Company Health Insurance Vs Individual Health Insurance

A detailed comparison of group health insurance Vs retail health insurance
Team Loop Health
May 25, 2021

Whether you’re an HR manager looking to attract the best talent from around the world or a rapidly growing small business, the real assets of your organization are your employees. It’s only when your employees are healthy, they can work productively and successfully contribute to business goals and objectives. A solid employee benefits package can help attract and retain talent. Whatever your portfolio, your employees’ health will always remain the best investment. And group health insurance, which has gained precedence because of the pandemic, is an excellent way to show you care.

Health insurance comes in varied sizes and shapes, but they share the same basic goal - provide financial coverage for medical costs. With company health insurance vs. individual health insurance, there are a few key differences, and knowing them can help you identify what type of insurance you need and how to get the most out of your coverage.     

Company Health Insurance: 

It’s one of the perks you enjoy as an employee of an organization.

  • It is a type of group health insurance the employer purchases for employees, where the employee pays little to no fee towards the premium. 
  • It covers you and sometimes your dependents.
  • The policy is pre-fixed and you can partially modify it.
  • Favorable option with almost immediate claims for pre-existing conditions too. 

Individual Health Insurance: 

An individual purchases individual health insurance.

  • You’re required to research plans, compare them against each other, and make an informed choice.
  • You’re responsible for the entire payment of individual health insurance. The costs depend on factors like age, health, your medical history, etc. 
  • Typically, policies come with long waiting periods and those with pre-existing conditions have to wait until the end of the waiting period for treatment. 
  • Individual policies need to go through a health-checkup if you’re over a certain age and comply with an onerous KYC process that you can easily circumvent with group health insurance.    

Key Features and Differences: Company Health Insurance Vs Individual Health Insurance:

1. Affordability

The greatest disadvantage of individual health insurance is the cost, especially if you have pre-existing conditions or don’t have access to company health insurance of any kind. You’ll have to shell out several thousands of rupees monthly or yearly plus, wait years before the coverage kicks in. Furthermore, individual insurance gets costlier with age. Premiums significantly rise when you purchase an individual policy after the age of 50 as compared to a health policy when you are 30 years old.  

The instant benefit of group health insurance is cost. The premiums are less expensive and it caters to employees of all ages without the stress of a hefty price tag. Plus, the employer also contributes towards premium, meaning lower financial costs, and deducts the premium from your pre-tax pay in smaller chunks. You also have the option of free round-the-clock medical care with a bunch of specialists for even minor concerns. Therefore, for employees, group health insurance is a solicited choice. 

2. Eligibility

The obtainability of insurance depends on factors such as age, fitness, and health. Irrespective of your age, individual health insurance takes your pre-existing conditions into account. And if you’re over the age of 45, you have to undergo a medical exam. And as stated earlier, with age, costs increase.  

So, those individuals who may not be eligible for individual insurance can enjoy the benefits of insurance with group cover. In group health insurance, providers consider the number of employees as against a single person. So, you’re selected by default. It also dispenses the need for prior medical check-ups.

3. Coverage 

Individual health insurance plans are customizable and designed to fit your every Individualistic, specific need. But most policies don't offer coverage for all types of conditions and diseases. You’re on your own and have to pay out of your pocket if you need care that falls into one of those gaps.

Group health insurance offers comprehensive, better coverage along with perks in the form of cover for pre-existing medical ailments and even maternity. So, employees can enjoy the extended benefits of group insurance and coverage that would otherwise be unavailable.

4. Processing time 

Buying individual health insurance is a time-consuming affair. Before you purchase a policy, you need to research the subject, compare plans and zero in on the right one. And it doesn’t quite end there. After locking in on the policy, it takes 6-8 weeks for approval. Let’s not forget the numerous times you have to call and follow up, or even how much you’ve got to read in between the lines!   

On the other hand, group health insurance covers employees almost instantaneously. With a simple decision, you can eliminate time spent on research, medical underwriting, lengthy approvals and ensure you’re insured at the earliest! The company has someone in-house who’s a point of contact to ensure a seamless and quick process. 

5. Waiting time 

Individual health insurance comes with a range of waiting periods like an initial waiting period, disease-specific waiting period, pre-existing disease waiting period, and maternity waiting period. The time frame varies anywhere from three months up to four years. If you have pre-existing conditions like thyroid, diabetes, blood pressure, etc, or disease-specific conditions like hernia or a tumour, the medical costs that arise due to these conditions aren’t covered until the end of the waiting period. Phew! It’s quite a wait before you can enjoy the benefits of your policy.

Whereas, most group health insurance doesn’t have any waiting period. Employees can start using the insurance almost instantly. Plus, it covers pre-existing conditions like diabetes, heart conditions, etc. The coverage begins from the first day of the policy, whether it’s for the employees, their spouse or children. As long as you’re enrolled in the company’s group health insurance plan, you can benefit from all coverages.     

So, What Should You Pick? 

Firstly, you should always keep health insurance as a priority instead of an option. Especially today where people lead stressful lives, it’s essential to maintain the overall health and wellbeing of your employees. Group health insurance is like killing a few birds with one stone - you get comprehensive health insurance, added benefits, lower costs, wider coverage, a shorter waiting period, and happier employees equals a happier workplace. If you are a human resource manager, big business owner or a small, medium enterprise, help your company benefit by taking a positive step. After all, you can’t predict the future. But you can certainly protect it!

At Loop Health, we offer optimum group health insurance schemes with free primary care and round-the-clock support. Our panel of specialist doctors brings you all-around care at absolutely no cost! Whether minor issues are keeping you from reaching your productivity or major issues coming in the way of your life, you can always consult a specialist of your choice, anytime! To know more about employee health insurance plans, feel free to get in touch with us.

Interested in learning more about Group Health Insurance? Click here

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