New Delhi: Being a member of a group, you enjoy certain benefits. One of such benefit is access to a group health insurance, which is remarkably cheaper than an individual health plan or a family floater plan. Other than lower premium, group covers also offer many other benefits, which individual policies do not offer. However, group policies come with their own set of disadvantages. Here we list out the pros and cons of a group health policy which you need to know.
Pre-existing diseases covered from first day
Typically group health insurance policies cover pre-existing diseases from first day. This is a major benefit as standard family floater insurances have a waiting period of two years, and up to four years for some diseases. Also, no medical checkups are required to avail this policy. This cover is available even to members having chronic diseases like diabetes or hypertension
As these policies are issued to a large number of people per head cost of insurance falls. You can also negotiate bulk discounts with the insurer.
All members are covered
Group health plans provide cover to all the members and their dependents irrespective of their age or any pre-existing diseases. Typically if you buy individual covers for older people in a family then it will cost you significantly more. But in a group health policy, the premium remains same irrespective of the age of the member.
Group health policies can be customised to suit your requirement. One such customisation is you can include maternity cover and OPD benefits. Also, separate limits can be set for normal, caesarean section or ectopic pregnancies. Even newborn babies can be covered immediately without the standard 90 days waiting period.
It may become unviable for insurer
While the benefits of group health policy are evident, such covers come with their set of risks. The key threat is the plan may become unviable for the insurer if it gets higher claims.
Renewal premium may increase in case of higher claims
If the claims ratio is too adverse, the insurer can notify the group to either pay an additional premium or accept cancellation. In such a case either you have to pay the additional premium or discontinue the policy leaving many members in the group unprotected.