| Coverage | Typically covers hospitalization expenses due to illnesses or injuries. | Offers broader coverage, including hospitalization, pre-hospitalization, post-hospitalization, and various medical services. |
| Nature of Benefit | Provides reimbursement for actual medical expenses incurred during hospitalization, up to a predefined sum insured. | Offers a wider range of benefits, including coverage for outpatient services, preventive care, maternity, dental, and more, depending on the policy. |
| Claim Process | Primarily involves submitting bills and documents for expenses related to hospitalization or specific medical treatments. | Involves a more extensive claim process that may cover various medical services beyond hospitalization, requiring documentation and verification. |
| Premium Costs | Generally has lower premiums due to its limited coverage scope. | Tends to have higher premiums compared to mediclaim policies due to its comprehensive coverage. |
| Policy Duration | Often available as one-year policies that need to be renewed annually. | Can be offered as both short-term and long-term policies, with varying durations, including lifelong coverage. |
| Additional Benefits | Typically lacks additional benefits like wellness programs or coverage for non-hospitalization-related expenses. | May offer various add-ons or riders, such as critical illness riders, maternity coverage, and wellness programs. |
| Pre-Existing Conditions | May have limitations or exclusions regarding coverage for pre-existing medical conditions. | Some health insurance policies cover pre-existing conditions after a waiting period or with specific terms and conditions. |
| Coverage Limits | Usually has a predefined sum insured, and once exhausted, no further claims can be made during the policy year. | Often provides higher coverage limits or options to increase coverage, offering more financial protection. |
| Preventive Care | Typically does not cover preventive care services such as health check-ups or vaccinations. | Some health insurance plans include coverage for preventive care services, promoting overall well-being. |
| Network Hospitals | May have a limited network of hospitals where cashless services can be availed. | Often has an extensive network of hospitals, offering cashless services at a wider range of healthcare facilities. |
