident cover add-on by paying an extra premium in addition to your mediclaim policy.

The major difference between the two is that a health insurance policy covers everything from pre and post-hospitalization expenses to ambulance fees, OPD charges, accidental cases, and much more. But, a mediclaim policy is limited only to hospitalization. This policy comes to you as a savior in case you are hospitalized due to an accident or illness.

There are a range of mediclaim policies available in the market. All you need to do is to choose the one that best suits your needs. There are policies available for individuals, couples, family, and even extended families. An individual mediclaim policy offers coverage to a single individual (insured person), whereas a family floater policy offers coverage to the individual and other family members under a single sum assured. Apart from this, there’s a group mediclaim policy for employees that covers not just employees but also, their extended families.

In order to port a mediclaim policy, you first need to approach a new insurance company at least 45 days prior to the expiry of your current mediclaim policy. If you fail to do so, the new insurer will dismiss your portability application. Once it’s done, you are required to fill in the proposal form and all the other details shared by the new insurance company. Afterward, you need to submit the form along with other documents. If you fail to submit the form on time, then the insurance company may reject your portability application.

You can easily buy a mediclaim policy online from the comfort of your home. Although, you must check the credibility of the insurance company from where you wish to buy the mediclaim policy. In addition to this, you must take a look at the company’s claim settlement ratio before buying a mediclaim policy.

Mediclaim policy premium calculator will help you calculate your mediclaim premium. All you need to do is to fill in your name, age, e-mail ID, and mobile number. Besides this, you need to enter the city name that you reside in. Based on your input, a range of mediclaim products are populated and from there you can select the one that best suits your needs. By entering your personal details, age, income, and other details, you can easily calculate your premium.

Generally, pre-existing diseases are excluded from a mediclaim policy. According to IRDAI, if a person is diagnosed with a disease or undergoing surgery within 48 months from the policy commencement date, then this condition is called a pre-existing medical condition.

Dental treatments are not covered under a basic mediclaim policy. Dental treatments are mostly covered in the event of accidents. However, you can take it as an add-on benefit along with your mediclaim policy by paying a few extra premiums.

Pregnancy treatment is not covered under a mediclaim policy. Treatment related to pregnancy, child birth, abortion, and miscarriage is excluded from a mediclaim policy unless these expenses have been opted for.

As per new IRDA guidelines, it is possible to modify sum assured in a mediclaim policy. It allows the policyholder to increase or decrease the amount of sum assured in the policy.

Yes, you can easily add or remove family members in your existing mediclaim policy. A mediclaim policy for the family allows you to insure new family members. In fact, this is one of the biggest benefits that a family floater mediclaim policy offers.

If your mediclaim policy has lapsed, then it is advisable to renew your expired policy as early as possible. If in case you have missed your policy renewal date, then you can renew your policy within the grace period. This is the time period that is given to you by the insurance company to make your payment towards the premium in case you missed your due date. But, if you fail to renew your mediclaim policy even after the grace period, then you will have to purchase a fresh mediclaim policy. Also, you will not be able to avail all the benefits and discounts that you have made over the years.

Anyone who cannot possibly bear the rising hospitalization costs and medical care expenses must invest in a mediclaim policy. The policy not just acts as a financial cushion for your loved ones but also gives you the peace of mind which makes it a perfect investment option.

Yes, a mediclaim policy can be cancelled after the completion of the free-look period. You get a 15-day free-look period within which you can cancel your insurance policy stating the reason. If you cancel your policy within the free-look period, then you will receive a 100% refund of the premium amount. But, if you cancel your policy after the completion of the free-look period, then the 100% premium amount will not be refunded to the policyholder.

No, LASIK surgery is not covered under a mediclaim policy. A mediclaim policy basically covers the cost of hospitalization that arises due to an injury, disease, or ailment. LASIK surgery is neither an injury nor a disease. Thus, a mediclaim policy does not cover the cost of LASIK surgery as this type of eye surgery comes under cosmetic treatment.