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Group Health Insurance vs Individual Health Insurance Policy in India – How to Find the Best One
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Group Health Insurance vs Individual Health Insurance
Buying health insurance for you and your loved ones but not sure which one to go ahead with? It’s only natural to get confused because you’d only want the best when it comes to health. Most insurance providers offer two types of health insurance plans – Individual Health Insurance Policy and Group Health Insurance Policy. While both come with their respective benefits and drawbacks, it’s a good idea to study each in detail before buying one to secure your future health needs.
What Does Group Health Insurance Cover?
As the name clearly suggests, group health insurance can be availed by a group of people together. However, the people in the said group need to be related to each other either by blood relation (as is the case with family) or any other common factor, such as a group of people working together for the same company. Most organizations opt for best group health insurance policy for their employees. In other words, this plan extends coverage for health costs to more than just one person.
What is Meant by Individual Health Insurance?
Contrary to the above explanation, individual health insurance plans promise coverage to only one person or individual, who is the policyholder in this case. As evident, the insurance benefits can only be availed by the said individual and not by any other family member.
Group Health Insurance vs Individual Health Insurance: Which is Better?
While both these health insurance plans are designed to meet different needs, it can sometimes be difficult to determine which one of these would actually suit your health needs better. This is why we’ve listed out the differences between these two health covers in detail in the form of a table below.
Individual Health Insurance |
Group Health Insurance |
| Coverage only to one individual (policyholder) | Coverage to a group of people bound by a common factor |
| Bought by the policyholder | Generally bought by an employer for employees or in case of Family Floater Health Insurance Plans, policy can be bought by the main family member on behalf of the rest |
| Only the policyholder is the insured | The employer/family head and other members (family/employees) are insured |
| The policyholder has full control over the coverage and add-on features of the health insurance plan | The employer generally has only limited control over the plan |
| Sum insured can be higher (Rs. 5 – 15 lakh) | Sum insured is generally lower (Rs. 5 – 10 lakh) |
| Policyholder can choose to buy add-ons to the base plan | Policyholder either has no choice or limited choice to buy add-ons |
| Policyholder must be 18 years or above to buy the policy | Eligibility only to permanent employee of a company |
| Policyholder can make direct claims with the insurer | Claims can only be made through a third-party (employer/main family member) |
| Policyholder can exit the plan upon completing 65 years of age | Policy’s existence is dependent only up to the time the employee stays in the company or until his/her retirement |
| Health checkup is must before buying health insurance | Medical checkup not needed before plan purchase |
| Policyholder is entitled to tax benefits upon buying the policy | No tax benefits available under group health insurance |
| Policyholder entitled to receive no-claim bonus | No-claim bonus not available |
| Claims for Pre-Existing Diseases (PED) can be made only after the completion of waiting period | PED coverage can be provided generally from day 1 of buying the policy |
| Maternity benefits need to be bought as an add-on feature to the base plan | Maternity benefits are covered under group insurance |
| Critical illness coverage can be provided in case the policyholder so desires | No coverage provided for critical illnesses under this plan |
How to Know Which Health Insurance Cover Best Fits Your Needs?
Based on the differences between individual and group health insurance plans detailed in the table above, both these policies offer specific benefits to the respective policyholders. It’s best to study the details of both carefully and make a wise informed decision.
However, the good news is that you are now allowed to purchase more than one health insurance cover. This means that you can safely choose group health insurance provided by your company while already having an individual insurance policy.
Besides, you can also opt for a Family Floater Plan to secure the health of your family members and also a Critical Illness Cover to ensure that the heavy cost on treatment of critical diseases can be made affordable in future.
All you need to bear in mind is to do a thorough check on each of the two plans – the best group health insurance policy in India as well as the best individual health insurance. Based on your research, you can go ahead and buy these plans from an insurer that promises the best coverage and premium rates.
Over to You
Care Health Supreme and HDFC ERGO Optima Restore are among the best health insurance policies in India today. It is a matter of your priority, coverage depth over cost effectiveness. Here’s a quick recap for you to make an informed decision.
Both offer coverage of up to ₹1 crore; Optima Restore starts at ₹3L, Care Supreme at ₹7L. Supreme offers unlimited recharge; Optima Restore offers 100% once a year, after a claim is made. Care includes OPD + unlimited e-consults; Optima lacks OPD, allows one consultation/year. Care gives a 30% discount + 500% bonus; Optima offers 8% discount + 50% bonus. Care Supreme is costlier but has more features. Optima suits budget buyers; Care fits those needing wider, long-term coverage.
Whichever health insurance plan you choose, ensure to read the policy wordings and seek advice from an expert before you make the purchase. The best health insurance is the one that covers you the way you want to be covered.
Speak to an Advisor Both offer coverage of up to ₹1 crore; Optima Restore starts at ₹3L, Care Supreme at ₹7L. Supreme offers unlimited recharge; Optima Restore offers 100% once a year, after a claim is made. Care includes OPD + unlimited e-consults; Optima lacks OPD, allows one consultation/year. Care gives a 30% discount + 500% bonus; Optima offers 8% discount + 50% bonus. Care Supreme is costlier but has more features. Optima suits budget buyers; Care fits those needing wider, long-term coverage.
Whichever health insurance plan you choose, ensure to read the policy wordings and seek advice from an expert before you make the purchase. The best health insurance is the one that covers you the way you want to be covered.
Author Bio
Paybima Team
Paybima is an Indian insurance aggregator on a mission to make insurance simple for people. Paybima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. Paybima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.
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