Group Health Insurance and Individual Health Insurance – Should We Opt for Both or Live with Either One of them?

July 21, 2021
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Group medical insurance in India is becoming popular day by day as more and more people are becoming aware of the advantages attached to it. Unlike individual and family health insurance, a group medical insurance is designed to provide coverage to a group of people like members of society, employees of a joint employer, etc. Advantages of group health insurance policy in comparison to other policies are comprehensive cover at lower premium payment amounts and coverage irrespective of insured’s past medical and mediclaim history.

Benefits of a group policy:

1. A Group Policy is purchased by an employer for eligible employees of a company
2. Properly administered, the group mediclaim cover can be hugely beneficial to employers as well as employees as they come with relaxation on many aspects:

a. Pre-existing disease coverage from Day 1
b. Maternity Benefits without any waiting period
c. Two years/ Four years waiting period for certain benefits
d. 30 days cooling off period before the commencement
e. 25% cheaper rates than an individual policy
f. usually spouse and kids up to 25 years of age are covered
g. some may cover dependent parents as well

3. Typically corporate cover their employees from 3 Lacs to 5 Lacs

4. Reimbursement for out-patient expenses like optical care, dental and mental care is done at nominal premium charges

5. Employees benefit largely from group health insurance policy as they not only share the premium payment amount with the employer but also get a comprehensive cover at minimal premium payment amount.

6. There are very few chances of a medical coverage denied to an individual under group health insurance due to his/her past health and claimed records

7. There are however instances where individuals with smoking/drinking habit, unhealthy eating habits, the filing of a claim in the past, may lead to increase in your premium payment amount sharply in case of an individual/family floater policy. You may even be denied coverage, but not in the case of group medical insurance.

8. Employers may benefit too by enjoying Tax deductions on the premium paid

It is advised however to invest in an excellent individual policy along with your corporate group policy for the following reasons :

• Job changes may leave you without any medical cover in case your new employer doesn’t have one. Taking up medical at that point in time may be expensive, and with the waiting period, older parents may not get coverage
• A good insurance individual policy starts giving full coverage of all the pre-existing diseases after four years of continuation of policy.
• At the age of 60 when you retire, and the corporate health cover ceases to exist, it is complicated at that age to start afresh in seeking a health policy which begins without any coverage of existing diseases.

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