Skip to main content
Group Health Insurance

What Is a Group Health Insurance Plan And How Does It Work?

What Is a Group Health Insurance Plan And How Does It Work 2

Importance of Group Health Insurance for Employees and Employers

Due to the recent pandemic, health insurance has gained the right popularity it has always deserved. Now people are beginning to realize the importance of creating a strong health insurance portfolio with different types of plans and how helpful these can be at the time of a medical emergency. One of such types is the Group Health Insurance for employees. This plan is provided by the employer, mostly free of cost as an added advantage of employment. Let’s take a look at why this plan is important for both employees and their employers.

One would be familiar with the logic that buying a product in bulk provides benefits as compared to buying a single item. If one enforces this logic with respect to health insurance, the resulting product would be called Group Health Insurance. In this article, let’s shed some light on what exactly is a group health insurance policy And how does it work?

What Is Group Health Insurance?

As the same suggests, a Group Health Insurance policy also called as Group Medical policy is a health insurance policy that covers a group of people. These People in one group can be related in any manner. They can either be employees Working in the same organization, members of an association, customers of a company, etc. However, Group Health Insurance is usually bought by employers to financially secure their employees in case of a medical emergency.

Features and Benefits of the Group Insurance Policy:

Group health insurance plans are beneficial for both- employers and employees. These plans provide a financial backup that can be used in case of hospitalization. Here are some of the features and benefits of the plan:

  1. Pre and post-hospitalization: The coverage depends upon the illness suffered by the insured. Pre-hospitalization expenses for 30 days are covered, i.e. expenses of treatment before getting hospitalized is covered. Expenses incurred for 60 days after the date of discharge may be covered under the post-hospitalization coverage under the plan.  
  2. Hospitalization: Depending on the terms of your health insurance company, the group health insurance plan may provide coverage for hospital accommodation i.e. room charges, doctor visits, specialist fees, nursing charges, etc.
  3. Coverage for family members: The scope of a Group Health Insurance plan extends not only to a group of individuals but also upon the dependents of that individual. Thus, instead of buying a separate cover for each member of a family, they are covered under the plan offered by an employer of one member of the family.
  4. Domiciliary Hospitalization: Sometimes, an insured person is unable to get admitted to a hospital and instead opts for medical treatment at home. This is called Domiciliary Hospitalization. This may be covered under Group Health Insurance at an additional cost. 
  5. Daycare Procedures: To avail the coverage of a health insurance plan, it is usually necessary to be hospitalized for at least 24 hours. Your insurer may cover you for daycare procedures that do not require  24-hour hospitalization.
  6. Cashless Hospitalization: Some insurers have a wide network of hospitals. If you are hospitalized in one of such network hospitals, you can avail of cashless treatments. Here you do not have to keep a track of the medical bills and other documents to claim insurance. Apart from the amount not covered, all other bills are settled directly between the insurance company and the hospital.

Who is Eligible For Group Health Insurance?

Providing Group Health Insurance to employees is an excellent opportunity for employers and non-employers to provide access to private medical care when medical costs are on the rise. Whether it is a small business, startup, welfare association, or a group with a common interest, the security of a group insurance scheme helps in boosting the morale of employees and the brand of your organization. But, are you and your business eligible for a Group Health Insurance plan? Read ahead to learn eligibility criteria for a Group Health Insurance.

Whether you are an emerging startup, organization small and large, social/cultural association, or a group with a common interest, you are eligible to apply for a Group Health Insurance Plan. Organizations or groups with more than 10 employees can opt for a Group Health cover. However, the insurance industry regulator, the IRDA has stated that micro-insurance plans can be availed by groups of less than 5 employees.

The Bottom Line

In today’s times, buying a health insurance cover is a good deal as you will be financially covered against expenses arising from hospitalization. These expenses have skyrocketed and burned a hole in your pocket if you don’t plan in advance. You can save only a portion of your income but with a health insurance plan, you don’t have to worry about any mandatory savings just for the sake of medical expenses.

Leave a Reply