Kudos, you’ve landed a job with handsome salary! Even better, your employer has also covered you under a group health insurance. Now you don’t have to worry, right? But what if your employer’s health insurance is suddenly unavailable when you need it most? If you’re wondering how that’s possible, allow me to elaborate=

  1. When you’re between jobs= These days, job hopping is a common scenario. In a situation where you are ‘between’ jobs and a medical crisis arises, you will be alone to deal with the expenses.
  2. Inadequate sum insured= In most of the cases, your employer may offer you cover for Rs 3 lakh or 5 lakh only, which may be inadequate to deal with the rising medical expenses.
  3. No coverage after retirement= Mostly, corporate health insurance is not available after retirement. It means, either you would have to survive without a health cover or buy a new mediclaim policy by shelling out extra premium after retirement.
  4. It is not compulsory= Remember, corporate health insurance is only a perk offered by your employer and it is not a mandatory cover. It means, your employer can pull out the insurance cover without worrying about the legal ramifications whatsoever. If your family member is hospitalised at the same time, this will turn out to be a tricky situation for you.  
  5. Change in terms and conditions= At any time, an organisation can change the terms and conditions of its group health cover and add new clauses, like no coverage for dependent parents/pre-existing ailments, no maternity cover, etc. According to a survey conducted by Marsh India, various companies have introduced a co-payment clause and asked their employees to bear a portion of medical claims. Some companies have also stopped covering the parents of employees to bring down the cost of their health covers.

Of course, the most important reason to look beyond a corporate health insurance cover is that it depends on the whims of an employer and you can’t customise it as per your requirements.

Further, most of the corporate health insurance policies are indemnity health covers i.e., they only reimburse the actual hospital expenses and do not cover other expenses, which a family has to deal with in case of critical ailments like cancer, heart attack, brain tumor, etc. The situation deteriorates further, if a breadwinner is diagnosed with a critical ailment and loses his/her job. It means, in addition to medical expenses, the family has to deal with household expenses, loan EMIs, children’s school fees also.

The number of people diagnosed with cancer under 30 years of age increased from 0.5% in 2015 to 0.8% in 2016. Since the treatment of critical ailments is long-term in nature, it translates into heavy expenditure. For instance, the cancer drug Herceptin, one of the effective drugs for breast cancer, costs nearly Rs 75,000- Rs 1 lakh for one vial and a breast cancer patient would need anywhere between Rs 6 to 17 vials for treatment. As the costs of treating critical ailments run into several lakhs of rupees, the coverage of Rs 3 lakhs or 5 lakhs offered by most of the corporate health cover may not be sufficient to deal with such exorbitant expenses. Sadly, many patients often prefer to abandon the treatment to avoid falling into penury.

What is the Solution?

A few things are more alarming than battling health issues—one is not having the sufficient money for treatment and the second is watching helplessly your family struggle with money. To deal with both the situations, it is imperative to go with a comprehensive health insurance policy which comes with an extra coverage against critical ailments like heart issues, cancer, kidney failure, etc. As opposed to a mediclaim policy, such plans pay the entire benefit on the first diagnosis itself without any medical bill. In addition to hospitalisation bills, the amount can be used to pay travel, food, and recuperating expenses.

Further, there are various critical illness insurance plans offered by insurers like ICICI Prudential which can help you in getting coverage against various critical ailments like heart attack, paralysis, kidney failure, etc. The most important thing is that you can buy such policies online in a few clicks of your mouse.

 

Final Verdict

It is good to be covered under a corporate mediclaim policy which is available either at free of cost or nominal premium rates, however, relying solely on it can prove harmful to your financial health. So, keep your employer’s health cover as a short-term option and go with a comprehensive health insurance as a long-term backup option.

 

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