Mr. Shreyas Patel, a 37-year old professional employed at a multi-national company, was given a health insurance coverage by his employer. This corporate health plan provided a coverage of INR 2 lakh. Mr. Patel thought that this amount was more than adequate and did not feel the need to invest in an individual health plan. Two years into the tenure, he suffered from a heart ailment, which required hospitalization. The expenses for hospitalization and medical tests, such as electrocardiogram and cardiac catheterization, amounted to INR 4.5 lakh. Mr. Patel was in a fix when he realized that he had to bear the costs in excess of INR 2 lakh.
In order to avoid such a situation, it is necessary to purchase an individual mediclaim policy that meets your individual needs and requirements.
Many individuals believe that their corporate medical insurance policy provides adequate coverage. However, such may not be the case. Following are five reasons why a group health insurance policy is not sufficient to secure your family’s health.
- Low sum insured
As seen in the above example, a lower sum insured amount may result in a financial burden. The sum insured amount offered by your employer may be insufficient, given the rising medical inflation. Therefore, it is necessary to ascertain the coverage offered and identify if the amount will suffice the potential medical costs.
- Co-pay clause
Many group plans have a co-pay clause as a part of the policy. Co-pay indicates that the insurer will cover a part of the medical expenses, while you will have to bear the rest. This means that if your policy has a 10% co-pay clause, the insurance provider will settle 90% of the bill amount, and you have to make out-of-pocket expenses for the remaining 10%. Such a clause does not eliminate your financial burden during medical emergencies, but merely reduces it. Hence, it is necessary to consider an individual policy to overcome this shortcoming.
- Employment status
An important aspect to note is that corporate medical insurance plans offer coverage as long as you are employed with the particular employer. You will cease to enjoy the benefits of the policy in an event that you are terminated or wish to switch to a new company.
- Number of members covered
Many group medical insurance plans do not offer coverage to all the members of your family. While some plans offer coverage for your dependents, some do not. Not covering your loved ones may result in a financial burden, in case a medical contingency were to occur. In order to secure your family’s health, you may buy a separate mediclaim policy, especially if you have older parents to take care of.
- Lack of coverage after retirement
As mentioned earlier, your corporate plan will cover you during your employment period. Once you retire, you are no longer eligible to avail of the benefits of the group plan. Purchasing a health plan at an older age not only attracts higher premiums, but also requires you to undergo various medical tests. Besides, the insurance plan may not cover pre-existing illnesses. Therefore, you may purchase an individual health insurance cover during the earlier stages of your career, instead of relying on your corporate medical insurance plan.
Though your group insurance policy offers health coverage, it is merely a benefit offered by your employer. So it is wise to supplement your group health insurance policy with your own health insurance cover. It helps you to remain financially protected at all times and secures your family’s health as well.