Can I have both corporate and individual health insurance plans?

Living in an age where there are growing reports of health risks and the number of individuals with health complications keeps increasing, all while facing the real concern of medical inflation, more and more people today are opting for insurance to secure their health and financial well-being. At the same time, realising this need and in an attempt to provide financial protection to their employees and reduce their financial burden, companies have started to provide some form of corporate health insurance to their employees.

Whether the company is providing group health insurance policy out of the goodness of their hearts or as a tool to attract and retain new talent, reduce employee turnover, boost morale and productivity, or as tax benefits, corporate health insurance offers a lot of benefits. However, while there are numerous benefits one can avail from the employer-sponsored policy, whether it is due to its nature or the specific policy opted for, one might feel that the coverage is limited and might want to either top up the plan or get an additional plan to supplement the existing one.

But is it possible to do so, and is it helpful in any way if you choose to do so in addition to the existing corporate policy? Keep reading to find out.

What is a group health insurance policy?

A group health insurance policy is a type of insurance specially designed to provide group health coverage to all members of a group in a single standardised policy. These plans, while comprehensive, allow companies to provide future of health insurance coverage to all employees in a convenient, cost-effective, and customisable policy. A corporate insurance policy is typically tailor-made based on the group’s specific needs, allowing them to get the right policy for the right price.

What is an individual health insurance policy?

An individual or personal health insurance policy provides financial protection to the policyholder from covered medical risks. In exchange for the initial premium amount, the insurer provides financial protection from medical expenses arising from covered risks.

Which is better: corporate health insurance vs individual health insurance plan?

Regardless of who it is, corporate health insurance is a valuable tool for providing coverage to many individuals. However, due to the nature of standardised coverage, there are often talks about lacking or non-specialised coverage, which can lead to insufficient protection in certain cases. Now, employer-sponsored group insurance is sufficient for a majority of individuals and can provide sufficient protection depending on the specific plan opted for.

However, there are scenarios where employees might find the coverage lacking and require additional coverage, whether in the form of a top-up plan or a separate personal insurance policy paid for by the individual employee. Other than this, while employees can also negotiate with the employer for specific additional coverage in exchange for a partial contribution to the premium, it depends on the specific employer and insurer to agree.

So, to conclude, “Which is better, corporate health insurance vs individual health insurance plan?” the answer really depends on who you ask. Group insurance plans are a preferable option for an employer looking to provide insurance coverage to a vast number of employees in a single policy without customising the policy for each employee.

Similarly, an employee who is unable to get a better insurance plan can greatly benefit from the policy, allowing them to avail of quality healthcare without having to worry about dipping into savings. On the other hand, some employees might have different requirements, whether it is coverage for pre-existing diseases or critical illnesses, which this particular policy may not cover.

So consider your needs and requirements and plan to opt for a top-up or individual health insurance plan accordingly.

Is it beneficial to opt for both a group health insurance policy and an individual policy?

To determine if it is beneficial to opt for a personal insurance policy on top of the policy provided by your organisation, consider the following factors.

• Coverage options

  Assess and determine whether a particular coverage is enough for your needs. If it is not enough, consider getting an additional policy. For example, if you have three children and the policy only provides coverage for two children, it might be necessary to opt for an additional policy for the non-covered employee.

• Policy sponsor

  Check who is paying for the policy. If the employer is wholly sponsoring the policy, no matter how lacking, it can offer some benefits, and it is beneficial to continue with it and get additional coverage separately. However, if you are contributing to the policy, it might be essential to consider the following factors and determine whether to continue or not.

• Network hospitals

  Consider the insurer's hospital network to determine whether it features preferred hospitals. If it does, it might be beneficial to continue with them for the additional coverage as well. If not, consider a different insurer for the policy. 

• Reliability of the insurer

  Consider the insurer's reliability. If the group's current health insurance plans are from an insurance provider that offers the cheapest plans, it might not be beneficial to continue or get additional coverage from them.

• Cost of the policy

  Consider the cost of the additional policy and whether it is sustainable or beneficial to opt for this particular plan over the other. 

• Tax benefits

  Consider tax benefits; insurance premiums are tax-deductible, and the deduction is proportional to the contribution, so if you wish to take advantage of these benefits, consider getting an additional policy. 

Read Also: Difference between Group Health Insurance & Individual Health Insurance Plan

Conclusion

Both personal and group health insurance plans for individuals and families of employees have a lot to offer. While it is possible to supplement one with the other, it is essential to note that one may need help to avail of benefits from both simultaneously. For example, availing claims from insurance provider A for a fracture treatment while also applying for claims from insurance provider B for the same treatment. This is why, although beneficial in conjunction, an individual should consider these factors before continuing the policy or getting an additional one.

However, whatever you choose to do, with the right insurance policy, you can secure yourself and your loved ones from financial hardships and promote a healthy life. So, live your life with confidence and peace of mind secured by a health insurance policy from Niva Bupa.

FAQ’s

1. What is the difference between individual and corporate health insurance?

The main difference between individual and corporate health insurance lies in who the policy is purchased for and who pays the premium. Individual health insurance is bought directly by a person to cover themselves and their family. It allows more flexibility in choosing coverage limits, add-ons, and network hospitals. Corporate health insurance, often referred to as group insurance or employee employer insurance, is provided by an employer to cover employees, and sometimes their dependents. In this case, the company may pay the premium fully or partially. Group insurance schemes usually offer standardised benefits for all employees, making it convenient but less customisable than individual plans.

2. Can I convert corporate health insurance to individual?

Yes, many insurers allow employees to convert group insurance schemes or corporate health insurance into individual policies if they leave the job or want continuous coverage. This conversion ensures there’s no gap in health protection. While converting, insurers often consider your age, sum insured, and claim history. Employee employer insurance records can sometimes help maintain benefits like no-claim bonuses and reduced waiting periods in the new individual plan.

3. Does corporate insurance cover surgery?

Yes, most group insurance schemes provided by employers cover hospitalisation expenses, including surgeries, provided they fall within the policy terms. The coverage typically includes pre- and post-hospitalisation expenses, room rent, and surgical costs. However, it’s essential to check your specific employee employer insurance policy, as some corporate plans have caps on certain procedures or require pre-authorisation for major surgeries.

4. Does corporate insurance have a waiting period?

Yes, group insurance schemes often have waiting periods, especially for pre-existing conditions. This means certain treatments or conditions may not be covered immediately after joining the policy. However, most standard employee employer insurance plans offer shorter waiting periods than individual health insurance, and maternity or elective procedures may have separate waiting periods. The waiting period ensures that the group insurance system remains sustainable for employers and employees alike.