Difference Between Standard Health Insurance and Medical Insurance Plans

Health Insurance

When a chronic condition kicks in your life and you have no other savings in your account that you could utilize for treatment, health insurance works as a true aid. These insurance plans assure the user about their future and financially supports them in tribulation.

But whether one should choose a standard health insurance plan or a medical insurance plan has always been a controversial subject.

So let’s clear all the doubts about these insurance plans to come up with the best option.

Table of Contents

What is Health Insurance?

Standard health insurance covers the entire minor to major hospitalization expenses of the policyholder. But how the insurance company will cover the expenses is subjected to their terms and conditions. For example- the post-hospitalization and pre-hospitalization expenses are clear in the terms and conditions. 

However, a standard health plan is also split into different categories. People can choose these policies based on their varying choices and expectations.

Types of Health Insurance Plans

Family health insurance plan:

These plans are meant to support the entire family in a medical emergency. Usually, families with small kids pick a family health insurance plan at a low premium; they get maximum coverage for the entire family. But it has a few pros and cons that you should know before. 

Individual Health Insurance Plan:

The individual health plan is a standard health plan provided to an individual. Such policies cover numerous benefits, and most people prefer them. 

Critical illness plan:

Amid today’s unhygienic and unbalanced lifestyle, critical disorders and diseases are on the rise. The treatment of most of these critical health conditions (cancer, heart disease or liver infection) can be way more expensive, the cost of which sometimes exceeds the coverage amount of a standard health plan.  But a critical illness plan, due to its varying terms and conditions, make the policyholder able to bear all the pricey expenses.

Senior Citizen Insurance Plan:

These plans are more recommended to the senior citizens, for whom the terms and conditions related to the premium and coverage vary as per their age.


Apart from these health insurances, some other standard health plans also exist in the market that caters to different needs of the policyholder.

What is Medical Insurance?

Unlike a standard health plan, Medical insurance plans offer comparatively limited coverage. For instance, medical insurance may cover only limited hospitalization expenses.

However, these insurance plans usually don’t offer any special assistance to the policyholder. Yet, this insurance plan can be considered the cheapest alternative that only provides you coverage of less than Rs 5 Lakh.

The claims in medical insurance plans are issued in the following ways.

1. Cashless

2. Reimbursement


In the medical insurance plan, companies often issue cashless claims. In case of a medical emergency, the insured does not need to panic about bearing the hospitalization expenses. The insurance company itself bears all the expenses once the policyholder is admitted to the hospital. 


A reimbursement claim doesn’t cover the on-site hospitalization expenses. The policyholder or someone from their family will have to inform the insurance company about the treatment of the policyholder. Meanwhile, the policyholder should cover initial or all expenses as the insurance company commits to issue the policy later. For the hassle-free claim settlement, the policyholder must keep the bills and record of hospitalization expenses.

Types of Medical Insurance Plans

Here are some of the basic medical insurance plans-

Individual Medical Insurance Plans:

Individual medical insurance plans are similar to a standard health plan with a modest difference that the individual policyholder receives limited hospitalization benefits.

Family Health Medical insurance Plans:

These medical insurance plans are similar to the standard family health plan. But it comes with a little drawback; if the policy owner dies, other family members won’t be getting any benefit from such plans. The policy automatically ends. 

Pre-existing Disease Cover Plans:

This plan covers all the diseases that originated from a previous underlying disease. To simply put, the insurance company will bear expenses on treatment of a pre-existing disease. However, standard health plans may not offer you this service. 


Other medical insurance plans depend upon the insurance company, as they may launch a new scheme for the good of the general public.

The Key Difference Between Standard Health insurance and Medical Health Insurance Plans

1. Medical insurance doesn’t offer any add-on or special coverage, but health does and may cover the hospitalization expenses entirely.

2. Medical insurance only covers the expense of pre-specified disease/disorder, and the amount is also limited. At the same time, health provides coverage for a variety of health conditions, including surgeries and dialysis.

3. Health insurance is flexible and enables the user to choose the premium amount, policy duration and other things. On the other hand, medical insurance doesn’t offer all such facilities.

4. Critical illness isn’t covered in medical insurance, but standard health covers. Aspirants can choose a critical illness policy plan that helps them to battle effectively with uncertain life-threatening diseases.

5. The health insurance may offer you coverage up to Rs 6 crores. On the other hand, medical insurance may only offer you coverage less than Rs 5 Lakh.

6. Medical insurance covers expenses for the treatment of a pre-existing disease, whereas a standard health may cover such expenses but at some terms and conditions. In most instances, the waiting period is extended in standard health policies.

The Bottom Line

Ultimately, now you can come across the best decision and pick the best policy based on your requirement. Standard health insurance, e.g., family healt insurance plans, offers you a wide range of benefits. The insurance company may cover multiple hospitalization expenses of the policyholder in their bad time. But medical insurance may not offer this facility. But people who can’t afford the expensive premium can choose medical insurance. Even though you seek some financial support for the treatment of a pre-existing health condition, medical insurance may assist them a lot. That’s why both options are available with some pros and cons.

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