Difference Between Government Health Insurance Plans and Private Mediclaim Policy

Charlotte Miller

Updated on:

In this blog, get to know about the features, benefits, and the difference between government health insurance plans and private Mediclaim policies.


Health insurance is one of the most sought-after insurance policies, especially after the coronavirus pandemic. The cost of healthcare during the pandemic has pushed us all towards buying a solid health insurance plan to help us cover any expensive medical treatment we may need in future. Though most of us purchase our health insurance plans from private insurers, the Government of India has also implemented several insurance schemes to cater to the varied requirements of Indian citizens. These plans are offered by both the State and Central governments to make health insurance plans both accessible and affordable for people from all walks of life. Let us take a look at the features, benefits, and the difference between government health insurance plans and private Mediclaim policies.

click here – Low Shower Pressure? Here’s How to Fix It

Government Health Insurance Plans

By definition, Government health insurance plans are any medical insurance policy that provides a wide range of quality healthcare at free or subsidized prices to make it affordable and accessible for the underprivileged. They are specifically designed for those who cannot afford to buy private insurance plans as they fall below the income line. Most of the key benefits of these policies can be availed at Government hospitals, where the systems are equipped to address the larger community needs. 


  • One of the main reasons why most of us are wary about health insurance plans is the cost of premiums. This is why government health insurance plans have lower premiums to make it affordable, especially for people from low-income families. 
  • Further, the deal only gets sweeter because the government health plans offer heavy discounts to encourage people to get their families insured. 
  • However, there are certain limitations to these policies, some of which include no no-claim bonus, relatively moderate sum insured, and coverage with an upper limit.  

click here  – 5 Tips to Breathe New Life Into Your Credit Score

Private Mediclaim Insurance Policy

Private Mediclaim insurance policies are health plans that focus on providing quality healthcare at a network of private hospitals for people from all classes of society. The policies offer both low and high-cost policies with access to advanced medical treatments. 


  • One of the key features of the private mediclaim insurance policy is that the policy does not have a cap on the coverage and offers full coverage on most medical expenses. 
  • The private mediclaim insurance caters to people from all walks of life and the sum insured offered is relatively higher and comes with top-up and super top-up plans to restore the same. 
  • Since the coverage is wide and the sum insured is higher, the plans come at slightly higher premiums and do not offer as many discounts as government policies. But, you can avail of discounts in the form of a no-claim bonus at the time of policy renewal.

Though the government and private health insurance policies seem poles apart in their key features, there are quite a lot of similarities in both the plans. Starting from their coverage which includes hospitalisation charges, AYUSH treatment, ambulance costs, critical illness cover, daycare procedures, etc., to their tax benefits and claim settlement procedures. Further, both the policies do not provide any coverage for diseases contracted within the first 30-days of the policy, dental and hearing treatments, sexually transmitted diseases, self-inflicted injuries, cosmetic procedures, treatment for alcohol or drug abuse, etc.