Medical Reimbursement [Thread 65977] - CiteHR
Country Hr Manager
M. Ramzan Sheikh
Human Resource And Administration
Hr Executive
Payroll Executive
Hr Professional
+1 Other

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hi , What is difference between medical reimbursement and mediclaim? In hospitalization bills in allowed to medical reimbursement and mediclaim? pls clarify. Regards taksheel
In my company there 2 option for medical benefit :
1. Reimbursement model : employee pay by him / her self, and the next day he / she reimburse to cashier via hr department
2. Insurance model by cashless : employee just go through the provider hospital / doctor, showing his / her insurance card, and cashless.
Do you mean with above info ? Please let me know.

The Medical Reimbursement is for the medical expenses incurred by the employee in Day to day medicines and only the bills and doctor prescription (optional) are required for the claim.
Whereas in Mediclaim it is a insurance policy to claim any thing from Mediclaim the hospitalization is required and amount of expenses is directly remitted to the hospital not to the employee.
Hope this help to clarify your doubts.

Can you pls tell me what is the industry standarad allowed for mediclaim and medical reimbursement
HI Taksheel,
There is amajor difference in medical reimbursement and mediclaim.You can Get medical reimburesment of 15,000 (This can be more but then it taxbale)for your current orgainiztion for which you have to provide all your Medical Bills in orginal and it is applied to any kind of medical Expenditure.
However mediclaim benefit can be availed only if you have mediclaim policy.But to avail this benefit there has to be hospitalization of atlest 24 Hrs ( There are some exceptions to this too like catract surgery).For this you have to submit all your orginal bills along with Orognal discharge summary , Main Hospitalization bill , Prescription by the doctors, and medicine bilss ,Invetigation reports and all.
Mediclaim can be cashless if your insurance compnay has tied up aith any of the TPA or Hospitals directly.But there are also other procedures involved like pre auth And all.
Do revert if you need any more clarification.
WIth regards,

Medical reimbursement is usually submitted to your work organization as per medical policy whereas Mediclaim is usually submitted to the Insurance company under their hospitalization scheme.
Ramzan Sheikh

Employee can avail the tax benefit in both Medical reimbursement upto Rs. 15000 that company provide him against the bills and Medical claim (upto Rs. 15000) premium that an employee pay to the insurance company?
Or, We can take benefit only in one.

Reg. Mediclaim I have one doubt, one of Our employee hospitalised, on emergency basis he got treatment , his mediclaim card issued the date of surgery, after a while we recevied the card But, all expenses he was paid. If any option is there to get back the money. please inform me.
Thanks & Regards

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