You are in your late 30s, and until today you haven’t felt the need to buy a health insurance as you are satisfied with the one offered by your employer. The corporate health insurance offers protection to you and your spouse and your children and even your parents, and you are confident that the coverage of your employer health insurance is enough, and meets all your requirements. However, you recently learned that your friend who also mostly relies on her employer health insurance had to bear a major part of her hospitalization expenses in spite of the insurance coverage. So, now you are left wondering whether your employer health insurance is enough? Let’s look at what happens when you only have a corporate health insurance policy.
Nowadays, most companies offer health insurance to their employees. It is their way to show them that they are not just a resource, but also an asset. Even as companies care about their employees, they still need to ensure that they are making profits, therefore, according to various surveys, several employers over the last few years have reduced the health insurance coverage from approximately Rs 5 lakh to Rs 2 lakh. In most cases, the coverage cannot be changed. But is coverage of Rs 2 lakh enough for a family of four or five? Read this case to understand it better. Nanda was quite satisfied with her employer health insurance of Rs 2.5 lakh, which also provided coverage to her husband. She was certain that the corporate health insurance is adequate for both she and her husband as they were healthy. However, Nanda’s family doctor urged her to buy a separate medical insurance plan as he was aware of the history of heart diseases in the family. A few years hence, Nanda unfortunately developed major heart problems due to which she was advised immediate surgery. Her medical expenses ran to the tune of Rs5 lakh. With only her employer medical insurance to fall back on, which did not cover the entire medical expenses, she had to foot majority of the hospital bill from her own pocket.
After she recovered from her surgery, Nanda tried to buy a medical insurance cover for herself, but most health insurance providers imposed a waiting period before her existing illness would be covered. If Nanda had purchased a separate health insurance with a higher sum insured, she would have saved a lot of money in the bargain.
So, if you are a family of four or five, health insurance coverage of Rs 2 lakh may not be sufficient for you and your family. So apart from having a medical insurance plan from your employer, it is recommended that you also buy a health insurance cover which allows you to choose your sum insured, even up to Rs1 crore.
In today’s times of economic uncertainty, with several companies reporting losses, you could lose your job in weeks or even days. With your employment ceasing, your employer medical insurance coverage also ceases. So, if you do not have a separate medical insurance, you are basically without health insurance coverage. If a medical emergency may happen to strike at such a time – whether minor or major – you will have to bear all the medical expenses yourself. With inflation impacting the medical sector too, medical bills can even run into lakhs. Without a job and health insurance, paying such heavy medical bills can be difficult. Therefore, you should not rely on employer health insurance alone, and buy a medical insurance plan to enjoy coverage always. If you are in the process of changing jobs, and would be opting for medical insurance offered by your next employer, any medical expenses that are incurred during this period, will have to be borne by you if you do not have a medical insurance. Even after you get the medical insurance from your employer, you will not be reimbursed for illnesses that occurred earlier.
In several companies, it is mandatory for employees to have the corporate health insurance cover. While this is a great way to ensure the well-being of their employees, employees cannot make changes—or at least major changes--to their corporate health insurance policy. This means that you will not be able to make changes to the illnesses covered, modify the number of dependents, and increase the coverage amount to your liking in the corporate health insurance policy. If you buy a individual health insurance policy, you can negotiate such details with your health insurance provider.
Your health insurance policy coverage will end on the day of your retirement. If you haven’t invested in a individual health insurance policy until then, and solely depended on your corporate health insurance cover, getting a health insurance cover at an older age might be difficult as the older one gets the risk of getting health problems increases. Even if you get a individual health insurance policy after retirement, your plan could be costly, which could put you under financial strain as you may not have a steady source of income at the time.
A corporate health insurance policy is a benefit that you should undoubtedly take advantage of as an employee. However, considering the above points, you will be able to manage your finances better if you also opt for a individual health insurance cover. Moreover, if you have two health insurance policies, you could use your corporate health insurance to make claims for minor procedures, and use you individual health insurance policy for major medical expenses. Being over insured may not be a huge problem, but being underinsured always is.
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