What is Group Mediclaim Insurance – Features, Cover and Best Plans
Group mediclaim refers to health insurance policies providing medical coverage to a group of people working under the same organization. For example, holders of the same credit card, bank account employees of the same company, social or cultural association, etc., qualify as a group covered by these policies.
With employee health insurance, the employer is the master policyholder, while the employees are beneficiaries. For non-employee mediclaim, each member of the group gets individual insurance certificates.
The primary advantages of these policies include standard coverage and very affordable premium rates. However, once a member leaves the group, the policy no longer covers him/her.
Take a look at the features, benefits, and coverage of group mediclaim insurance plans.
Key Features of Group Mediclaim Plans
- These policies are available only for groups with well-defined purposes. A group created for the sole purpose of buying mediclaim is excluded from the policy.
- These health insurance policies provide coverage up to a limit decided by the nature and composition of the group.
- Group mediclaims come with zero waiting period and can cover pre-existing ailments from the very first day.
- Their premium is a lot cheaper than all individual health insurance plans. However, the rates vary with factors such as group size, type, sum insured, the insured members’ average age, etc.
- These insurance policies have a cashless claim facility for treatment at network hospitals.
Why you May Want to Have a Group Mediclaim Insurance Plan?
Given are some reasons why employers may want to get a group mediclaim:
1. Helps with Employee Retention
Employees value add-on benefits like medical insurance highly. Hence, employers can increase their employee retention and the value of their jobs by providing health insurance coverage.
2. Increases Productivity
Employee health insurance policies make employees feel like a part of the company, motivating them to work better. This increases their productivity which boosts profits for a business.
3. Tax Benefits
Employers can claim expenses incurred to purchase these plans as a business expense and claim tax deductions accordingly.
The following are the benefits of group mediclaim insurance policies for employees:
4. Wide Range of Coverage for Low Premium
Group health insurance plans provide a range of coverage for pre and post-hospitalization costs and additional expenses for medicines, diagnostic reports, etc. Moreover, all of these come with a very affordable premium.
5. Coverage for Dependents
Many group health policies allow coverage for one’s family members, including spouses, children, and elderly parents.
6. No Co-payment Clause
Group insurance policies do not have a clause where insured people need to pay a part of the claim out of their own pocket.
7. No Need for Medical Check-ups
Group Mediclaim policies have simple terms and conditions and thus, do not require a pre-medical screening.
What Expenses are Covered by Group Mediclaim Insurance Policies?
- Medical expenses upon getting admitted to a hospital
- Daycare procedures
- Cover for pre-existing diseases from day one
- Maternity and newborn baby coverage
- Fees of medical practitioners and specialists
- Room rent and nursing charges
- Ambulance expenses
- Chronic illnesses like diabetes, arthritis, etc.
- Option to include spouses or kids
- Cost of medicines, blood, oxygen, diagnostics, anesthesia, etc.
List of Some of the Best Group Mediclaim Insurance Plans
This is a flexible health insurance product covering expenses for treatment of sickness, accidents, hospital bills, daycare treatments, etc. Navi also offers various other group mediclaim policies covering accidents, critical illnesses, vector-borne illnesses, and hospital daily cash needs.
2. Bajaj Allianz Health Care Supreme Health Insurance
The group policy under this offering covers all sorts of medical expenses, including hospital bills, ambulance charges, maternity cover, recovery benefits, etc. There are three variants of the plan – Vital, Smart, and Ultimo having sum insured ranging from Rs. 5 – 50 lakh.
3. HDFC Ergo Group Health Insurance Policy
This policy can be tailored to suit the requirement of a group and covers hospital-related expenses, nursing expenses, doctors’ and consultant’s fees, etc. It also offers various add-on benefits, including dental treatment, eye care, family floater, waiting period waiver, and more.
4. ICICI Lombard Group Health Insurance
The policy covers medical expenses incurred as the insured gets admitted to a hospital and for injuries and illnesses that occur. It covers OPD expenses, critical illnesses, ambulance charges, travel expenses for treatment, etc.
5. Star Health Classic Group Health Insurance
It covers room rents, nursing expenses, doctors’ and specialists’ fees, ambulance charges, modern treatments, etc. It also provides hospital cash and patient care benefits for a specific number of days.
You can buy a single policy for your employees or group members and their families with Navi’s group Mediclaim. Download the Navi app to get a health insurance policy with a super-fast and zero-hassle claims process.
The following are the advantages of choosing Navi for group health insurance:
1. Choice of Several Groups Mediclaim
We offer various group Mediclaim policies like Group Health Insurance, Group Critical Illness Insurance, Group Seasonal Byte, Group Personal Accident Insurance, and Group HospiCash policies.
2. High Claim Settlement Ratio
With a high claim settlement ratio of 97%, you can be assured of getting your medical bills covered.
3. Quick Cashless Claims
Our claim settlement process is very quick, hassle-free, and 100% paperless. Our 24×7 customer support takes only around 20 minutes to process cashless claims.
4. The Largest Network of Cashless Hospitals
We have a network of 10,000+ cashless hospitals across the country to make your treatment seamless.
5. Easy Monthly EMIs
We are one of few insurers offering affordable monthly EMIs starting at only Rs. 240 per month.
Also Read
Final Word
With job seekers looking for group mediclaim benefits at their workplaces, employers may want to look for affordable options for employees. These policies mitigate risks of financial instability for employees and help to attract talented staff. For employees, the nominal premium rates and coverage from expensive medical treatments make these policies necessary.
FAQs
Ans: The following are some exclusions of group health insurance policies:
• Non-allopathic treatments
• Pre-existing illnesses not declared previously
• Congenital diseases
• Complications due to drug or alcohol abuse
Ans: Furnish the following documents to make a claim:
• Prescriptions
• Medical reports
• Duly filled claim form
• Final bill
• Cash memos
• Discharge summary
• Police report (for accidents)
Ans: Group health plans can cover existing or new employees of a company and also provide the option to cover their family members.
Before you go…
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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