Health & Beauty

What Does a Critical Illness Insurance Exactly Cover?

If you are a newbie in health insurance, there is a chance you may get confused between critical illness mediclaim and health insurance.  However, both serve the same purpose of providing health safety and financial cushion during a medical emergency. But, they vary in terms of coverage, claim, benefits, etc. Therefore, it is essential to choose a plan that suits your health care requirements. Moreover, if you look at the present pandemic scenario, lifestyle has changed, pollution levels are increasing again,  corona survivors facing several side effects, and incidences of several life-threatening diseases are growing. 


In such a situation, you and your family need complete health care protection, and critical illness insurance is apt for it. So, let’s check out in detail what this type of mediclaim exactly covers?



Critical Illness Coverage


Under critical illness mediclaim, you get the lump sum amount after submitting the diagnosis to the health insurance company. It covers critical illnesses such as cancer, end-stage renal failure, multiple sclerosis, benign brain tumor, motor neuron disorder, end-stage lung disease, major organ transplant, stroke, paralysis, coma, etc. The treatment costs of critical illnesses are expensive and recurring. But do not worry, from hospitalization to medication, this mediclaim covers most of the expenses.

Leading brands like Care Health Insurance include 32 critical illnesses under this plan. Check out their websites for more details.


Coverage for In-Patient Hospitalization

You will get coverage against the expenses related to in-patient hospitalization due to severe ailments. Costs for room charges, nursing expenses, ICU, surgeon’s fee, doctor’s fee, blood, oxygen, and OT (operation theatre charges) are included in the policy coverage.

Daycare Treatments


Next comes daycare treatment; these treatments do not require a patient to be admitted to the hospital for more than a day. Critical illness insurance also covers daycare treatment for cataract surgery, chemotherapy, dialysis, etc. Room rent, doctor’s visit, medicines, etc. are covered under the plan.


Pre and post hospitalization


At times, patients need to undergo several pre and post-hospital tests and medicines that collectively can become a vast amount and difficult to bear. Critical mediclaim covers such expenses and give reimbursement for the same. It also covers OPD expenses. You can check more about the reimbursement process on the offical websites of health insurance companies.


Additional Coverage


Mediclaim gives you additional benefits such as air ambulance cover, no specific ailment waiting period, alternative treatment, doctor on call, global coverage, and so on. These benefits are helpful to enhance the policy coverage. 


Annual Health Check-Up


You can also avail of annual health check-ups under the plan. It includes a blood sugar test, urine routine test, blood groups, kidney function test, and ECG check-ups. You do not need to pay any extra charges for these tests and save your money. 


Tax Exemption 


Under section 80D of the Income Tax Act 1961, a premium paid for critical illness health insurance for self, dependent parents, spouse or children, is entitled to tax exemption. The taxable amount is subject to income, age, number of persons insured, etc. that reduces your taxable liability. 


Below is the list of the best critical illness insurance plans in India; check which one suits yours and your family’s healthcare requirements:


Health Insurance Company

Sum Insured

Network Hospitals

Aditya Birla Mediclaim

10-30 Lac


Care Critical Mediclaim Policy

3-60 Lac


Bajaj Allianz Mediclaim Policy 

1.5-50 Lac


Bharti AXA Mediclaim

3-5 Lac 


Digit Mediclaim Policy 

2-25 Lac


Source: Policy Bazaar


Over to You


Thus, critical illness insurance is crucial. It gives you comprehensive coverage against lifestyle diseases and critical illnesses. So, opt if today and live with peace of mind.