Employees are the most valuable asset to any organization, and it is important to take care of their well-being and health to ensure the organization’s growth. In today’s world of ever-increasing medical costs, every individual must have medical coverage that will protect them in the event of a medical emergency. Now the question is whether an individual health plan or group health insurance coverage is more advantageous.
What is a personal health insurance policy?
This sort of plan is tailored to an individual’s needs and requirements; factors such as age, health, family medical history, and so on are taken into account while deciding the premium amount. Policies typically include long waiting periods, and patients with pre-existing ailments must wait until the waiting period is over before receiving treatment.
What is the process for Group Health Insurance?
This type of insurance policy covers several people under a single insurance plan. Typically, businesses pay the premium and provide group coverage to their employees as a bonus. Depending on the policy, coverage may also include family members. When you opt for a group insurance plan and pay the premium, coverage begins on the first day, including pre-existing diseases. In case of a medical emergency, the covered individual can use the group insurance policy or plan to obtain cashless services at a network hospital or a hospital of their choosing and opt for reimbursement.
Difference between Group Insurance and Individual Health Insurance Plans:
| Particulars | Group Health Plan | Individual Health Plan |
| Who is insured? | The insured person and their dependents. | Only one individual i.e. the policyholder. |
| Who is the purchaser? | Purchased by an employer or the head of the household. | Purchase of an individual health insurance plan by the insured. |
| How much control does the insured have over the plan? | Limited control (the employer or the purchaser has control over the coverage and add-ons of the plan). | Full control (The policyholder can control the coverage and add-ons of the plan). |
| Option to buy Add-ons: | None or limited. | The policyholder can buy. |
| Claims: | Claims are usually made through a third-party administrator. | Claims can be made directly with the insurance company. |
| Sum Insured: | Can be between Rs. 5 to 10 Lakh. | Can be between Rs. 3 lac to 1 Cr. |
| Eligibility Criteria: | Should be a permanent employee of an organization. | Must be at least 18 years of age. |
| Entry & Exit option: | The insurance plan ceases to exist when the employee leaves the company or gets retired. | Minimum entry age shall be 18 years and maximum age at entry shall be 65, exit depends on the insurer. |
| Tax benefit: | No | Yes |
| Coverage for pre-existing diseases: | Mostly from day one. | Post completion of the waiting period. |
| Maternity Benefits: | Covered. | Need to be purchased under add-ons. |
| No Claim Bonus: | Not Applicable. | Applicable. |
Medical Check-ups before purchase: | Not required. | Required. |
| Coverage for Critical Illness: | No. | If chosen by the policyholder. |
Team, MyGoalMySip
Comment below with your thoughts.
For more information, reach us at support@prudentwealth.in
Get your copy of PW INSIDER now!
Read Next: ChatGPT: Redefining AI?
