The Key Differences Between Health Insurance And Critical Health Insurance Plan


The human body is quite complicated, and it is hard to tell when it may start suffering from ailments. There are common diseases such as fever where one does not has to bear a massive cost for treatment, and on the other side, there are ailments such as cancer which can make one bankrupt for medical treatment.

Diseases are categorized in different categories by the health insurance service providers where there is health insurance and critical illness insurance. For a common man, they may be the same, but in fact, there is a vast difference in both of these categories, and hence it is necessary to know both of them in a little depth.

The differences you need to know about

Type of insurance plan:

This is a basic difference in both the plans. The health insurance sum assured is paid as a part of the total sum assured when one undergoes the medical treatment. At the same time, Insurance Plan offers the sum assured, which is a fixed amount whether one goes for the treatment or just diagnosed with a critical illness.

Let’s take an example: if one has a health insurance plan and has to get hospitalized where the cost of treatment comes as 2 lakhs; he has a sum assured of 5 lakhs from which the 2 lakhs will be paid by the service provider. In case of diagnosis of critical illness, if one has a sum assured of 5 lakhs, he is paid the full amount of sum assured with the diagnosis only irrespective of his treatment.

Period of coverage:

Usually, the health insurance has to be renewed every year while the critical illness plan may cover 10, 15 or even 20 years. However, these days there are also critical insurance plans with one-year renewability.

Waiting period:

In normal health insurance, the coverage starts immediately for any unknown disease, yet the pre-existing diseases are not covered. They can be covered after a certain period which may range from 90 days to 2 years depending on the service provider. However, in case of critical diseases, a new or unknown disease may get immediately covered while other illnesses which may be pre-existing may not cover with the plan. It depends on the service provider’s terms for the same, which vary from service provider to service provider.


In a plan of critical insurance, only those diseases which are mentioned in the policy documents covered, while in case of health insurance, any illness for which one has to get hospitalized is covered.

The treatment:

To have a claim in health insurance, it is necessary for one to get admitted in a hospital while in case of critical health insurance one can get the sum assured with the diagnosis only.


The amount of insurance in case of health insurance one can get as per the treatment cost which can cover hospitalization expenses, ambulance charges, cost of medicines etc.

Hence one needs to provide the bills of all treatments while hospitalization. In case of critical illness, one just needs to furnish the diagnosis report, and he is paid the full sum assured for the same with which he can go for treatment or also go for payment of a personal debt. One can have critical illnesses also covered by normal health insurance plan while in critical insurance plan, other diseases except mentioned in the policy documents cannot be covered.

Premium Amount:

Usually, the premium of critical health insurance is not much high compared to the premium for normal health insurance.Coverage to members: In standard health insurance, one can have coverage for more than one member which is not possible for the critical health insurance policy.

So, these are some of the few major differences between the health insurance and critical health insurance policies.

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