How to Evaluate your Group Health Insurance Cover?

Group health insurance is a type of health insurance in which a group of people are covered under a single master health insurance policy. The group health insurance is usually taken by the employers to cover their employees as a part of the employee benefits. Group health insurance is usually taken for a period of one year and it would be difficult to cancel the policy after the policy start date due to many complications involved in the process. It is therefore advisable to evaluate and select the best group health insurance policy before taking one. The advice of an insurance broker such as Ethika insurance broking would come handy while evaluating the group health insurance cover.

Evaluate your Group Health Insurance Cover

Group health insurance cover should be evaluated on the below parameters:-

1. Coverage: The first and foremost thing while evaluating the group health insurance is to check for the coverage offered by the insurance company. Group health insurance policy should cover the hospitalization expenses, room rent, icu rent and other expenses under the policy. There should be adequate coverage under each seduction of the policy and the minimum coverage required should be specified by the insured at the time of taking the policy.
2. Exclusions: The other important thing to consider while taking the group health insurance policy is the exclusions under the policy. Exclusions can be in the form of waiting period or certain specific exclusions such as age of the employees, disease wise capping etc. Exclusions play an important role in reducing the premium of the group health insurance policy and therefore should be taken care before making the purchase.
3. Co-pay: The co-pay or copayment under the group health insurance policy is the amount of claim that has to be borne by the insured customer at the time of claim settlement. The co-pay option can be taken by the insured to reduce the premium or some insurance companies would include a copay option for certain diseases which should be checked before taking the group health insurance policy.
4. Premium: The other important thing to evaluate the group health insurance policy is the premium charged by the insurance company. Very high premium or very low premium should be avoided as both of them would not be beneficial for the customer. A low premium group health insurance policy would definitely be low in coverage or have certain hidden exclusions such as co-payment or disease wise capping limit or certain waiting periods such as pre-existing waiting period, specific disease waiting period etc.

Network hospitals: The most important thing to consider while evaluating the group health insurance policy is the list of network hospitals. More the number of network hospitals, the better for the insured customers to avail cashless claim settlement facility. It is important to check the number of network hospitals in your area of residence or operation and then decide on taking the group health insurance policy. The number of network hospitals can be checked with city wise or pin code wise.