Do I need another health insurance policy if my employer covers me under one?

Featured 25th Jan-2022

Do I need another health insurance policy if my employer covers me under one?

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Is depending on a corporate health insurance policy good enough?

When someone talks to us about investments and finances, we have our answers ready! We have done our research on what is best for us and how to select the right avenues. But when it comes to choosing the best health insurance plans for family or oneself, to protect our savings and someone questions us on it, often our answer is “Why do I need one? My company  covers me and my family under their corporate health insurance policy.”

Most of us can relate to this situation of having a corporate health insurance plan. And you might wonder what’s wrong with it? Well, technically, nothing. However, the integral question that remains unanswered is “Is it enough to cover your family's health or do they need another health insurance policy?”. And that is exactly what we will be addressing here, in our simplification drive.

A corporate health insurance policy or a Mediclaim policy is definitely a great benefit. Why? Simply because it offers a certain level of protection for you and your family, at the expense of your employer. :D And the employer makes sure that with this added benefit of an employers health insurance, there will be better retention in the company.

But, the problem with depending on only a corporate health insurance plan.

Firstly, the employers health insurance policy has a standardized Sum Insured for all employees and their families.

However, your needs might differ from the other employees. The right Sum Insured should ideally be based on your age, life stage, family structure, lifestyle, medical history, etc. Depending on your and your family's requirements, a standard employer's health insurance policy may not protect you completely when you actually need it.

Suppose, your Sum Insured is 2 lakhs and unfortunately you face an illness that requires hospitalization and the bill comes up to 3 lakhs. The extra 1 lakh after your insurance claim has been paid,  has to be borne by you if you don't have an additional individual health insurance policy.

Now, you might have your savings to bank upon. But in case (God forbid), someone in your family suffers from a Critical Illness and the treatment cost shoots up to more than 10 lakhs, can you still bank on your savings? And even if you can, exhausting all your savings leaves you financially unprotected for the future, esp. in a time which is otherwise also very mentally straining.

Secondly, an employer's health insurance policy is till you are employed. When you leave your job, your corporate health insurance cover ceases to exist immediately. So, the time when you are in between jobs or on a sabbatical, you are basically without any health insurance policy. If anything unfortunate does happen during this period, you are completely unprotected.

And the most important reason is your family. Though some corporate health insurance policies cover your dependents in your plan but again that coverage which ranges from ₹2 lacs to ₹5 lacs is not enough. And given the healthcare inflation is 20% as compared to 8% overall, it is important to evaluate your health insurance protection.  

So, what is the solution?

Simple, take a personal health insurance plan parallelly with the right Sum Insured that fits all your needs, so even if your corporate health insurance plan cannot cover your health expenses completely, you always have your individual health insurance policy to make an insurance claim with. And if 2 health insurance policies are becoming a pain to maintain, stick to your corporate health insurance plan and take a top-up plan on it. This way, even insurance claims needs that are over and above your corporate plan, are taken care of.

Note- In case you leave your job, the amount of cover that was borne by your employer earlier will have to be paid from your pocket as a deductible.

Let us clarify this with an example

Suppose, Rajat has a corporate health insurance of ₹2 lakhs. He takes a top-up plan of ₹5 lakhs, making the total Sum Insured as ₹7 lakhs. Now, he had to leave the job due to a personal reason and unfortunately, has to be hospitalized for a treatment, and the bill comes to ₹7 lakhs. As the plan is a top-up plan, at the time of claims, it will only come into action after the company pays the initial ₹2 lakhs. Given that the employer is no longer responsible for Rajat's health insurance claim, that amount will have to be paid by Rajat himself, as a deductible.

So, if you take our advice, don’t just depend on your corporate health insurance plan. The wise thing to do is to take a personal health insurance plan, so that you are never under-insured or left without a health insurance.

After all, this is about the most important aspect of life: your well-being.

Here is blog explaining how to choose the best health insurance policy for yourself and your family.