An employee health insurance policy provides financial security in case of health-related concerns. It is a perk given to the employees by the employer, covering not just the employee, but their family as well, depending on the plan.
While an employee can use an employee health insurance policy in case of medical needs, such policies also enable you to do regular medical check-ups as they have tie-ups with network hospitals. This policy provides hospitalisation coverage, including pre- and post-hospitalization expenses.
Some employee health insurance policies also offer reimbursements for doctors fees and post check-up expenses. Some policies even provide for hospital cash allowance, which is needed to meet daily expenses like travel etc. It also provides cover for domiciliary treatment. Even pre-existing diseases are covered by employee health insurance policies, which usually have a waiting period depending upon policy to policy.
Here are five things to know about your employee health insurance policy:
Group Plan Validity: “The primary thing that an employee must understand about his or her group health plan is that the plan remains valid only until the employee is a part of the company (which provides health insurance). If the employee leaves the company then he or she would not be a part of the group health plan, which means that the employee would remain uninsured until he or she has joined a new company that offers a group plan while joining,” says Rakesh Goyal, director, Probus Insurance Broker.
Coverage: The coverage offered by such employee health plans might differ from company to company. It depends on the insurer and the coverage that the employer has opted for (which could be insufficient in certain situations). Hence, it is recommended to consider such plans as secondary plans and have another additional health plan handy owing to the coverage limits.
Varying Features & Coverage: Though an employee health insurance policy seems simple, it is actually a tad complex as it has different features and coverage. And its different benefits such as cashless claim facilities, maternity benefits, etc. differ from insurer to insurer.
Additional Cover: It would be wise for an employee to treat his employee health cover as an additional cover, and not the only cover. Unlike individual health insurance plans, employee health insurance plans do not offer the No Claim Bonus (NCB) facility. Hence if you have both an individual health plan and an employee health plan, you could claim from the employee health plan and avail of NCB on your individual plan without claiming it.
Limited Tenure: You only have the employee health insurance policy until you are an employee of the organization you are working in. The day you leave the company, you lose access to the employee health plan. As the policy is generic, it might not provide you with a comprehensive cover. Also, the insurance provider and coverage might change based on the employer’s needs.
