There are various sorts of medical insurance policies, so pick the one that best meets your needs. Group health insurance and individual health insurance are two of the most widely used types of programmes. Although the coverage provided by various policies may be of the same character, what differentiates them from one another is who is allowed to make use of it. Let’s examine carefully the variations between business group health insurance and personal health insurance:
A group of persons who are connected to one another by at least one common factor are covered by a group health insurance coverage as opposed to an individual’s health insurance. For instance, coworkers in the same company or blood relatives. It provides coverage for several individuals. However, the policyholder of an individual health insurance plan is the only person it protects.
Most family health insurance plans and employer-sponsored insurance are group policies that are significantly less expensive than individual health policies. You can use a health insurance premium calculator to check the premium amount. However, they share the fact that they both offer coverage for unexpected hospitalisation costs.
Here is a table that compares individual health insurance policies to employee group health insurance:
| Parameter | Group Health Insurance | Individual Health Insurance |
| General meaning | A group of people are insured under a group health insurance plan. | The holder of an individual health insurance policy is protected. |
| Who is insured? | The insured individual and their connected family. | The policyholder is the only individual. |
| Who is the purchaser? | The majority of the time, a company purchases group health insurance (or the main member of the family for the Family Floater Insurance plan). | Purchase of an individual health insurance plan by the insured. |
| How much control does the insured have over the plan? | Only limited control (The employer or the purchaser has less amount of control over the coverage and add-ons of the plan). | Entire control (The policyholder has full control of the coverage and add-ons of the plan). |
| Option to buy Add-ons: | None or limited | The policyholder Is able to buy any of the available add-ons. |
| Claims: | Claims are generally made through a third-party administrator. | Claims are usually made directly with the insurance company. |
| Available Sum Insured: | Low as compared to Individual Health insurance. Is usually between Rs. 5 to 10 Lakh. | Is presented with an option to choose a higher sum insured as compared to a Group health policy. It Can be between Rs. 5 to 15 Lakh. |
| Eligibility Criteria: | Must be a permanent employee of an organization | Should be at least 18 years of age |
| Exit criteria: | The insurance plan stops to exist when the employee resigns or gets retired. | The policyholder reaches the age of 65 years |
| Tax benefit**: | No | Yes |
| Coverage for Pre-existing diseases: | Generally from day 1 | Upon the completion of the waiting period. |
| Maternity Benefits: | Covered | Needs to be purchased under add-ons. |
| Cumulative Bonus*: | Not Applicable | Applicable |
| Medical Check-ups before purchase: | Not required | Required |
| Coverage for Critical Illness: | No |
In summary, individual and group health insurance strategies have different advantages and goals. To ensure enough financial support in times of need, one should always purchase health insurance as needed. An individual may now hold numerous medical insurance policies, according to new regulations. As a result, it is highly recommended that you build a comprehensive health insurance portfolio to reduce any undesirable financial risks in the event of an unexpected medical emergency.
Health insurance policies for individuals and groups range in their benefits of health insurance and objectives. To ensure enough financial support when needed, it is advised to choose health insurance based on personal needs.
* Standard T&C Apply
** Currently, there are 2 tax regimes in India – new and old. To get the tax benefit you desire, choose the correct one after consulting an expert. You can opt for a regime change during the next financial year.
# Visit the official website of IRDAI for further details.
## All savings are provided by the insurer as per the IRDAI-approved insurance plan. Standard T&C apply
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