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5 Important Things to Know About Employee Health Insurance Policy

Team AckoJan 17, 2024

Health insurance is an effective way to secure yourself against unforeseen medical expenses. However, people tend to overlook the benefits associated with medical insurance plans and create a savings plan for medical emergencies. While it is good to create a savings plan, it does not always meet the purpose of minimizing financial losses in case of a medical emergency.

For example, in case of hospitalization, the fixed deposit might get utilized and the person will be left with less/no savings. This is where a medical insurance policy comes in handy as it is a dedicated product meant to provide financial security in case of health-related concerns. An employee medical insurance policy is an integral component of your health insurance portfolio.




Read 5 Important Things about Employee Medical Insurance Plans

1) Meaning and Scope

Employee health insurance policies are purchased by an employer for the benefit of the employees. It offers affordable healthcare benefits for the employees. Such policies are termed as group plans. Here, the premium charged is less as the risk is spread between a huge group. In this case, the risk is distributed across employees of a company. In certain cases, the benefits of employee medical insurance plans can be extended to the immediate family of the employees as well.

2) Less Complications

Health insurance policies are known to be complex. However, employee health insurance plans are simplistic in nature. This can be attributed to the fact that they are generic and meant for a large group. Thus, there’s no scope for customization. This makes it easier to purchase these policies. A lot of people can avail the benefits of an employee insurance policy as it offers coverage with minimal complications. For example, requirements pertaining to pre-existing diseases, health check-ups, etc. are not that strict in a group plan as compared to an individual health policy.

3) Varying Features & Coverage

Although the employee health insurance policy is generic in nature, the features and coverage offered by the policy might differ based on the insurance provider. For example, certain benefits such as cashless claims facilities, maternity benefits, etc. differ from insurer to insurer.

4) Additional Cover

One should look at employee health insurance as an additional health insurance cover and not as the only cover. Unlike individual health insurance plans, employee health insurance plans do not offer the No Claim Bonus (NCB) facility. Thus, if one has an individual plan as well as an employee health insurance plan, it might be productive to claim from the employee health insurance policy and avail NCB on your individual plan by not claiming it.

5) Limitations

The biggest limitation of an employee health insurance policy is that it is based on the tenure with the employer. If one leaves the company, the person will no longer be an employee of the company and thus not be a part of the employee health insurance policy. As the policy is generic, it might not offer the kind of cover one needs to stay insured in a comprehensive manner. Besides, the insurance provider and the coverage might change depending upon the employer’s requirements.

Also, read: Family health insurance plans

Ideal Health Policy in India

As health requirements vary from one individual to another, there is no one ideal health policy in India. Thus, one should analyze own health requirements and conduct basic online research to find the right health insurance cover. Whether it is an employee health insurance plan or an individual health policy, one must go through the inclusions and exclusions of the policy thoroughly before purchasing it.

Disclaimer: *Except for exclusions like maternity benefits, undisclosed diseases, etc. Please check policy wordings for more details.
**The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet; and is subject to changes. Please go through the applicable policy wordings for updated ACKO-centric content and before making any insurance-related decisions.

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