What is the difference between mediclaim and fixed benefit health insurance

Basic coverage

A mediclaim plan offers basic coverage such as hospitalization, accident-related treatment and pre-decided illness for a pre-specified time.

A fixed benefit health insurance plan offers specific coverage such as critical illness coverage, personal accident cover,hospital cash policy.

Add-on coverage

Does not offer any add-on coverage.

Further add-ons can be added such as senior citizen plans, indemnity cover, independent covers, top up plans etc.

Features

Features of a mediclaim plan vary from plan to plan and insurance provider.

Mostly, the features and benefits of such plans for a specified sum insured are the same over most insurance providers.

Flexibility

It provides only basic coverage as mentioned early. No flexibility as such.

This plan is so flexible that you can change your policy period, or lower the premium rates after a specified period. It is suggested to avail long term policies to enjoy maximum insurance benefits.

Sum assured

Upto 5 Lakhs Rupees of sum assured for a medical insurance plan.

Upto 6 crore rupees per year of sum assured can be availed because of its extensive coverage.

Claims

Claims can be made up to the total sum assured till it's exhaustion.

This policy will pay lump sum only in case of surgery. But such claims can only be made once during the entire policy tenure. Apart from this, you can file claims as long as your sum insured is not exhausted.

Critical Illness coverage

No coverage for critical illness.

Provides coverage for more than 35+ critical illnesses such as cancer, organ failure, paralysis etc.

Hospitalization

It is crucial to get hospitalized for mediclaim.

Not needed to get hospitalized to avail policy benefits.