Corporate Wellness

Health Insurance VS Medical Insurance: Which Is Right For You?

Confused about health insurance vs medical insurance? If you are unsure of the difference between health and medical insurance, read on to find out which one is best for you. We tell you all to learn more about how to choose the right type of insurance for your needs.

By URLife Team
16 Jan 2023

As a working professional, it's important to have a solid understanding of your healthcare options. Choosing health insurance vs medical insurance is often a dilemma a lot of us struggle with when deciding the best type of protection for ourselves and our loved ones. .

Health insurance and medical insurance may seem interchangeable, but they actually have some significant differences. It's essential to know the distinction between the two, as well as the pros and cons of each, in order to make an informed decision about which type of coverage is right for you.

If you're new to the workforce, this may be your first time exploring insurance options. And even if you're an experienced professional, it's never a bad idea to review and update your knowledge about health and medical insurance. Don't wait until you're faced with a medical crisis to figure out your coverage. Take the time to research and understand your options so you can make the best decision for your health and financial well-being.


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Health Insurance vs. Medical Insurance: A Comparison



Medical Insurance

Health Insurance

What it covers

Hospital stays, specific medical conditions, and a fixed amount. Does not cover extra charges.

Comprehensive coverage including hospital stays, acute illness, preventive care, ambulance, and more.

How to access benefits

Must be hospitalised to get benefits.

Can get benefits without being hospitalised.

Number of claims allowed

Allows for multiple claims until the policy limit is reached.

Typically provides a single claim, such as a lump sum payment for a critical illness.

How payments work

Uses a cashless payment method where the policyholder or hospital is reimbursed.

Uses a cashless payment method where the policyholder, hospital, or a lump sum payment for certain illnesses or critical illness is reimbursed.

Maximum coverage

Usually has a maximum coverage of Rs. 5 lakhs.

Can have coverage up to many crores.

Additional coverage options

Does not offer additional coverage options.

Offers added coverage for various healthcare needs, including pregnancy, accidents, serious illnesses, etc.



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What Is Health Insurance And How Does It Benefit You?

A health insurance policy is a type of insurance that covers the cost of medical and surgical expenses incurred by the policyholder. There are two main ways that a health insurance policy can cover these expenses: the policyholder can pay for them out-of-pocket and then be reimbursed by the insurer, or the insurance company can directly settle the bill with the network hospital.

Health insurance policies generally offer more extensive coverage than hospitalisation policies, including coverage for pre- and post-hospitalisation expenses. As a result, health insurance policies are usually more expensive than medi claim policies, which only cover hospitalisation expenses. However, the added coverage provided by a health insurance policy can be well worth the extra cost in the event of unexpected medical expenses.


Need all your wellness solutions in one place? A whole new world awaits just a click away.


Benefits of A Health Insurance Policy

1. Cashless Treatment At Network Hospitals: One of the main benefits of having a health insurance policy is the ability to avail cashless treatment at hospitals covered by the policy. This means that you don't have to worry about paying for any medical expenses out-of-pocket and can simply provide your policy number for a hassle-free experience.

2. Coverage For Pre And Post-hospitalisation Expenses: In addition to covering hospitalisation expenses, a comprehensive health insurance policy also covers pre-hospitalisation and post-hospitalisation expenses for a certain period of time (usually 30-60 days). This means that you don't have to worry about bearing any transportation costs or other related expenses.

3. No Claim Bonus And Free Medical Check-ups: If you don't make any claims on your health insurance policy for a year, you may be eligible for a no-claim bonus in the form of an increment in the sum assured or a discount on your premium. Many health insurance companies also offer free medical check-ups to their policyholders.

4. Tax Benefits: In India, purchasing a premium health insurance policy can also get you tax benefits under the Income Tax Act. If you fall under a certain tax slab, you may be eligible for a tax deduction of Rs. 25,000 for individuals aged 18-50 years and Rs. 30,000 for senior citizens under section 80D of the Income Tax Act.

5. Co-Payment Option: A comprehensive health insurance policy also offers a co-payment option, which means that the insurance company will bear a portion of the medical expenses while the policyholder pays the remaining amount. This can be a useful option for those who want to lower their premiums while still having some coverage.


Related Story: 7 Reasons Why getting Health Insurance Should Be A Priority In 2023


Different Types of Health Insurance Policies Available In India

There are several types of health insurance policies available in the market, each catering to specific needs and requirements. Some of the common types of health insurance policies include:

  • Individual health insurance plan
  • Critical illness policy
  • Pre-existing diesease cover
  • Family floater mediclaim policy
  • Senior citizen health plan
  • Preventative healthcare


Related Story: Future-Proof Your Family: How Often Should Yopu Schedule Regular Check-Ups


What Is Medical Insurance?

Medical insurance is a type of health insurance that is designed to cover specific medical expenses. It is typically more targeted and limited in scope compared to other types of health insurance, as it only covers a predetermined set of medical expenses.

Additionally, medical insurance usually has a cap on the maximum amount that it will pay out, which is generally around INR 500,000. This means that there is no opportunity to enhance the coverage through additional riders or add-ons. Despite these limitations, medical insurance can still be an important tool for protecting against unexpected medical expenses and helping to cover the costs of necessary medical treatment.


Related Story: Uncovering The Benefits of Regular Health Check-Ups


Different Types of Medical Insurance Policies Available In India

There are several types of medical insurance policies available in India, which can be broadly classified into the following categories:

  • Individual coverage for one person
  • Family floater coverage for multiple family members
  • Coverage specifically for senior citizens
  • Coverage for critical illnesses


Need all your wellness solutions in one place? A whole new world awaits just a click away.


When deciding between health insurance and medical insurance, consider your healthcare needs and budget. Health insurance offers comprehensive coverage, while medical insurance is more targeted and limited. Take action to safeguard your health by choosing the right coverage for you and your loved ones.








Anil Kumar Biswas 21 May 2024

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