What is Medical Insurance vs Health Insurance?

Medical Insurance vs Health Insurance

Life is full of surprises, where some are wonderful, and others can be life-threatening. Health emergencies are the most lethal and nightmarish situations for anyone. No matter how well prepared you might be, a sudden critical accident can leave you disabled or bankrupt in one go. 

Since the Covid-19 episode shook the world, major health intricacies have befallen the world very frequently. Due to this dire situation, once a choice of getting health insurance has now become a necessity.

It is included in US law for certain states, for citizens to get health or medical insurance. Both health and medical insurance serve similar purposes but differ in features. For people out there, who do not understand the difference, here’s a complete overview.

Difference between Health and Medical Insurance

There are many differences between both which are not publicly well known. Novices believe getting medical insurance is a substitute for health insurance. In some cases, it might be true, they’re exceptions. In most cases, health insurance and medical insurance differ widely based on these criteria:


The first and foremost difference between the two is their scope. Health insurance has a 360-degree, extensive, comprehensive, holistic, and all-encompassing scope. Whereas medical insurance has a limited scope. Try understanding this through their coverage limits below.


Medical insurance will compensate you for a specific time period, and certain medical bills for some diseases only. However, Health insurance accounts for all your sudden bills, expenses, high deductibles, and costs for any, and all illnesses or injuries. 

It is a one-time substantial lump-sum cash amount that will protect you from in-patient hospitalization, pre-hospitalization, post-hospitalization, anesthesia fee, ambulance costs, and every other expenditure.


You can make multiple claims for medical insurance until you use up all your in-sum amount but you claim one time for health insurance lump-sum cash. In this aspect, it is somewhat similar to life insurance. Nevertheless, like your car needs protection with auto insurance, your health needs security with health insurance.


You can only get and use benefits from your medical insurance if you’re admitted in a hospital and you receive treatment for certain diseases from your medical plan. But you can gain benefits, increments, and bonuses on your health insurance without being hospitalized.

Insured Sum

This is the main differentiating factor that elaborates the scope of both distinctly. Medical insurance is way cheaper and you buy it and use it for a certain set of diseases and for some time, only. It has an insured sum of around $2000. You can make multiple claims and use them up till it gets finished. 

On the contrary, the health insurance claim is a once-in-a-lifetime occurrence. It is used only for critical health emergencies. Usually, the insured sum for a health insurance policy can range from billions of dollars.

Add-ons/ Riders

Medical insurance is limited in scope, coverage, and available features. That’s why you cannot go for more add-ons or new riders. Instead, if you opt for health insurance since this is for a lifetime, it accounts as a lifesaver in a really dangerous accident, you can keep on adding features like add-ons and riders to it. The better features it has, the safer you shall be from any looming life threat.

Which insurance is best: medical or health insurance?

Health insurance is not an accessory to be taken lightly as a choice or lifestyle. It is an unavoidable necessity of life which has been included in the US law of many states. People who cannot afford an elaborate health insurance policy can and should opt for medical insurance. 

Better to have something than nothing, stats prove that people have experienced a complete overhaul of lifestyle and economic class with the advent of critical diseases. People who do not have health insurance or medical insurance go bankrupt with one crucial accident.

Furthermore, health insurance covers: 

  • For in-patient hospitalization.
  • For pre-hospitalization costs.
  • For post-hospitalization costs.
  • For ambulance or transportation charges.
  • For anesthesia expenses.
  • For maternity expenses.
  • For delivery charges.
  • For C-Section surgery expenses.
  • For prescription drug charges.
  • For all other medicines.
  • For daycare procedures
  • For cataract treatment
  • For non-allopathic treatment costs
  • For organ donation/ transplant costs
  • For newborn baby expenses
  • For modern or advanced treatments costs
  • For all surgical procedures costs
  • For all diagnostic tests
  • For all annual health check-ups
  • For all secondary consultations

Following are some of the controversial and illegal, medical costs that are excluded from health insurance coverage programs:

  • Pre-existing diseases
  • Cosmetic surgery like botox, liposuction, etc.
  • Voluntary abortion
  • Health supplements
  • Self-inflicted injury
  • Sexually transmitted diseases
  • Infertility treatment
  • Injuries due to alcohol consumption

Whereas medical insurance covers only:

  • Costs of in-patient hospitalization at an allopathic facility/registered hospital
  • Costs for domiciliary hospitalization (home care treatment)


Are medical and health insurance the same thing?

The purpose of both is to protect you from overbearing medical expenses in case of a sudden injury, accident, or illness. However, medical insurance has a limited scope, coverage, features, time span, and budget compared to health insurance. Health insurance is holistic, comprehensive, and all-inclusive. 

Which is better, health insurance or medical insurance?

People who are young and healthier, with a limited budget should go for medical insurance. But anyone who can afford health insurance must opt for it. You should keep upgrading its features, add-ons, and riders with time. It is the only entity that is going to help you even in a state of coma and paralysis. In fact, it helps you even after death, when the repatriation of your mortal body remains is collected and sent to your family after any fatal accident.

Medical insurance is suitable for which people?

Younger lot with volatile careers and incomes, and stable health should pursue medical insurance that suits their needs. It is recommended to pursue both if possible, but people with a limited budget must ensure that they’re covered with medical insurance, at least.