Health Insurance February 18, 2020

Mediclaim Policy for Employees in India

Many people try to understand mediclaim policy for employees in india simply because group insurance is a very common thing. Mediclaim for employees, as the name suggests, is health insurance offered by the employer to the entire workforce. All the employees of a certain company are insured under a common health insurance plan. Take a look at this article to know more about this type of health cover and get to know what is mediclaim policy for employees.

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Mediclaim policy for employees in india – how it works

Let us begin by understanding how a group health insurance cover works:

Who is covered?

All the employees of the company are insured commonly under such a plan. Any company that has more than 20 employees can enjoy a group health cover. The group health covers are commonly found in private firms, both large scale and small scale.

How is the premium charged?

The premium is deducted from the employees’ wages. It is a small percentage that everyone needs to pay. The risk is divided among many people so the premium is not too high. While some people are considered to be more likely to make claims, some are not. The risk is thus well spread out and the premium rates are very affordable.

Who is the policy owner?

The employer owns the policy and pays the premium on behalf of his employees. He includes new employees in the plan and excludes those who have discontinued service due to termination, retirement or resignation. Anyone still employed in the firm is automatically included in the group health coverage.

Advantages of mediclaim policy for employees

Now let us explore some of the benefits you get when you stay covered under such a medical insurance plan:

1. Comprehensive coverage

The group health plans offer comprehensive health insurance covers for all the employees. The employees can get hospitalisation covers, pre and post-hospital care, domiciliary care, daycare expenses, OPD costs and so on. The group health plans offer a wholesome medical cover for everyone insured.

2. Coverage for the entire family

The cover is not limited only to the employee. His or her dependent family members are also covered under these plans. So if you are the employee who gets the group health cover, you can also make claims when your spouse, child or parent is admitted to a hospital following an illness, surgery or accident.

3. Automatic coverage

There are no formalities to complete especially to get the group health cover. As soon as you become an employee of the company, the health coverage is automatically issued in your name. This is a major advantage of a mediclaim policy for employees.

4. No waiting period

There is no waiting period in group health insurance. The employees are covered under the plan for pre-existing illnesses and special conditions such as maternity benefits, from the first day of the cover. This is another stand-out benefit of a group plan.

5. No worries about renewals

You do not have to worry about the expiry dates, premium payments renewals, etc when you stay covered under a group health insurance policy. Your employer deducts the necessary amount automatically from your salary and your health cover remains in action for as long as you remain employed.

Disadvantages of mediclaim policy for employees

1. Cannot be customised

The biggest drawback of a mediclaim policy for employees is that is cannot be customised. Health insurance often requires customisation to suit the individual needs of the insured. But when you have a group plan, you cannot get it customised in any way. You have to accept and share the broad covers offered in the plan by your employer, along with all your colleagues.

2. Can be lost instantly 

Another huge disadvantage of a group mediclaim policy is that you can lose it overnight. If you get fired or resign on your own or even retire, your group health coverage will end instantly. You will only stay covered until the time you work. This can leave you and your family without health insurance overnight, something that is quite dangerous.

3. May not be sufficient

As mentioned above, the group health plan cannot be customised. As a result, you cannot add features to it to make it suitable for your family. The basic group health cover may not be sufficient for you or your family members, so you need to complement it with a personal health insurance policy as well.

To wrap it up

Now that you have a better understanding of what is mediclaim policy for employees in India, make good use of your group health cover. Keep the advantages and disadvantages in mind. Try to get an individual cover along with it too, as a back up in case you lose your job. But while still employed, enjoy this benefit and stay covered insurance comprehensive manner.

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