Group or Corporate insurance schemes for employees are no doubt a blessing, for they hedge the most prominent risk in recent times. The pandemic brought to the fore how vulnerable we are in terms of infectious diseases. Many could not fend the hospital bills for the lack of adequate coverage. This brings us to the important question, “Is group insurance health plans’ coverage sufficient?”.
In many cases, group insurance scheme coverage can be insufficient. There may be times when the employee may be vulnerable to lack of adequate coverage. There are many reasons to opt for a personal individual health insurance plan with the company offered group insurance policy. We discuss the most prominent ones:
Employer coverage may be insufficient:
Often the group insurance health plans offer standardised and basic coverage, this may be insufficient in many instances. During the pandemic, despite in many instances being a simple hospitalisation, the cost of medical assistance had inflated.
The group insurance policies either offered only a part of the covid related expenses. This was a tough period for many employees. This led to the realisation of many that there is a need for individual coverage in addition to group insurance coverage.
Group insurance scheme for employees is not customisable:
A group insurance scheme is usually designed in such a way that it is usually common to all employees; unless the employer chooses to differentiate among different ranks of employees. Also, these plans could be limiting the sum insured or room rent.
However, in either case, the features are common across the same set of employees and are often not customisable. So, if you want any specific coverage, that may or may not be available with your group insurance plan!
Additional benefits:
Individual health plans offer a no-claim bonus for being fit and not filing a claim in the entire policy year. This benefit is not available in group insurance health plans. Also, group insurance health plans do not offer annual health checkups. These are very effective for preventive care and help you in your health journey.
Lack of control:
There is a gross lack of control over these group insurance schemes. If you intend to enhance the plan if may not be allowed by the employer. The employer yields power on the extent of coverage and the items that are covered. There are times when the dependent coverage may also be restricted.
Group plans are designed to keep everyone’s interest at heart and in a large company, it is not possible to keep all employees happy; hence the plan is sub-optimal.
This iterates the importance of having a personal health insurance plan which will offer the needed coverage and the desired extent of coverage. You can choose the plan, coverage and benefits that you need so that you are comprehensively insured!
An increased instance of lifestyle diseases:
The stress levels and the pollutants in the environment are leading to increased instances of lifestyle diseases, autoimmune conditions and critical illnesses. These types of illnesses require prolonged treatment and often may require only OPD or daycare treatment.
Lifestyle illnesses have shifted a decade backwards and people now have diabetes and hypertension even in their 30s. Hence, it makes sense to enhance this limit with a complimentary personalized health insurance policy.
Coverage during job transitions:
One of the most crucial factors about group insurance policies is that they do not offer coverage when the employee is not on the payroll of the company. In case of sudden job loss for any reason or change, the transitionary period could be quite stressful. You will be left without any health insurance coverage. Such vulnerability is undesired as any emergency health condition could potentially wipe out your savings and create unnecessary financial stress.
So, if you are in your job change or start an entrepreneurial journey, and your new company does not offer a group health plan, then you would be left without coverage.
Tax benefit under section 80D:
If the group insurance scheme premium is paid by the employer, then the employee is not allowed to claim tax benefits under section 80D.
However, for any personal health insurance policy that you avail of, the premiums paid towards the same will qualify for tax benefit under section 80D. You can claim up to Rs. 25,000 for a medical premium paid for yourself, your dependent spouse and your children.
If you are of age 60 years and above then you can claim up to Rs. 50,000. In addition, you can claim the premium paid towards the medical policy of your parents.
Group insurance scheme coverage may be reduced:
If the company is going through tough times, then they are likely to scout for means to reduce their expenses. Group insurance health plans could be one area to take the hit. The coverage or the benefits could be reduced, which translates to lower premium payments by the company. This unforeseen lowering of coverage is not conducive for employees.
Need for coverage during post-retirement years:
The most important aspect of a health insurance policy is the need for coverage as you grow old. The probability of illness and hospitalisation during post-retirement is higher. Group insurance policy might not offer coverage post-retirement.
This iterates the need for personal insurance earlier in life to ensure that you are covered adequately in the years. Individual health insurance plans offer lifelong renewability. Even if the plan is discontinued, an alternative plan would be provided by the insurer.
Buying early leads to a lower waiting period during younger years:
Availability of a personal health insurance plan in addition to a group insurance health plan is a part of good financial planning practice. Availing insurance at a young age ensures that the underwriting is smooth and policy issuance is not a concern. Even for a higher coverage such that the waiting periods are completed before you start to claim health insurance!
Comprehensive coverage:
Health insurance covers indemnity plans wherein the hospitalization expenses are met. However, there are other types of health plans which complement the indemnity plans for comprehensive coverage. These accident and critical illness plans.
Group health plans usually offer indemnity coverage only without extending fixed benefit coverage for diagnosis of any critical or terminal ailment. This is where personal health insurance plans play a critical role so that you can enjoy the most comprehensive medical risk coverage.
Hope these 10 reasons convince you to avail of a personal insurance plan which will ensure that you and your family are comprehensively covered at all times. To know more about personal health insurance plans visit https://blog.oneassure.in/