When your corporate health insurance is not enough to protect your family’s health

When someone talks to us about our investments and finances, we have our answers ready! But when it comes to choosing the right health insurance plans for family or oneself, to protect our savings, often our answer is “Why do I need one? My company covers my family and me under their corporate health insurance policy.” 

Employees, today, who are working in organisations and private firms are satisfied that they do not need a separate health insurance policy as they have a company sponsored Mediclaim. However, questions such as “does it cover the pandemic”, “is it enough to cover your family's health,” “is there a need for another health insurance policy” or “is it enough to meet expenses adequately during medical emergencies, etc.” need to be verified individually before just settling for the health insurance provided by the employer. 

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Here are the six compelling reasons why you would require a separate health insurance plan besides your corporate plan: 

Standardised Sum Insured  

The employer’s health insurance policy has a standardised sum insured for all employees and their families. However, your needs might differ from the other employees. The right sum insured should ideally be based on your age, life stage, family structure, lifestyle, medical history, etc. A standard employer's health insurance policy may not protect you completely when you need it. 

Employment Status 

An employer’s health insurance policy is valid until your employment with the firm continues. Your insurance cover ceases as soon as you leave your job or your employer terminates you for any reason. So, the time when you are in between jobs or on a sabbatical, you are basically without any health insurance policy. If anything, unfortunate does happen during this period, you are entirely unprotected. 

Coverage for Dependents 

Few organisations provide health plans that cover four members from a family i.e. self, spouse and children. In case they have dependent parents, then the employees are at a disadvantage with regards to the policy since older people are the ones who need health insurance the most. 

Not Portable 

If you opt for independent health insurance, the bonus added can be ported if you decide to switch. However, in the case of an employer-provided plan, it is not portable. 

Tax Benefit 

Employees can avail of tax benefits on the premium they pay if they have an individual health insurance. The limit for health insurance deduction under section 80 D has been increased to Rs. 25,000 and Rs 50,000 for senior citizens. This cannot be availed for a corporate health policy.  

Changes to Terms & Conditions

At a certain point of time if your employer decides to cut down the expenses incurred towards the group health insurance and modifies the terms and conditions of the health plan, then it might catch you by surprise. Also, if these modifications arrive at a time when you or one of your family members is undergoing medical treatment, then it could burn a hole in your pocket. 

Moreover, it is also important to know how strong your insurer’s network hospital list is i.e. the hospitals with whom the insurer has tie-ups. The sole idea of going for health insurance is to minimise out-of-pocket expenses to the bare minimum. Therefore, it’s better to do background research and find out if that policy is meeting your expectations. You could also explore an individual cover or family floater plan.

(Authored by Dr Sudha, Head — Health and Travel at Digit Insurance)