Living a healthy and protected life in today’s world, has become quite expensive. Certain medical emergencies can crush the financial stability of an individual within no time. One of the solutions to avoid such financial blocks is to get health insurance. Majority of Indian companies offer health insurance policies to their employees with the goal of offering financial stability for health emergencies and to boost the productivity of the employees.
What is Group Health Insurance Policy?
A type of health insurance policy that offers comprehensive coverage to the members of a society, company, or an organization is termed as Group Health Insurance policy. The insured amount is equally given to all the members of the group irrespective of the risks involved. Due to the number of members dividing the risks and the lack of flexibility in the policy, the insurer offers low premium payment for a group health insurance compared to other insurance policies.
How Does Group Health Insurance Work?
Unlike family health insurance policies, group health insurance policies can assure any group of people with same credit cards or hold similar bank accounts. Usually, employers of large companies/MNCs offer group plans to their employees. The group policy offers comprehensive covers with low premium payment. The employer can choose the coverage of the policy. If the policyholder does not opt for health insurance plans for family, one can take additional plans known as top-ups. The individual has to handle the policy renewal and premiums of such top-ups themselves.
Where can one get Group Health Insurance Policy?
There are many public and private sector companies offering group health insurance policies. One can compare the benefits provided by different insurers online to choose the one with maximum benefits at affordable premiums.
Who can get Group Health Insurance?
Any individual (for instance company or institution owners) who wants to get comprehensive health coverage for a group of people can avail a group health insurance.
What does Group Health Insurance Cover?
Below are some of the covers offered by group insurance plans:
- Pre-existing medical conditions.
- Insured can extend the coverage by top-ups for spouse, dependent parents, in-laws and children.
- Chronic illness.
- Hospital bills paid for a critical medical condition.
- Cashless hospitalization in network hospitals of the insurance company.
- Pre-hospitalization and post-hospitalization expenses.
- Ancillary charges.
What are Riders?
Riders or top-ups are additional features that an individual can opt for along with the group plan. Riders like accidental covers and critical illness covers are the most preferred ones.
Group Health Insurance vs. Individual Insurance Plans
As the names suggests, individual insurance plans offer medical coverage to an individual and group insurance plans provide medical coverage to a group of people. Following are some differences between both the plans:
|Individual Health Insurance Plan||Group Health Insurance Plan|
|Different renewal dates||Same renewal dates|
|Completely customizable||Partially customizable|
|Does not cover pre-existing medical conditions||Covers pre-existing medical conditions|
|Modifications in the policy permitted||Modifications in the policy not permitted|
Advantages and Disadvantages of Group Health Insurance
- One need not submit any medical checkup reports while claiming money with a group insurance plan.
- The premium payment is divided among the members of the group,making it an extremely affordable policy.
- The members get a comprehensive coverage with minimal premium payment.
- The premium of this policy is about 30% to 35% cheaper compared to that of an individual insurance plan.
- It is one of the best possible ways to assure a considerable amount with comprehensive coverage for large and small corporate institutions.
- This plan provides private medical assistance and health checkup for each member of the insured group.
- The extensive plan offers a wide range of benefits for maternity, child vaccination, health checkups for parents, etc.
- The sum assured under this plan ranges from Rs 1 lakh to 50 lakh though this range can differ from one insurer to the other.
- This insurance plan offers coverage against pre-existing medical conditions.
- There is no waiting period for availing the insurance amount.
- The inclusions, exclusions, and all the terms and conditions of the insurance plan is the same for each member of the group.
- One can opt for additional top-ups to the group insurance policy.
- One can get tax benefits from group policies by getting a reduction in their tax liabilities.
- In case of a change in the job, the insurance coverage of that employee will cease.
- The benefits will also come to an end in case of change of job.
- The employer gets to decide if the policy can cover employee’s parents, spouse and children.
- The employer can cut down the benefits of the group insurance policy at any point by lowering the health insurance coverage.
Best Health Insurance Companies in India
With increasing population and medical conditions, the health insurance sector in India is experiencing significant growth. Following are the list of some best health insurance companies in India:
|Insurance Company||Maximum Sum Assured||Incurred Claim Ratio||Waiting Period||Maximum Entry Age||Network Hospitals|
|Religare Health Insurance||25 crore||57.25%||Up to 4 years||NA||4500+|
|CignaTTK Health Insurance||12 crore||48.14%||30 days to 2 years||80 years||4000+|
|Royal Sundaram Health Insurance||1 crore||62.09%||Up to 3 years||NA||3000+|
|Bharti AXA Health Insurance||60 lakh||76.88%||Up to 4 years||NA||5000+|
|National Health Insurance||50 lakh||126.98%||Up to 4 years||80 years||6000+|
|Star Health Insurance||25 lakh||60.51%||Up to 4 years||75 years||7950+|
|Universal Sompo General Health Insurance||10 lakh||86.14%||Up to 4 years||70 years||5000+|
|HDFC ERGO Health Insurance||10 lakh||50.76%||Up to 4 years||65 years||4800+|
|New India Health Insurance||8 lakh||102.94%||Up to 4 years||80 years||1200+|
1. When can I use the sum provided in the top-up scheme?
Ans. You can use the amount offered by the top-up plan only when the sum of the actual group health insurance plan is exhausted.
2. Can I claim insurance for hospitalization of less than 24 hours?
Ans. Yes, group health insurance policies cover the costs incurred in day-care treatment.
3. What should I do if I get admitted to non-network hospitals?
Ans. You can get reimbursement in case you get admitted to non-network hospitals. You may need to provide the necessary documents like the bills paid for the treatment in order to get access to the claimed money.