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 plansIndividual 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.

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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.

I don't need individual policy since I am already covered by my company

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.

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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

Read More: Family Health Insurance Vs Individual Health Insurance Plans

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.

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Also Read: Exclusions in Health Insurance Policies – Things That Are Not Covered Under Health Insurance Plan | What is the Free Look Period in Health Insurance Policy? – Know Features & Benefits of Free Look Period

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Jul 13, 2022
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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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