Are corporate health insurance plans different from regular plans?

Corporate health insurance or Group Medical Cover (GMC) is medical coverage offered by employers to their workforce.

GMC plans are basically regular health insurance plans, in that the features and benefits are largely similar. There are some basic differences between the two, which are:

• Waiver of Waiting Period: This is one of the biggest advantages of being insured under GMC. Usually, regular health insurance plans carry a waiting periods of 2 to 4 years that apply to pre-existing illnesses, certain specified medical conditions, and maternity benefits. In GMC, the employee gets coverage right from the beginning of the policy and waiting periods are typically waived off.
• Claims Acceptance: Due to the waiver of waiting periods, medical claims even for pre-existing diseases are accepted from the start of the policy of GMC. Whereas in regular health insurance plans, many insurers may deny claims or coverage until the waiting period for pre-existing diseases is served or completed.
• No-Medical Checkup: GMC policy is issued to employees without them having to undergo a pre-medical screening. In regular health plans, a pre-medical test may be required, depending on your age and pre-existing medical conditions.
• Fixed Sum Insured: Usually, GMC plans are standard policies with a fixed sum insured amount, as specified by the company for different seniority levels, covering the cost of hospitalization in the event of an illness or accident. Since the specified Sum Insured amount is provided to all employees, it could be a low amount and can mean limited coverage. Regular health insurance plans can be customized to one’s family requirements, including the coverage amount.
• Addition of Family Members: Some organizations opt for the most basic GMC plan with low coverage amount for employees only. Such plans may not allow for family members to be included in the plan. Whereas nearly all insurers allow family members to be added to family health insurance plans.

Are corporate health insurance plans enough?

While GMC cover is beneficial, it is applicable only until the employee is on the job. As life is unpredictable, it is quite risky to imagine a day without health insurance coverage. Economic slowdown, cost-cutting, retirement and other reasons could lead to loss of job as well as health insurance at the same time.

Additionally, when you switch jobs, your erstwhile corporate health insurance plan cannot be transferred to your new workplace. Therefore, it is advisable to have a personal health insurance policy in addition to a GMC cover.

Investing in a regular health insurance will augment the coverage offered by your GMC plans, and can be customized to suit personal medical requirements. For example, you can avail of add-ons or riders in your personal health insurance plan to enhance the base coverage. Additionally, you can enjoy features such as no-claim bonus, free checkups and wellness benefits. You can buy a health policy that covers your spouse, children or even your elderly parents under a family floater plan. These plans factor in the age, gender, medical history of insured members for intended coverage. With tailoring the coverage, you have better control over choosing a plan with lower deductibles, co-pays, and sub-limits

If you are looking to only increase the sum insured amount, a Super Top-up plan is worth considering.  Super Top-up plans come at a nominal premium amount, while offering a wide range of benefits and features, much like regular health insurance plans. A word of caution though.  Super Top-up plans have a deductible amount, which will need to be covered by the GMC or your base plan.  In the absence of a GMC cover, you will have to pay for the deductible amount from your pocket.  The safest approach in these times of job uncertainties is to have a combination of your own base plan and Super Top-Up plan, over and above the GMC plan that your employer might offer.

SANA.Insure is a health portal that conveniently provides access to complete information on various health insurance plans in India. We assist with selecting and purchasing both personal and corporate Health Insurance plans. We also plan and manage demography-based wellness activities for our corporate partners to add to employee delight.

Our Health Insurance Experts and Relationship Managers offer 24x7 on-demand Query Resolution and on-time Claims Assistance. You will be provided expert and unbiased advice, and can select the ideal plan that fits your specific needs: whether for a group, an individual or a family.

We invite you to visit our health insurance portal, SANA,insure to learn more. For assistance with any health insurance related query, you can connect with us on WhatsApp at 8278271818 or call our toll-free number at 1800 202 8118.

Wish you a healthy and happy life!