Does your place of employment provide group health insurance? And do you already have an individual or family floater plan you are happy with? Are you confused about continuing with your individually sponsored policy or using the employer-sponsored one? Then you have come to the right place. This article will help you understand what both of them do and compare the benefits and disadvantages of group health plans and individual plans.
What is an individual health insurance plan?
Individual or family floater health plans are health insurance plans typically paid for by the individual themselves. These policies cover various health risks and ailments, securing the health and protecting the financial security of the policyholder and their loved ones.
What is group health insurance?
A group health plan is a type of health insurance typically sponsored wholly or partially by the employer. Following the COVID-19 pandemic, the government had mandated all professional organisations to provide health insurance to their employees. That is when, due to their customisability, convenience, and cost-effectiveness, these plans rose as the best option.
What are the differences between individual and group health policies?
The following are some common differences between individual health insurance plans and group health policies. While the following lists some differences, referring to the specific policy document for a relevant comparison might be essential.
| Scope | Individual health policy | Group health policy |
| Who owns the plans? | The individual who buys the plan owns it and is the policyholder. | The head of the organisation, or the corporate entity providing the insurance, is the owner and policyholder. |
| Does coverage continue when an employee’s job is lost or changed? | Yes, as long as the individual keeps paying for the policy, the policy will continue. | It depends. If an employee’s job changes and they are no longer a part of the group, thus not eligible for the group policy, they can port the same policy to an individual plan. |
| Are premiums tax-deductible? | Yes, the individual who purchases the policy is eligible for tax benefits. | The employer/organisation which sponsors the policy is eligible for tax benefits. |
| Is health insurance coverage allowed for those with pre-existing conditions? | Yes, depending on the specific policy opted for, individuals can have coverage for pre-existing diseases. | Similarly depending on the policy opted for, employees can be covered for pre-existing diseases. |
| Which one is more customisable? | In most cases, individual plans are customisable to the extent of adding certain additional coverages. | Group plans are highly customisable, allowing companies to build the right policy for their needs. |
| Does the employee have a choice of healthcare providers? | While individuals should be free to get healthcare services from any healthcare provider, cashless claims depend on whether your preferred healthcare provider partners with the insurer.
It is still possible to opt for a different insurer which does cover your preferred healthcare provider. |
Similarly, the choice of healthcare provider depends on the insurance provider the organisation is partnering with.
In this case, however, the employee might not have the authority to request a different insurance provider just to get a preferred healthcare provider. |
Conclusion
In conclusion, there are several key differences between group and individual plans. However, it is essential to note that in most cases, a group plan might not be comprehensive enough, requiring individual policies to supplement it. It depends on your specific needs whether to continue with your existing policy, opt only to get group coverage sponsored by the employer or have your existing policy in addition to the group policy. This is why it is essential to tabulate your needs and consider the pros and cons before making such a crucial decision for your and your loved one’s health and wellness.
So make the right decision and secure the well-being of yourself and your loved ones with the right health insurance policy.
0
0
