Financial PlanHealth Insurance

6 Reasons Why Group Health Insurance is Not Enough

As a salaried individual, you may enjoy health coverage provided by your employer under a group insurance plan. In most cases, such coverage is offered at no cost to you.

Most companies try to minimize their expenses by providing the bare minimum coverage under a group plan. Certain policies that are available with co-pay clauses are affordable. Employers may opt for these to reduce their costs.

A group health insurance policy is often used to lure prospective employees. However, you need to consider the following six reasons why group coverage is not enough to meet your requirements.

  1. Co-payment

As per this clause, you need to pay some part of the total expenditure. The insurance company will only pay the balance after you have paid your contribution to the total expenses. This reduces the financial burden but does not completely eliminate it. In most individual health insurance plans, co-payment clause is not included thereby providing higher coverage.

  1. Room rent limitation

As per this clause, the hospital room rent amount covered is limited to a certain maximum amount. In most cases, the maximum amount is half of the actual per day room rent. Additionally, it may cover only the room rent while other expenses such as doctor fees and nurse charges may not be covered. This increases the amount you need to pay out of your pocket.

  1. Coverage subject to employment status

The group health insurance coverage is only available as long as you are employed by the company. In case you resign or are fired, the coverage is discontinued. In the interim, until you find another job that offers group insurance, you will be left with no coverage. In case, you need to be hospitalized during this period, you will have to pay the entire expenses through your own resources. This may be avoided when you opt for an individual insurance policy.

  1. Number of insured individuals

Your dependents may or may not be covered under a group plan. An important aspect when you buy a health insurance policy online is to include your parents, spouse, and children in the same policy. The primary objective is to minimize or possibly eliminate expenses in case you or any of your family members need hospitalization.

  1. Post-retirement cover

As already mentioned, the coverage under a group plan is available only as long as you are employed with the company. When you retire and your employment ceases, the health insurance coverage also stops. Procuring a new coverage at that age is very difficult and cumbersome. You will have to undergo several medical tests to be eligible for coverage. Moreover, existing conditions are not covered, which means that if you are hospitalized for a pre-existing disease, paying for such expenses is not the liability of the insurance company. In most cases, when you are older, you may be suffering from pre-existing conditions and not having insurance coverage for these may result in financial difficulties. Therefore, you must procure health coverage when you are younger and healthier. Doing this would ensure that the policy continues until after your retirement for maximum benefits.

  1. Effective coverage

In most cases, group health insurance does not cover much financially. The total amount would not be very high and in serious illnesses, the money would be insufficient to meet all the expenses. Additionally, insurance companies and employers work together to limit their liability and reduce the costs. Therefore, the terms and conditions may be changed at any point without any previous notice.

Group policies are additional benefits offered by companies to retain talent. However, it is important that you buy a health insurance policy online to cover yourself and your family members against financial difficulties. in time of a medical emergency.

Vikas Agarwal
the authorVikas Agarwal
Vikas Agarwal is an IIT-Varanasi graduate in Chemical Engineering. He is the Founder and CEO of - an investment advisory website. He is a Business Development Professional but a Value Investor at heart. He writes articles on Finaacle, which focus on simplifying the art of investing and the causes of human misjudgment when it comes to investing. He also shares his experiences as an investor and lessons from some of the greatest investors of all time.

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