Introduction

Before we start comparing these two policies we have to set out some ground rules.

Both products are marketed by different insurance companies. Medi Classic is sold by Star Health and Mediclaim Insurance Policy is sold by Oriental Insurance. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.

Second, we know that both products are quite basic in their structure. They offer modest protection and aren’t comprehensive enough to cover a wide array of use cases. So if you are looking for something more robust, then both these policies may not cut it.

And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?

That’s something you’ll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.


Let’s start with Medi Classic. The product comes from Star Health’s stable:

Star Health Insurance is India's first standalone health insurance firm. And with an army of retail advisors pushing their products across the country, they’ve managed to capture a fair share of the Indian market.

The company also boasts a network of over 14,000+ hospitals and a decent claim settlement ratio of 83%.


Mediclaim Insurance Policy meanwhile comes from Oriental Insurance’s stable:

Oriental Insurance is a government-owned company that offers health, vehicle, business, and farmer insurance. The company is a fully-owned component of the Oriental Government Security Life Assurance Company Ltd.

Now because it is a government-owned insurance firm, you can’t expect operational efficiencies across the board. Although, the company does boast a fairly high claim settlement ratio with over 3,264 network hospitals across the country.

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Insurance Parameters

Recommended
Not Recommended
Network hospitals
14,000+
3,264
Claim settlement ratio

(avg. of last 3 years)

83%
96%
Co-payment

10%

(if purchased after turning 61)

No

Room rent

Any Room

(max ₹5,000)

Any Room

(up to 1% of sum insured)

Disease sub-limit

Yes

Yes

Pre existing diseases waiting

3 years

3 years

Pre/Post hospitalization

30/60 days

30/60 days

No claim bonus

5% per year

(up to 25%)

Domiciliary
Ayush treatments
Restoration benefit

200% restoration

(once for different illness)

Health check-up
Once every 4 years
Once every 3 years
Maternity
Out Patient Department

Up to ₹5,000

(Annually)

Day care

Feature Comparison

coPay

Co payment

With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. In this case, however, Medi Classic requires you to co-pay a part of the bill 10% if you purchase after turning 61 whereas Mediclaim Insurance Policy doesn’t impose a co-payment clause

diseaseSublimit

Sub limits

Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, Medi Classic imposes disease-wise sub-limits on Cataracts, Modern Treatments whereas Mediclaim Insurance Policy imposes sub-limits on Modern treatments

ped

Waiting periods for pre-existing diseases

If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. This cooling period is referred to as the Pre-existing-disease waiting period. In this case, Medi Classic imposes a 3 year waiting period on pre-existing diseases and Mediclaim Insurance Policy will similarly tell you to wait 3 years before making a claim related to your pre-existing diseases

prePost

Pre and post Hospitalization expenses

Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, Medi Classic covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Mediclaim Insurance Policy covers expenses incurred 30 days before hospitalization and expenses incurred 60 after hospitalization, although there may be different sub-limits

ncb

No claim bonus

Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. In this case, however, Medi Classic offers a no-claim bonus whereas Mediclaim Insurance Policy doesn’t offer a no-claim bonus.

domiciliary

Domiciliary

Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, Medi Classic doesn’t offer domiciliary protection whereas Mediclaim Insurance Policy offers domiciliary cover.

ayush

Ayush treatments

Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case, Medi Classic covers Ayush procedures and Mediclaim Insurance Policy also extends coverage for Ayush treatments.

maternity

Maternity benefits

If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, neither Medi Classic offers maternity cover nor does Mediclaim Insurance Policy.

opd

Out Patient Department (OPD)

Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, Medi Classic doesn’t offer OPD protection whereas Mediclaim Insurance Policy offers OPD cover.

Final Conclusion

After considering all the features on hand and the claim settlement ratio of Oriental Insurance, we believe that Mediclaim Insurance Policy is a better alternative to Medi Classic for most use cases that we’ve evaluated so far.

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