Do You Think Your Employer's Health Insurance Is Enough

If you are on the payrolls of a company that provides a Mediclaim coverage, you probably think in case of a health issue requiring hospitalization your health insurance policy will take care of the bills. You may be correct if the sum insured is high enough and policy clauses limit your out-of-pocket expenditure to a minimum. If this is not the case, it’s time to check your corporate Mediclaim policy once more.

Drawbacks of a Group Health Insurance

A group health insurance plan comes with the following drawbacks:

1. Standard Coverage

Health insurance coverage provided by your employer is usually bought under Group Health Insurance Scheme. Essentially, all employees of the company are provided with similar coverage. While this may not be all that bad, but, an individual's insurance needs can be quite different from one employee to another , even if they are in the same age-group and income level. This is usually not customizable under a corporate health insurance.

2. Low to Average Sum Insured

Sum Insured amounts in corporate health plans are usually in the low-average range when we take into account current medical costs and inflation. It is typical for a corporate coverage to have a sum insured of 3 to 4 lakhs as standard coverage. Clearly, this amount may not be adequate according to current needs, especially if this also includes family members.

3. Limited Coverage for Family

Corporate Mediclaim plans are often limited in one way or another when it comes to family coverage. Either there are limitations on the number of dependents who can be covered or a standard coverage amount provided per plan with additional premium for incremental benefits. Sometimes both of these limitations are put in place as it is a standard offering across the board.

4. Requirement for Co-Pay

Many insurers include Copay clauses when they offer health plans through employers. While this may still be affordable in case of smaller hospitalization expenses, when the bills get bigger the Co-Pay can hurt personal savings.

5. Employer Dependent

Mediclaim cover provided by one employer doesn’t automatically move over to another in case you need to change jobs. During the recent pandemic, many people lost their jobs too. Unfortunately, the coverage ceases as soon as the employment relationship with the employer terminates.

Additionally, the policy can be different between employers. It leaves the employees vulnerable to situations of going from higher to lower coverage during a change of employment. Mediclaim is a good will gesture or a perk provided by the employer and coverage may vary.

Conclusion

Given the risks, an over-dependence on the employer-provided Mediclaim is not in your best interest. It is often advisable to get additional health care cover through an individual health care plan for self and/or family. 

Good corporate Mediclaim policies do exist, and sometimes offer multiple benefits at much lesser premium due to corporate tie-ups. It is always prudent to be aware of the risks and benefits of both company-provided Mediclaim as well as individual plans to arrive at an appropriate conclusion with respect to coverage. 

Sometimes, when there are elderly parents or in-laws, a combination of company provided coverage and an individual policy works in ensuring adequate insurance for every member at much reduced costs.
  

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Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.