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Group Health Insurance

Group health insurance policy is a comprehensive health insurance plan that provides insurance coverage for a group of people. This group can be employees of the same company, members of a society, or members of a common group. Generally, employers provide the benefit of group mediclaim plan to their employees. In some group plans, the families of the employees are also covered.

The increase in health care expenses and the rise in health problems at a younger age have made group health insurance one of the necessities for employees. Today anyone who searches for a job wants perks such as a health insurance plan for him and his family. This is the reason why group health insurance is offered by various companies. Employer provided health insurance is also known as corporate health insurance.

Key Features of Group Health Insurance Policies

Here are the key features:

  • These plans offer cashless hospitalization.
  • Most of the plans cover maternity benefits.
  • It provides insurance coverage to the entire family (self, spouse, and children). Moreover, some provide coverage for dependent parents as well.
  • Some plans also cover pre-existing illness and provide the option of critical illness rider.
  • It covers follow up check-up expenses and reimbursement for various facilities.

Best Group Health Insurance Plans in India

Since a group health plan is purchased for a group of people, most of the providers offer a comprehensive coverage at comparatively discounted rates. Below mentioned are some of the best group health insurance policy in India:

  • Star Health – MediClassic Insurance Policy
  • HDFC ERGO Group Health Insurance Policy
  • ICICI Lombard Group Health Insurance Policy
  • Future Generali Group Health Insurance Policy

Group Health Insurance– Inclusions

The common inclusions offered by most of the group health insurance providers in India are:

  • Cashless Hospitalization: Like any other health insurance plan, a group health insurance policy offers cashless treatment in network
  • Day Care Treatment: Some plans offer coverage for daycare treatments. A day care treatment is one wherein the patient does not need to be hospitalized at least for 24 hours in order to undergo the treatment. When the treatment requires only a few hours of hospitalization, the expenses will be borne by the insurance provider.
  • Pre and Post Hospitalization Expenses: We have already mentioned that group health insurance plans offer comprehensive coverage. There are some plans that cover pre and post-hospitalization expenses. However, the duration of pre and post hospitalization is fixed and pre-defined.
  • Domiciliary Hospitalization: Insurance providers cover the domiciliary expenses, which may range up to 20% of the basic sum assured.

Group Health Insurance– Exclusions

The common exclusions offered by most of the group health insurance providers in India are:

  • Pre-existing diseases or injuries are not covered.
  • Any disease or illness that is contracted within the first 30 days of policy inception is not covered. However, in case of an accident coverage is provided.
  • Alternative treatments like homeopathy, Ayurvedic, Unani, etc. are not covered in most of the policies.
  • Congenital diseases are also not covered.
  • AIDS/HIV or other sexually transmitted diseases are not covered.

Benefits of Group Health Insurance Policies:

There are various benefits of having a group health insurance plan, below mentioned are a few of them:

  • It offers enhanced coverage to the employees who have individual health insurance plan or family floater plan.
  • The premium of a group health insurance plan is comparatively lesser than the basic health insurance policy.
  • Maternity benefit is another advantage of having this plan.
  • Mostly, the employees are not denied to be covered in the plan on the basis of their age and past medical history.

Group Health Insurance FAQs

Q1: Why do organizations offer health insurance?

A health insurance plan for employees work as a boost for retaining and acquiring good workforce because of the significant increase in health care cost. Many employees who cannot afford to purchase an individual health insurance or a family floater plan are benefitted the most from group health insurance. So it is always good to offer mediclaim policy to the employees.

Q2: Is it required to undergo pre-policy medical checkup to avail group health insurance plan?

Generally, there is no need to undergo any kind of pre-policy medical checkup for availing the benefits of this plan.

Q3: Do group health insurance policies have a waiting period?

Yes, but it varies with the organizations and coverage. However, the best part of group health insurance policies is waiver of the waiting period. If the organization wants, it can request the insurance provider to waive off the waiting period.

Q4: What is maternity benefit in a group health insurance plan?

One of the biggest attractions of the group mediclaim plan for young employees is maternity benefits. Under this benefit, the delivery charges for both normal and c-section delivery are covered, room rent is also part of it, even the charges of visiting doctor and nursing are also included.

Q5: Does maternity coverage of group health insurance plan also covers newborn baby?

Generally, a newborn baby is not covered under the maternity cover of group health insurance plan unless the baby is 90 days old. However, one can customize this and get the baby covered from day 1 by paying an extra premium.