Group Cover Vs Individual Cover

Going solo

Being part of group insurance cover is a good start, but it may not be enough to meet your healthcare related costs.

It is common for people to have their first brush with health insurance through their employers. Group medical policies (GP) are typically issued by employers as part of their welfare schemes for their employees. Through these policies, you can insure your family members including parents, which is a very good move for those who have no health insurance cover at all.

The GP is a tailor-made plan specifically catering to the group, which allows it to include features that are generally not on offer in individual policies. For instance, the list of exclusions is less, compared to individual policies such as maternity and OPD. There are other benefits like instant coverage under the policy that one is entitled to, the moment they join employment. Likewise, at the time of making a claim, the policy does not restrict the type of stay at the hospital or the treatment course that one undergoes.

Despite all the positives, the one major limitation with such a policy is the quantum of cover that one can take—it depends on the designation one holds and the salary structure one falls under. These factors also play a role in the number of family members whom you can include in the policy. So, there could be a situation where you can only include your spouse and not your children or include your family but not your parents, and so on.

Then, there are chances of losing on the continuity benefit accrued under GP in case you leave an organisation, as there is no porting option under the GP, as the terms and conditions provided under the GP by your new employer may not be identical. It is situations like these that emphasise the need for a standalone health policy. Likewise, you could be in between jobs, which could leave you uncovered for sometime, and that could pose significant monetary risk. Taking a standalone policy for such situations also makes sense.

You can also take a standalone policy in case your GP does not provide you with adequate cover to complement what you get from your employer. You could use this approach to also include family members, who otherwise may not be part of the GP. Keep in mind that it is in your best interest to supplement a group plan with an individual cover, and not be only dependent on a group cover.



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