With group medical insurance, also known as corporate insurance, becoming mandatory for all companies, you can now buy corporate health insurance online for your employees at minimal expenses. However, the question remains of whether this policy coverage is enough for your work family or not.
At times, an employee might not question anything beyond their corporate health insurance policy and depend on it for all emergencies. However, that can be a little problematic considering the fact that medical inflation is at an all-time high. Group medical insurance generally comes with a sum insured of 2 or 3 lakh, not to mention, such plans also come with a lot of exclusions in terms of coverage.
Additionally, it might not be enough to cover various critical illness-related hospitalization costs and could have a co-pay clause that would require you to pay a part of the hospital bill from your pocket. So, before we dive into why a group cover may or may not be enough for you, let us first understand, the intricacies of group medical insurance.
Corporate insurance is available for both individuals and families. As such, it is immensely helpful for the workers as it can cover their family insurance requirements.
For example, an employee can include her/his children as well as parents in the group medical insurance.
The premiums of group medical insurance are usually paid by the companies. Employees can, however, choose to pay extra to get more benefits.
Group medical insurance is more or less a contractual policy based on your position in the company. While there are various benefits of opting for this coverage it is crucial to look into the drawbacks as well
The Pros and Cons of Group Medical Insurance
No Waiting Period for Pre-Existing Conditions
While individual medical insurance might require a 2 to 4 years wait period for pre-existing illness cover, no such period exists for group medical insurance as coverage is provided from the very first day.
Meaning, these medical conditions do not delay an insurance cover for an employee, who can have this insurance active from its first day.
No Medical Screening Required
Almost all medical insurance policies require a medical check-up to evaluate the illnesses to cover. However, an employee can skip this step while opting for group medical insurance under their company. Irrespective of their age, a pre-medical screening does not exist in this insurance format.
Pre-Existing Conditions Are No Issue
If an employee under group medical insurance refuses to state their pre-existing medical illness to the insurer, it shall not result in rejection of claim settlement.
Corporate health plans do not need any in-depth analysis of the employee’s past medical history for any claim settlements.
Pay Premiums only For Extra Benefits
An employer pays the premium on group insurance deals. Meaning, the employees do not need to spend a penny on the monthly/quarterly/annual premium payment. Of course, if they wish to update or add in an extra sum assured, then they can pay the excess premium out of their own pockets.
Limited Coverage Amount
In most cases, a limited amount of coverage is provided under corporate insurance. This puts the insured individual at a disadvantage. This is because due to medical inflation, the costs of treatment will only go up and any additional expense beyond the coverage amount has to be paid by the employee herself/himself.
Co-payment clauses in group health insurance coverages can be troublesome for employees in the lower-income strata. At times, the insurance company might propose to cover only 75% to 80% of the total medical fees, leaving the insured to pay the rest.
In the long run, owing to rising medical costs, it becomes an additional expense for the insured individual.
While an individual insurance policy continues even after an employee quits a company, the same is not true in the case of group medical insurance.
Once an employee leaves a company, they shall also lose their insurance coverage, which shall be terminated.
This means that till the time an employee joins a new company if she/he does not have an individual health cover, the person is left uninsured.
Pre-Defined Room Rent
While corporate health insurance coverages vouch for in-patient and out-patient care, there are limitations to these benefits. For example, various insurance companies cap their room rent.
Meaning, the employee has to pay the excess amount in case of any emergency hospitalization.
Limited Dependent Members on The Plan
Similar to the room rent, there might also be a cap on the number of family members under an employee’s policy. Meaning, some of their hospitalization and pre-existing illness emergencies shall require separate insurance coverages.
Is group medical insurance enough to cover your medical expenses?
When you buy corporate health insurance online, it might not be enough for all the employees as everyone comes from a different financial background, with varied illness histories.
Thus, the employees might have to opt for individual insurance, despite having corporate coverage under their names.
It is essential to find the right insurer so that your employees get adequate coverage and for that purpose, Vital would be the best place to check for group medical insurance.
So, try out the benefits of digital insurance purchase today from Vital to help your employees receive the best professional treatment.