Difference Between Group Health Insurance and Individual Health Insurance

The purpose of buying health insurance is to get financial cover for any disease or ailment you might get affected with in the future. And there is a wide range of health insurance plans in India. Today, in this post, you will know which health insurance plan is better: a Group Health Insurance plan or an Individual Health Insurance plan. First, know the definition of both. A group health insurance plan is provided to you by an employer or association, whereas you buy individual health insurance for your own. Now you know the basics, so read this post and know the difference between the two health insurance plans.

Group Health Insurance Plan

In a group health insurance plan, your employer gives you the following benefits:-

1. Choice of health insurance plans
2. Choice of paying the monthly premium
3. Deduct your premium from your paycheck

If due to unemployment or any other reason you can’t get coverage from your employer anymore, you should buy an individual health plan.

Individual Health Insurance Plan

Unlike group insurance, you’ll buy this individual health policy for you. It will allow you to make all your premium payments monthly and get the cover as per the sum insured.

Difference Between Group Health Insurance vs Individual Health Insurance

Cost:- The premium of a Group Health Insurance is lower compared to Individual Health Insurance because the policy is given to the employee at low or no cost. If you buy something in bulk, you will get a discount. A Group Health Insurance policy works just like that. Employees don’t have to pay an additional fee for the policy unless anyone in the group buys additional coverage in the policy.

Also, it is convenient for the policyholder as the premium amount gets deducted from their salary each month without any hassle. Whereas in an Individual Health Insurance you have to pay the premiums separately. To ensure no payment delay in an individual health plan too, you can have the automatic payment activated for health premiums on your bank account. With this, the premium will get deducted automatically from the bank account. All you need to do is have the required money in the account. You will get alerts about the premium payment on your registered mobile number and email address.

Approval:- Your Individual Health Insurance Policy may be denied due to medical or financial reasons, but this can’t happen in the case of a Group Health Insurance policy. Because if you are an employee of the company, you become automatically eligible for it. And the process of underwriting in Group Health Insurance where the insured is examined closely in terms of medical history is sometimes waived off by the insurer.

Freedom:- You might not get any freedom in a Group Health Insurance plan. Other than you, there are other insured people, that is why the terms and conditions cannot be amended. On the other hand, in an Individual Health Insurance plan, you have the freedom to choose the policy that suits you the best. And the policy will depend on your personal medical history, financial and social status rather than spreading over a group of people.

Bonus:- In a Group Health Insurance plan, if you don’t make any claim in the previous year, you will not be eligible for any bonus. On the other hand, in an Individual Health Insurance plan, you can get a ‘No Claim Bonus’ that can appear in the form of a discounted policy renewal, increment cover, or no additional cost benefits.

Sum Insured Exhaustion:- When anyone in a group claims under the Group Health Insurance Plan, the overall cover will be reduced. And if the employer doesn’t agree to pay the premium for the Group Health Insurance plan to increase the sum insured, it stays at the level where it was previously, which could cause inconvenience to other insured people.

In an Individual Health Insurance plan, if you make a claim, it would be reduced from your sum insured, and later you can manage it by making the monthly premium payment without any hassle. This helps make your plan stable and secure you from further health risks as well.

Coverage:- You get coverage for the Group Health Insurance plan as long as you are employed or if the employer is paying the policy premium. However, if you resign or retire from the company or organization, you have an option to convert the Group Health Insurance plan into an Individual Health Insurance plan.

However, the Health Insurance plan conversion should be done when you agree to pay a higher premium. Because conversion premium is typically above the premium amount that a new individual gets in an Individual Health Insurance plan. So, convert your Group Health Insurance plan only if it suits you.

In an Individual Health Insurance plan, you can get coverage for 1 year and can renew it as long as you want.

Top Group Health Insurance

If your choice is a Group Health Insurance Plan, after reading this post, these are some of the top plans for you!

Oriental Mediclaim Insurance Policy (Group)

1. Available to any Group, Association, Institution, Corporate Body of more than 50 persons or families.
2. Reimburses reasonable customary and necessary expenses of Hospitalisation and Domiciliary Hospitalisation expenses for the insured
3. Cashless facility at  Network Hospitals
4. Pre acceptance medical check-up for the insured who are 45-55 or above 55 years old
5. Pre-existing illness, ailment, injury, or disease are excluded from the policy
6. Sum Insured ranges from INR 50,000-5,00,000

Reliance Group Mediclaim Insurance Policy

1. Customized Policy
2. Cover for all employees and their families
3. Cashless claims across Network Hospitals
4. Daycare procedures are also covered
5. Discount on premiums at the time of renewal
6. Lowers the employee turnover amount
7. Lower premium costs for the insured
8. Regular health check-ups for the employees

Kotak Group Health Care

1. In-patient Treatment
2. Pre-hospitalization Medical Expenses
3. Post-hospitalization Medical Expenses
4. Daycare Treatment
5. Domiciliary Hospitalization
6. Emergency Ambulance
7. Donor Expenses for the surgery

Aditya Birla Group Activ Health Plan

1. Quick & easy policy issuance
2. Simple documentation
3. Cashless settlement
4. Customized options per individual

Aditya Birla Group Activ Secure

1. Personal Accident Cover
2. Critical Illness Cover
3. Hospital Cash Benefits

Aditya Birla Group Activ Travel

1. Plans for your travel needs
2. Travel insurance with a wide range of cover
3. Additional services for medical and non-medical emergencies
4. Mugging cover
5. Emergency home visit
6. Lifestyle support due to accidents
7. Cover under a single trip or multi-trip
8. No specific entry age

New India Group Mediclaim Policy

1. Covers reimbursement of hospitalization expenses for Illness or Injury
2. Cost of treatment in General Ward of the Hospital or a Daycare Centre
3. Pre and Post-Hospitalization expenses
4. Ambulance service
5. Cover for specified diseases

Top Individual Health Insurance plan

If you want to have individual health insurance plans, choose from these best options available for you. Here is the list of best plans

1. Aditya Birla Activ Assure Diamond Plan
2. Max Bupa Health Companion Individual Plan
3. Star Health Family Health Optima Plan
4. HDFC Ergo My Health Suraksha Plan
5. New India Premier Mediclaim Policy

Aditya Birla Activ Assure Diamond Plan

1. Sum insured from INR 10 lakh to INR 2 Crores
2. Policy terms for 1, 2 or 3 years
3. This policy is for both an individual or family
4. The minimum age is 5 years for an individual
5. And no restriction on the maximum age limit
6. Covers in-patient, pre-hospitalization, post-hospitalization, ambulance charge, domiciliary and daycare treatments

Max Bupa Health Companion Individual Plan

1. Cover from INR 3 lakh to INR 1 Crore
2. The policy covers In-patient treatment, health check-up and gives hospital cash benefit
3. The policy premium starts from INR 5,085

Star Health Family Health Optima Plan

1. Affordable premium
2. Additional sum insured
3. Health check-up cost
4. Automatic restoration of the policy
5. Assisted reproductive treatments and newborn cover

HDFC Ergo My Health Suraksha Plan

1. No room rent limit
2. Sum insured rebound
3. Free health check-up every year
4. Cashless home health care service

New India Premier Mediclaim Policy

1. The policy covers Proposer, Spouse, Dependent Children and Dependent Parents
2. Sum Insured of INR 15,00,000 to 100,00,000
3. Covers room rent, nursing expenses, Intensive Care Unit (ICU), Intensive Cardiac Care Unit (ICCU), Surgeon, Anesthetist, Medical Practitioner, Consultants and Specialist fees.
4. Hospital cash benefits
5. Critical care benefits
6. Ambulance charges