Group Health Insurance

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Why you are advised to buy an independent health plan even after being covered by a GMC
If you are a salaried employee, chances are that you are enjoying an employer-sponsored group mediclaim policy. If the employer is paying the premiums of the policy under its employee benefits program, the cover is even free for you. Alternatively, you might also enjoy group health insurance cover by being the account holder of a bank or a member of a club as many institutions opt for group mediclaim policies for their members. So, if you are enjoying a good group mediclaim cover by being a part of a group, do you need an independent health insurance policy?
Yes you do. Do you know why? Let’s understand why but before that, some basics –
What is group mediclaim?
Group mediclaim is a group health insurance cover which can be bought by a group to insure its members. If you are a part of a group which has invested in a group mediclaim policy, you would get coverage. 
What are independent health insurance plans?
Independent health insurance plans are normal health insurance plans which you can buy for covering your financial loss in case of a medical eventuality. These plans cover your medical bills and give you a relief from the adverse financial implications of a medical emergency.
Why independent health insurance coverage is needed?
Even though you are covered under a group mediclaim plan, you need an independent health insurance plan. Here are the reasons why – 

  • For customising your coverage 

Group health insurance plans offer you standard coverage benefits. Though these benefits are good, they might not fulfil your coverage requirements. For instance, you might be planning a family in the near future and your group mediclaim plan might not have maternity coverage. Since maternity costs are quite substantial you might need to get them covered under a health plan. Similarly, your group mediclaim policy might not provide you international coverage or coverage for OPD expenses. If you need these coverage benefits you need an independent health insurance plan. Independent health insurance plans allow you to buy the coverage benefits that you require. You can compare and choose the most suitable health insurance plan based on your needs. Moreover, you can customise an independent plan with the required add-ons, a feature which is absent in group mediclaim plans. So, while group mediclaim plans give you a fixed set of coverage benefits, independent health plans have a more comprehensive benefit structure and even allow you to customise your coverage with the benefits you require.
(Know how group mediclaim policies can be customised)

  • For supplementing the coverage level

The coverage level under group mediclaim plans is limited. You might get coverage of INR 1 lakh or INR 2 lakhs from your group health insurance plan. This coverage is not sufficient to meet the rising medical costs. Medical inflation is rising with each passing day and a simple case of hospitalisation incurs tens of thousands of rupees. If you suffer from something severe the costs easily run into lakhs. In such cases your group mediclaim policy might prove insufficient. This is where an independent health insurance plan becomes useful. The plan supplements your existing coverage and helps you meet the expensive medical costs easily.

  • For lifelong renewals

Even if your group mediclaim policy promises you a high coverage level and good coverage benefits, the cover is available only till you are a part of the group. As soon as you exit from the group you would lose the coverage under the group mediclaim plan. You would, then, be left without insurance and would have to foot your own medical bills. Independent health insurance plans, on the other hand, provide lifelong renewals so that you can enjoy the coverage even in your old age when you need it the most.

  • For availing tax benefits

Under most group mediclaim plans, the premiums of the policy are paid by the group itself and the members enjoy free coverage. Since the members are not paying any premiums, they cannot enjoy the tax deduction available under Section 80D. Section 80D of the Income Tax Act allows health insurance premiums to be tax-free deductions from your taxable income. You can claim a deduction of up to INR 25,000 by paying health insurance premiums. If you are a senior citizen, the limit increases to INR 50,000. Moreover, if you pay the premium for your dependent parents too, you can claim an additional deduction of up to INR 50,000 if your parents are senior citizens. Independent health insurance plans allow you to claim deductions on the premiums that you pay and you can lower your tax liability.

  • For covering the entire family

Though many group mediclaim plans extend coverage to the dependents of the covered members, such coverage is not necessary. Your dependents might or might not be covered under your group health insurance plan. However, if you buy a family floater health insurance plan, you can ensure coverage for your entire family.  
(Here’s what your family floater health plan should include)
You would have to pay a premium for buying independent health insurance coverage but the plan would ensure that you get the coverage that you require. You can even buy specialised health insurance plans like critical illness plans, disease specific plans, top-up or super top-up plans as per your requirement. Independent health insurance plans are a good addition to your existing group coverage and should be taken to supplement the coverage level and also for lifelong coverage. When you have an independent health insurance plan you would not have to worry about the out-of-pocket expenses when your medical expenses exceed the coverage of your group mediclaim plan. So, invest in a health insurance plan for yourself even when you have group mediclaim.
(Find out how heart patients can get health insurance cover)