You Can Shift from a Group Health Insurance Policy to Family Floater or Individual Health Insurance

A group health insurance policy is an insurance plan that provides coverage to a specific group of people having the same interest. For example, employees of an organization or people of an association like a bank offer group health insurance coverage to its credit cardholders. With a group health insurance policy, you get many benefits ranging from no waiting period to coverage for your pre-existing illnesses from day one to maternity benefits. Some group health plans as well cover your family members like you get coverage for your spouse, children, and sometimes even for your dependent parents.

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    Despite all this, one biggest disadvantage that group health insurance has is as soon as you leave the group like your organization, it discontinues. However, the good news is you can port your group health insurance into a family floater or individual health cover. Like many of us, Mr. Sharma as well as this confusion after he lost his job due to pandemic whether he can port the group health insurance policy offered by his office to a family floater plan or does he need to purchase a new health insurance cover?

    When you and your family members are covered in a group health insurance policy, you are eligible to migrate it to family floater or individual health insurance at the time of exiting the job or when the group health insurance policy is being modified. However, the insurer has to be the same and you must go through its terms and conditions.

    For example, Mr. Sharma is 59 years old and has heart issues and his wife is 51 years old and has arthritis. In this case, he has to look for different health insurance plans for both. The reason for the same is age and health conditions are different and aa general family floater may not cover these things. In addition to this, there is some insurance provider who does not cover a person for more than 55 years. So, he should check with his group health insurance provider for all these things. Some insurance plans provide coverage for critical health issues like heart disease, so he should look for such a plan.

    The premium of his health insurance policy may be on a higher side as it depends on many factors including the age of the policyholder and the coverage, he/she is opting for. Some plans offer rent of the hospital room as a specific percentage of the sum insured. Some insurance policies provide a specific type of room or some do not have any cap on room rent. The insurance plans that have capping on the charges of the room as well have optional coverage for removing this capping or for enhancing the category of room. It is always better to have a health insurance policy with minimum restrictions even if it has a little more premium.  

    Even the Indian Regulatory and Development Authority of India (IRDAI) has urged the health insurance providers to develop illness-specific health insurance plans that can help the policyholders to get coverage specific to their ailments. The Chairman of IRDAI has asked the insurers to develop disease-specific health insurance policies such as insurance products for heart, diabetes, and kidney-related issues.

    So, you can migrate from a group health insurance plan to an individual policy or family floater as per your requirements. However, it is always good to have an individual health insurance policy or a family floater cover despite you are covered in your company’s group health insurance. You get the following benefits with an individual health insurance plan:

    Advantages of Having an Individual Health Insurance Policy:

    • You can purchase a plan as per your specific health condition as Mr. Sharma can buy a health insurance policy that provides specific cover to heart patients.
    • You do not have any fear of losing your job and resultantly losing the benefit of group health insurance cover as you are already covered with your health insurance policy.
    • You get tax benefits for paying the premium of your health insurance policy. Unlike a group, health insurance plan wherein your employer gets the tax benefits as it pays the premium.
    • You also get the benefits like discounts and bonuses if you select a high sum insured for your health insurance policy. The insurers as well offer discounts when you do not claim for one policy year. The insurance providers as well offer bonuses by making you eligible for a higher sum insured in the coming policy year by giving you the policy at the same premium.  
    • You are not limited to a set of inclusions offered in your group health insurance policy. This is because you can increase the coverage by including add-ons or riders in your health insurance policy.

    The Final Words!

    A group health insurance plan is a good option as it does not have any waiting period and your pre-existing diseases are as well covered in it. But when you leave your job, you are left with nothing. Moreover, if you are more than 55 years like Mr. Sharma, you will have to pay a huge amount as a premium to get yourself covered in an individual health insurance plan or a family floater. So, it is always suggested to purchase an individual health plan or family floater at a young age.

    Written By: PolicyBazaar - Updated: 29 July 2021
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