Medical expenses and healthcare costs are skyrocketing rapidly, and having health insurance coverage in this scenario, without paying an out-of-pocket premium is an exceptional perk. Employers providing group health insurance policies to their employees covering medical expenses such as pre-existing diseases, hospitalization expenses, daycare procedures, and more are preferred by the modern workforce.
But who is eligible for group health insurance plans? We have answered your query about group health insurance eligibility requirements, inclusions, exclusions, best group health insurance plans, benefits of having group health insurance, and so on. Read on to learn more about the group health insurance eligibility requirements in India.
Group Health Plans | USPs |
---|---|
Niva Bupa Group Health Insurance | No pre-policy health check-ups required, Coverage for parents, Maternity coverage, Choice of outward portability into an individual policy |
Star Group Health Insurance | Get covered with a sum insured of upto 1 Crore, Cataract surgery and modern treatment cover, Choice of adding members or removing them from the corporate policy |
Care Health Group Health Insurance | PEDs are covered from day 1, More than 504 daycare procedures are covered, Critical illness hospitalization expenses are covered from day 1 |
Aditya Birla Group Health Insurance | It covers ailments which are not covered under any individual health insurance such as PEDs, maternity care, dental care, etc, No need to go through a pre-acceptance medical check-up |
Tata AIG Group Health Insurance | Medical cover for the employee and their family members, Coverage starting for pre-existing diseases from day 1, Maternity benefits are covered without any waiting period |
Key Takeaways
Here are the terms of eligibility criteria for buying a group health insurance:
Group health insurance policies are intended to provide health and medicare facilities to salaried employees which further helps them manage their finances. On the other hand, it doesn’t provide any policy benefits to individuals in the following occupation/profession:
The employer does not generally cover the employee’s dependent children, parents, siblings, and grandparents. On the contrary, if a company or an employer invests in their dependent family’s healthcare, an additional premium cost might be applicable.
In the case of an individual buying group health insurance for a family member and a non-family member involved in the business, the group health policy will cover the spouse. However, the spouse is not covered if the business holder has no other members in his business, either from the family or external employees.
An entrepreneur who’s working on their own business without any employee or helper, can not buy group health insurance. Whereas, they can invest in suitable individual health insurance to avoid any financial constraints or medical challenges in future.
Inclusions | Exclusions |
---|---|
Pre-existing diseases | Cosmetic surgery, dental care, etc |
Hospitalization expenses | Non-medical expenses |
Daycare procedures | Self-inflicted injuries, suicidal attempts, etc |
Pre and post-hospitalization | Unproven treatments, infertility, HIV/AIDS, STD, etc |
Note: These are not a full list of inclusions and exclusions, check your policy documents for a detailed list.
Group health insurance plans offer basic healthcare facilitation in the common interest of salaried employees in a company. Businesses, relevant employers, start-ups, unicorns, etc are eligible to buy group health insurance for their employees. Given, that the small group health insurance requirements or small business group health insurance requirements are different from a large company group health insurance.
To know more about group health insurance eligibility requirements in India, call our experts at 1800-4200-269.
As per IRDAI, group health insurance is a matter between an employer-employee and a non-employer-non-employee. Hence, the eligible groups can avail of the group health insurance coverage as an additional benefit from their employer.
The policyholder and the employer should be an Indian resident and they must fulfill the eligibility criteria related to the policy.
Yes, only if the husband and the wife both are the proprietors of a family business they can be covered together under group health insurance. In the case of the businessman having a sole proprietorship, the wife cannot be covered under the group health policy.
Generally, the minimum number of employees to get a group health insurance should be 20.
The minimum age limit to get covered under a group health insurance policy is 18 years, but the maximum age limit is between 60 to 80 years, varying from insurer to insurer.
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Simran has an experience of 3 years in insurance content writing. She transitioned from hospitality to the insurance industry after her emerging interest in how vast insurance is. With her ability to write complex insurance concepts in a simple, relatable manner she keeps her audience hooked and solves their doubts smoothly.
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