Top Healthcare Benefits in Group Health Insurance



As the name suggests, a group health insurance policy is a policy that covers several people. A group health insurance policy can be availed by companies for their employees or by organizations for their members. Usually, companies offer health insurance to their employees as one of the perks and benefits of working with them.

Group health insurance is not only more cost-effective but it also has several health-related benefits.

Depending on the insurance service provider, here are some of the health-related benefits that you can expect from a group health insurance policy.

Comprehensive Coverage

A group policy provides highly comprehensive coverage to the insured. Usually, the coverage offered under group policies is more comprehensive than individual policies. This is because group policies cover several people, which makes it possible for insurance providers to provide better coverage.

The insured can expect coverage for hospitalization due to almost any illness. Further, they can expect coverage of costs incurred during the pre-hospitalization and post-hospitalization periods as well.

Further, there may be fewer sub-limit in a group policy as compared to an individual or a family policy. A sub-limit is lower than the sum insured and is the maximum possible payout for certain types of illnesses such as cataracts or knee replacement surgery.

Fewer sub-limits mean that the insured can receive the full benefit regardless of the type of medical condition that they face.

No Waiting Periods

Almost every individual or family health insurance policy has a waiting period for pre-existing diseases. A pre-existing disease is a medical condition that the insured suffers from before the insurance has been availed.

For example, if the insured suffers from hypertension at the time of availing an individual health insurance policy, then the insurance policy may not cover hypertension related hospitalization until a certain waiting period (this may be one year, two years, four years, or more).

The primary advantage of a group health insurance policy is that there is a lower waiting period or no waiting period for pre-existing diseases. Hence, employees can get complete coverage from day one.  

Dependents are Covered

Companies can opt for a group health insurance policy that covers all the dependents of the employee. This means that the policy covers the parents of the employee, the spouse, and the children. This total coverage means that the employee does not have to purchase a separate health insurance policy for their dependents which reduces their financial burden.

The cost of availing of a group health insurance policy that covers the dependents of the insured is much lower than a family policy that the employee may have had to purchase. Hence, this is an excellent benefit that can be offered by companies to their employees.

No Medical Tests

A health insurance group policy does not require the insured to undergo any medical tests. In contrast, if an individual or family policy is availed, then a medical test may have been required by the insurance service provider.

This makes group health insurance policies much more hassle-free and convenient for the insured. It also means that employees do not have to worry about their coverage being rejected due to any pre-existing illnesses or medical conditions. They can take advantage of complete health insurance regardless of the current status of their health.  

Maternity Coverage

The top health insurance companies in India by market share provide maternity cover. This means that if an employee or the spouse of an employee is having a child, then the hospital costs of the delivery are covered by the policy.

Maternity coverage can be a boon for employees since it lowers their healthcare costs significantly in case they have a child. Such maternity coverage may also cover certain pre-delivery and post-delivery expenses as well.

Preventative Healthcare

Preventative healthcare means the steps that a person can take to ensure that they do not suffer from a medical condition in the future. Group health insurance policies cover certain preventative healthcare costs as well.

For example, such a group health insurance policy may cover a routine check-up with a doctor along with certain medical tests. Since the check-up is free, it may incentivize the insured to take better care of their health by seeing a doctor and by getting routine medical tests done.

This can go a long way in helping to ensure that the insured is in good medical condition by catching medical conditions early.

OPD Coverage

Several group health insurance policies don’t just cover hospitalization costs but also OPD costs as well. OPD (outpatient department) is a part of a hospital that enables patients to consult with doctors without having to undergo hospitalization.

OPD coverage means that the insured can consult reputed doctors at any time without incurring any cost for the consultation.

COVID-19 Cover

Since the start of the coronavirus pandemic, people have been worried about the medical costs in case they catch the virus. Hence, insurance providers have started providing specific cover for coronavirus-related treatments in their policies.

The top health insurance companies in India by market share will cover the COVID-19 related expenses of the insured including any hospitalization expenses. Such cover can be availed by companies without having to pay any additional premium.

Wrapping Up

Overall, it is clear that there are several benefits of group health insurance policies. Companies can be certain that opting for such a policy will help with employee morale, productivity, and retention. Employees that feel like they are being taken care of by their employers are much more likely to perform to the best of their abilities. A company can avail of a much more cost-effective policy for their employees rather than having the employees get individual or family policies.

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Susheel Agarwal

Namaste. I'm Abhinay Nedunuru, a Fellow of the Insurance Institute of India with a passion to make insurance simple and crisp. I write on insurance and investment. I have a passion for teaching and training in particular to insurance. I'm currently doing my PhD from IIM in Management.