How to Shift from Group Medical Cover to Personal Medical Policy?

by Vinaya HS on August 25, 2016

in Finance

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One of the biggest perks of working at a multi-national company is that your health is secured by your company’s group medical coverage. In fact, not only is your health secured, many companies offer health insurance plans that cover your dependents as well. The benefits offered by your health insurance policy tend to vary from company to company and it is also a function of your tenure at the company. For group medical coverage, the cumulative risk of all the members is considered while deciding upon the premium amount. In any group, some members are less likely to make a claim than the others. As a result of this, the risk factor is balanced to a great extent.

However, not everyone works at an MNC & not all companies provide health insurance plans to their employees. In this case, there are individual health insurance plans available that only cover one person’s medical expenses. An individual health insurance policy is only valid for the time decided by the policyholder and is not dependent on any other factors like employment. The premium rate is fixed at the time of buying the policy.

What happens when you quit your job to start your own business or join another company? Your group medical coverage is not in force anymore and before you seek employment elsewhere, your health is not covered. In this case it is advisable to shift from your group medical plan to an individual plan. Since a group medical policy underwrites a group, the norms are more relaxed. Hence, the waiting period that you have accumulated for pre-existing conditions can be carried forward the when you switch your insurance plans. This is only possible if you opt to stay with the same insurer. You can only switch insurers when you have completed at least one year with your individual policy with the present insurer.

Usually, there are no waiting periods in a group health insurance and pre-existing conditions are covered from the very first day. However, as per the IRDA the credit gained for pre-existing conditions in the form of a waiting period is eligible to be carried forward. When shifting your policy from group to individual, you can also shift policies if your entire family is covered by it. You can choose individual policies for each family member or opt for a family floater cover.

The transition can be carried out by filling a form to port from one policy to another. You will need to furnish the details of your policy, your medical history and declarations alongside. Certain insurance providers might also ask you to take a few medical tests. The benefits of portability can only be availed if your previous policy has been carried forward without interruptions. It is important that you submit your form for porting at least 45 days prior to your renewal date.

Once the application for porting is processed, the insurance provider underwrites the new policy and the terms and conditions associated with it along with the new premium. This typically takes around 15 days. Once the premium is paid by the insurance holder, the new policy begins.

There are several benefits of shifting from a group medical plan to an individual health plan. An individual insurance policy gives you more exhaustive coverage than a group coverage would. You can choose a customized policy to suit your specific medical needs. In addition to this, you can enhance the cover when you shift from one health insurance plan to another. However, the benefits of the waiting period will only apply to the existing sum assured and not the new sum assured.

Whether you have a group plan or an individual plan, it is essential to have medical insurance in this day and age. There are several insurance service providers that offer various health insurance plans and critical illness insurance as well that cover a variety of medical conditions. These days cashless health insurance is also a popular option that is available so if you do not have a health insurance policy, get one today & safeguard your health today!

About HDFC Health

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, HDFC Mediclaim and other health insurance plans in India cover individual, family floater, critical illness and cancer care insurance plans.

Further reading:

  1. Should You Buy Health Insurance For Maternity Benefits?
  2. Commonly Used Terms and Phrases in the Health Insurance Sector
  3. Lesser Known Facts about a Mediclaim Policy
  4. Health Insurance Riders
  5. 6 Common Health Insurance Mistakes You Should Avoid

Thanks for reading this article. I'd love to hear your opinion. Please use the comments section below to share your thoughts. I frequently write new articles that also cover several other aspects of personal finance including credit cards, financial goals, health insurance, income tax, life insurance, mutual funds, retirement planning, and much more. You can Subscribe through Email and receive new articles directly in your Inbox or you can Subscribe through the RSS Feed and receive new articles in your feed reader.

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