A group health insurance plan offers unlimited customizations at significantly lower premiums compared to retail health insurance plans for individuals. Therefore, a group health insurance policy is highly recommended to cover standard groups of people like employers/employees, formal associations and financial institutions. It’s important to keep track of new-age policies that can help your group select the right benefits and maximize the effect of the insurance for every individual in the group.
Here are some benefits that modern companies and associations set up with their insurance provider to safeguard their members’ health and financial well-being. Some insurance startups support most of these by default, and some may come at an additional cost.
Psychiatric treatments: For a long time, health insurance only covered physical health issues. Insurance Regulatory and Development Authority of India (IRDAI) has asked health insurance companies to add mental illnesses to all regular health insurance policies. These policies usually cover in-patient hospitalization expenses for mental illness.
Chemotherapy for cancer patients: Cancer treatment can be long and financially destabilizing. A cancer-specific policy is a special case of critical illness policies. It can help cover costs associated with diagnosis, hospitalization, chemotherapy, radiation, and surgery.
Ayurvedic treatment coverage: Modern insurance companies now embrace alternative perspectives without judgement. If you prefer to opt for alternative medicine, look out for provisions that cover Ayurveda and non-allopathic medicines. Thanks to IRDAI, many insurance providers are not restricted to allopathic medicine.
LGBTQ and live-in partner cover: Allowing all individuals in the group to include their partners in the health insurance plan, regardless of sexual orientation or marital status, is a good and inclusive practice. Many group health insurance platforms provide LGBTQ partner and live-in partner coverage at no additional cost.
Lasik cover for even +/- 5 correction: Lasik or laser eye surgery is a type of refractive surgery that offers a long-term alternative to eyeglasses or contact lenses. Many insurers used to consider this a cosmetic surgery, but modern insurance companies can come to the rescue for surgery and treatment. It is important to note that a huge chunk of our population suffers from vision-related issues.
Stem cell, robotic surgery and cyberknife: Some insurance companies fail to keep up with new treatment procedures that are not based on common medical practice. Make sure to check your policy to see if these are excluded. With a view to increasing the scope of health insurance coverage, IRDAI is reducing the number of exclusions of technologically advanced procedures.
Air ambulance cover: It’s always good to have health insurance that can cover emergencies even at inaccessible locations. Air ambulance is a service where an aeroplane or helicopter is used to transport patients to a hospital. New-age insurance policies offer help in arranging the air ambulance and reducing the costs involved in its operations.
Internal and external congenital diseases: People who suffered genetic disorders–like cleft lip and heart defects–found it difficult to get coverage for their treatments. IRDAI recently issued guidelines that allow health insurance companies to cover both internal and external, or visible, genetic disorders.
IVF: In vitro fertilization (IVF) is a set of procedures that can help with fertility and help a couple having difficulties in conceiving a child. They are often not covered by insurance companies. However, many new-age policies include coverage with long waiting periods to prevent fraud.
Surrogacy: Subject to proper documentation of infertility and surrogacy, the same conditions as maternity coverage in a health insurance policy will apply. However, only the maternity expenses of the surrogate mother will be covered.
Dental treatments: Health insurance companies do not provide coverage for dental treatments as many treatments fall under the cosmetic category. However, dental procedures can be covered as out-patient procedures (OPD) with a few restrictions.
Organ donor expenses: Some critical cases and medical emergencies may require removal of damaged organs. A few health insurance companies help cover the expenses incurred by the organ donor with reasonable limits.
Every insurance provider offers a long list of ‘exclusions’ of the policy. Make sure you check whether the costs of treatment are covered or not and obtain documentation of all the terms and conditions. Ensure that your group health insurance plan offers competent claims support and makes your documents accessible with a few clicks.
High-quality group health insurance also stretches into preventive care and maintenance of good health. It is not uncommon for a new-age policy to include doctor teleconsultations, dental checkups, mental wellness sessions, fitness memberships, and other health benefits that are adapted to match your group’s needs.
The author is Co-founder, Plum.
DISCLAIMER: Views expressed are the author's own, and Outlook Money does not necessarily subscribe to them. Outlook Money shall not be responsible for any damage caused to any person/organisation directly or indirectly.
