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Is It Wise to Just Depend on Your Employer-Provided Health Insurance?

Let’s start with being honest – health insurance has hardly ever been on top of our shopping lists. For the longest time, many of us thought of it as an unnecessary hassle that requires hours of research, comparison, and analysis – all of which could be easily avoided if you already have employer-provided group health insurance. It covers you and your young family, doesn’t require you to pay the premiums, and can seem like it’s enough.

That is, until it’s not.

However, if COVID-19 has taught us one thing, it is to never ever take your health and medical expenses for granted. This pandemic has made it clear that unpredictable medical exigencies must be something we all plan for, regardless of our age or gender. You don’t have to be very old to fall critically ill, which is why it’s crucial that you must have a personal health insurance that covers you and your loved ones during these tumultuous times. The first step in the right direction is to think beyond the employer-provided health insurance. Here’s why.

Most big corporations and businesses offer their employees a group health insurance plan, which covers a large percentage of medical expenses including hospitalisations. Most professionals might think that should protect them from unforeseen medical expenses. However, the need of the hour is to prioritise personal healthcare. With unprecedented medical crises come unpredictable hospital expenses that can quickly pile up and drain off your savings faster than you can imagine. And that’s the main reason most of us shouldn’t depend solely on the health insurance provided by our employer. While these policies are helpful some of them might come with loopholes that appear only when you are starting at a fat bill. These group insurance policies fall short and might disappoint you on the following fronts.

1. Sufficient coverage: Employee-provided medical policies are designed to offer coverage for more common ailments and their treatments, and might not provide coverage for some genetic ailments you and your family members may be predisposed to.

2. Can’t guarantee 100% freedom from medical expenses: Many group policies provide incomplete coverage, wherein you might have to shell out money from your own pocket. This is especially true for specific surgical requirements, therapies, and mental health treatments.

3. Flexibility: Most corporate health insurance policies have restrictive clauses due to capping and co-payment stipulations. This may mean that not all your family members would be covered under the policy and you are forced to leave out some. Such policies rarely cover pre-existing illness you or your parents may have, which would require treatment in the near future.

4. Guarantee: Your coverage only lasts for as long as you work for the company. In these times of job uncertainties, this can be a major stressor. Additionally, your coverage can be reduced whenever the company makes an executive decision to do so.

5. Taxes. A personal health insurance policy not only protects you and your family from the unforeseen, but also helps protect your savings. These are eligible for tax exemptions under Section 80D of the Income Tax Act.

Now that we’ve established that corporate group health insurance is not sufficient in the current scenario, what should be the next steps? How then do you get the best personal health insurance and what’s it that you need to watch out for? 

Here’s a handy guide.

1. The right choice: The most effective strategy is to get a personal health insurance policy that complements your existing corporate plan. This is likely to differ from one person to another. Depending on the size of your family, age of family members, and the pre-existing medical conditions, the right cover can be anything from Rs 2 lakh to Rs 10 lakh. A policy provider like TATA AIG Health Insurance can help you make the right choice, based on your specific needs.

2. Keep an eye out for COVID Coverage: Many insurance companies now have comprehensive insurance plans that also provide coverage for COVID-19. With the right plan, you and your family will be covered for medication, treatment, and hospitalisation required to beat the novel coronavirus.

3. In a comprehensive plan you must trust: Since your personal health insurance policy can be customised based on the specific needs of your family, it’s a good idea to look for a premium policy that offers you cashless treatments as well as ease of use. A good comprehensive health insurance plan has you covered for everything from in-patient treatments; pre-hospitalisation medical expenses like diagnostic tests; post-hospitalisation medical expenses like follow-ups; to day-care procedures, which don’t require overnight hospitalisation, domiciliary treatment, where an illness, injury or disease makes it impossible to reach hospital and treatment must start at home. It also takes care of organ donations, vaccines, and accidental dental treatments.

4. Top it up: A top-up plan can be a saviour. It increases your health insurance cover after the threshold limit is crossed. Top-up plans make more sense as you and your family members age and your medical expenses grow, but it’s most pertinent in the current scenario. COVID-19 is sparing no one and medical expenses can become overwhelming, especially when the entire family is hit.

While we are more mindful of our health today than we were in the pre-coronavirus days, it’s time to be more conscious of the choices we make when it comes to health insurance. Having a back-up won’t hurt you, especially if you turn to a trustworthy provider like Tata AIG Health Insurance.