Can you depend only on group health cover?
Group health insurance policies are generally provided by the employers and cover pre-existing diseases. Some group policies also cover old parents with or without paying extra premium. The claim settlements under group policies are easier. The moot point is whether one should take additional individual policies when one is covered under group insurance policy?
Why one should buy individual health policy?
Disadvantages of depending only on group policy
a. Now days, most people are changing their job frequently without knowing whether their new company are providing group health cover or not. But once employer is changed, benefit under the old group policy ceases.
b. After retirement, the benefits under the old group policy also ceases. For taking fresh individual policies after retirement, Companies are charging higher premium which will have also waiting period for pre-existing diseases which is around 3 to 4 years.
c. Recently the finance ministry has issued direction to increase premium of group policies due to high claim ratio. Due to higher premium in group health insurance, many employers are proposing to reduce the benefits or increase deductibles or introduce co pay or want employees to share the premium load.
Advantages of taking an individual health policy early
a. At early age, many companies issue policies without medical examination.
b. As one’s age increases, health insurance premium increases due to higher chance of hospitalization. At old age, health insurance is more costly than younger age.
c. Individual and family floater policies are mostly one year/two year contract. After issuing policy, companies generally do not hike the premium without any valid reasons or hike it marginally. If no claims are preferred, Companies provide “No claim bonus” either by giving a discount to the premium or by hiking the sum assured.
What one should do nearing retirement?
If one is nearing retirement, he/she should check with the current group cover provider about the possibilities of getting an individual policy after retirement with the continuity of benefits of the group scheme (i.e. waiver of waiting period for pre-existing diseases).
Claim process
As per a recent IRDA guideline, if one takes health insurance policies from more than one Company, the insured has the option of making the claim against any one company. So the insured may prefer the claim under the group policy and continue to get the “No claim bonus/discounts” under the individual policy.
Tax benefits
Under section 80D, one is eligible to get deduction of Rs 15,000/- (Additional Rs 20,000 for senior citizens Parents) by taking Individual health insurance policy.
As may be observed from the above, one should buy separate health insurance policy even if his employer is providing group health insurance policy.
Get done your risk profiling by fee-only certified financial planner. It will give you more clarity on your health insurance needs and actual cover available. Also it’s very important in planning your retirement.